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Cryoproteinaemia is characterised by the presence of detectable proteins in both serum and plasma that precipitate at 4°C and dissolve at 37°C. Cryoglobulins are constituted by immunoglobulins and are detectable in both serum and plasma, whereas cryofibrinogen is detectable only in plasma. The importance of studying cryoproteinemia was the main theme of the meeting held in Modena in March 2023, entitled: Cryoglobulinemia. Laboratory and clinic, a fruitful collaboration for the correct management of a rare pathology - 4th edition, organised by the Italian Society of Clinical Biochemistry and Molecular Biology (SIBioC) and the Italian Association for the fight against Cryoglobulinaemia (ALCRI). The aim of this conference is to promote a dialogue between clinicians and laboratory professionals, highlighting the information that the clinician expects from the laboratory and the critical points that the laboratory faces when performing a test that is still predominantly performed manually. During the meeting, data from three laboratories were presented and compared, and a group of clinicians who deal with cryoproteinemia in different medical fields -- rheumatologists, nephrologists, haematologists, and neurologists -- contributed their experience in treating patients with cryoproteinemia. The collaboration between laboratory and clinic and the respective scientific societies (SIBioC and ALCRI) have made possible to draw a common line to guide both entities in their daily activity. The road seems long and complex, but a common system is emerging from this interaction, the fruits from which patient will benefit. [ABSTRACT FROM AUTHOR]

Introduction: cryoproteinemia is associated with a broad spectrum of clinical symptoms and significant variability among patients; in this context, laboratory diagnostics play a crucial role in diagnosis and treatment. However, diagnosing cryoglobulinemia is difficult from a clinical point of view and in the laboratory. SIBioC (Italian Society of Clinical Biochemistry and Molecular Biology) has proposed a survey to the Italian laboratories to assess the adopted methods. Methods: the survey consisted of 40 questions: 8 concerning general items, 9 on the pre-analytical phase, 14 on the analytical phase, 4 on the post-analytical phase, and 5 on the cryofibrinogen. Results: sixty-six laboratories responded to the survey, mainly from Northern Italy. The results show non-homogeneous situation. Preanalytical phase: some laboratories are not equipped with adequate devices for transporting the sample maintaining a temperature-controlled chain. Analytical phase: not all laboratories apply the same procedures to separate the serum, to wash the cryo-precipitate and to measure the cryocrit. Postanalytical phase: almost all laboratories apply the Brouet classification. 11% of laboratories perform cryofibrinogen testing, 20% participate in an external quality assessment, and 62% of participants feel the need for an adequate scientific information and training. Conclusions: the survey shows that the procedures for cryoprotein testing vary widely among laboratories. The need of recommendations emerges strongly; these could start from the existing literature in the field, the already available procedures, trying make a synthesis where the processes are diversified. It is also crucial to participate to External Quality Assessment and to spread the culture of continuous dialogue with clinicians. [ABSTRACT FROM AUTHOR]

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