Survey on cryoproteins testing among Italian Laboratories: from pre-analytical phase to reporting / Indagine sulle modalità operative dell’analisi delle crioproteine: dalla fase preanalitica alla refertazione

Survey on cryoproteins testing among Italian Laboratories: from pre-analytical phase to reporting 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.