Analysis of cryoproteins with a focus on cryofibrinogen: a study on 103 patients
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Patrizia Natali
,
Daria Debbia
Abstract
Objectives
Cryofibrinogen (CF) is an abnormal protein in plasma that precipitates at 4 °C and dissolves at 37 °C. Whilst serum cryoglobulins (CGs) analysis is common practice, CF investigation is rarely performed. This study aims to describe the testing methodology developed at our laboratory, potential pitfalls for all analytical phases, the distribution among hospital wards and clinical conditions underlying test requests and clinical conditions in which to order CF analysis is useful.
Methods
Retrospective analysis of laboratory samples received between January 2019 and June 2021 with CF testing requests.
Results
A complete protocol for CF pre-analytical, analytical and post-analytical phases are supplied. Most test requests were received from the rheumatology department for systemic sclerosis or liver transplant screening. Among the 103 in-patients included, CF+ was confirmed in 68 patients (66%). Of observed CF+ patients (n=68) most cases were CGs− (n=44, 67%). Isolated CF was found in 43% of the cases. Among CF− patients (n=35; 34%) only 2 patients had positive CGs (CGs+). Among rheumatology patients (n=66), isolated CF+ was observed in 45% (n=30/66), whilst among patients with systemic sclerosis with CF+ (n=19), isolated CF+ was detected in 79% (n=15/19).
Conclusions
Described analytical procedures may be used for the creation of harmonized recommendations and indications for CF analysis. Isolated CF positivity among hospitalized patients, predominantly rheumatology and systemic sclerosis patients, appears higher than rates previously reported in literature. We propose CF test recommendations should be included in investigation protocols for diseases where cryofibrinogenemia may occur.
Acknowledgments
We thank the Protein Unit technicians for their valuable contribution: Lucia Lezzi, Emanuela Lifonso, Gennaro Giannini, Claudia Collini, Angela Quagliarella, Lucia Mantuano and Cecilia Simonini.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: None declared.
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Ethical approval: None declared.
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
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- Frontmatter
- Editorial
- Measuring FGF23 in clinical practice: dream or reality?
- Reviews
- Fibroblast growth factor 23: translating analytical improvement into clinical effectiveness for tertiary prevention in chronic kidney disease
- Pursuing appropriateness of laboratory tests: a 15-year experience in an academic medical institution
- General Clinical Chemistry and Laboratory Medicine
- Moving average quality control of routine chemistry and hematology parameters – a toolbox for implementation
- Practical application of European biological variation combined with Westgard Sigma Rules in internal quality control
- Total bilirubin assay differences may cause inconsistent treatment decisions in neonatal hyperbilirubinaemia
- Early predictors of abnormal MRI patterns in asphyxiated infants: S100B protein urine levels
- Interlaboratory comparison study of immunosuppressant analysis using a fully automated LC-MS/MS system
- Analytical evaluation and bioclinical validation of new aldosterone and renin immunoassays
- Improving clinical performance of urine sediment analysis by implementation of intelligent verification criteria
- Clinical evaluation of the OC-Sensor Pledia calprotectin assay
- Serous body fluid evaluation using the new automated haematology analyser Mindray BC-6800Plus
- Analysis of cryoproteins with a focus on cryofibrinogen: a study on 103 patients
- Reference Values and Biological Variations
- Within-subject biological variation estimates using an indirect data mining strategy. Spanish multicenter pilot study (BiVaBiDa)
- Short-term biological variation of serum glial fibrillary acidic protein
- Reference ranges for GDF-15, and risk factors associated with GDF-15, in a large general population cohort
- Serum GFAP – reference interval and preanalytical properties in Danish adults
- Determination of pediatric reference limits for 10 commonly measured autoantibodies
- Hematology and Coagulation
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- Reply to the Letter of Sun et al. [1] relating to Clin Chem Lab Med 2022;60(9):1365–72
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