Diagnosi di crioproteinemia: preziosa collaborazione tra laboratorio e clinica per la corretta gestione di una patologia rara

Cryoglobulinemia is a rare pathologic condition that can be difficult to diagnose both clinically and in the laboratory, which is why close collaboration between the clinic and laboratory is essential. The laboratory needs the skills and experience to interpret the laboratory tests and the clinician should not hesitate to contact the laboratory when the result is not supported by the clinical signs. To strengthen this collaboration, the Protein Study Group of the Italian Society of Clinical Biochemistry (SIBioC) in collaboration with the Italian Association for the Fight against Cryglobulinemia (ALCRI) under the patronage of the University of Modena and Reggio Emilia, organised a conference in Modena on September 2021 entitled "Cryoglobulinemia: laboratory and clinic, a virtuous collaboration for the correct management of a rare pathology". This collective paper is aimed to summarize the topics discussed during the meeting. The conference consisted of two parts: the first aimed at highlighting the critical components of the pre-, intra- and post-analytical phases of cryoglobulin investigation. Cryoprotein testing remains totally manual and operator dependent so it was important to identify areas where best practice guidance or even harmonisation of the laboratory investigation would be beneficial. The second part of the conference focused on clinical aspects and the effects of therapies, including antiviral drugs with direct action against HCV. These drugs are able to eradicate the virus, but the elimination of HCV-related cryoglobulins is seen in only about half of cases. Finally, the clinical consequences of the diagnosis of cryoglobulinemia and the multidisciplinary implications that this entails were highlighted, underlining how the continuous dialogue between the laboratory and clinic is crucial for the correct management of the patient