The Diagnostic Value of the Pleural Fluid C-Reactive Protein in Parapneumonic Effusions

Purpose. The aim of this study was to evaluate the sensitivity of pleural C-reactive protein (CRP) biomarker levels in identifying parapneumonic effusions.Methods. A single-center, retrospective review of 244 patients diagnosed with pleural effusions was initiated among patients at the Rabin Medical Center, Petah Tikva, Israel, between January 2011 and December 2013. The patients were categorized into 4 groups according to their type of pleural effusion as follows: heart failure, malignant, post-lung transplantation, and parapneumonic effusion.Results. The pleural CRP levels significantly differentiated the four groups (p<0.001) with the following means: parapneumonic effusion,5.38±4.85 mg/dL; lung transplant,2.77±2.66 mg/dL; malignancy,1.19±1.51 mg/dL; and heart failure,0.57±0.81 mg/dL. The pleural fluid CRP cut-off value for differentiating among parapneumonic effusions and the other 3 groups was 1.38 mg/dL. The sensitivity, specificity, positive predictive value, and negative predictive value were 84.2%, 71.5%, 37%, and 95%, respectively. A backward logistic regression model selected CRP as the single predictor of parapneumonic effusion (OR = 1.59, 95% CI = 1.37–1.89).Conclusions. Pleural fluid CRP levels can be used to distinguish between parapneumonic effusions and other types of exudative effusions. CRP levels < 0.64 mg/dL are likely to indicate a pleural effusion from congestive heart failure, whereas levels ≥ 1.38 mg/dL are suggestive of an infectious etiology.

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Soluble myeloid triggering receptor expressed on myeloid cell 1 might have more diagnostic value for bacterial ascites than C-reactive protein

Open Life Sciences ◽

10.1515/biol-2018-0054 ◽

2018 ◽

Vol 13 (1) ◽

pp. 456-462

Author(s):

Qiang Guo ◽

Chuanqin Xu ◽

Chao Sun ◽

Yubao Zhao ◽

Weifu Zhang

Keyword(s):

Predictive Value ◽

Myeloid Cell ◽

Roc Curves ◽

Diagnostic Value ◽

Control Group ◽

Health Examination ◽

C Reactive Protein ◽

Reactive Protein ◽

Sensitivity Specificity ◽

Medical University

AbstractThe timely and accurate diagnosis of ascites is of great significance for early treatment and prognostication. This study explored the value of soluble myeloid triggering receptor expressed on myeloid cell 1 (sTREM-1) and C-reactive protein (CRP) for assessing ascites. A total of 133 patients with ascites who received treatment at the Affiliated Hospital of Taishan Medical University between September 2015 and September 2017 were retrospectively analyzed. The ascites in 22, 45, 33 and 33 patients were tuberculous, bacterial, tumorous, and transudative, respectively. Healthy volunteers (n=30) who received a health examination at the same hospital during the same period constituted the control group. Before treatment, both ascitic sTREM-1 and CRP showed significant differences among the ascites subgroups (P<0.001), with the highest levels in the bacterial subgroup. Serum sTREM-1 and CRP also showed significant differences among the groups. A correlation analysis showed a positive correlation between sTREM-1 and CRP. ROC curves of the bacterial subgroup showed that when the optimal cutoff point was set to 20.2, the sensitivity, specificity, positive predictive value, and negative predictive value of the serum sTREM-1 index were 0.933, 0.955, 0.914, and 0.965, respectively. sTREM-1 may provide more diagnostic value than CRP for the diagnosis of bacterial ascites.

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DIAGNOSTIC VALUE OF C-REACTIVE PROTEIN AND THE INFLUENCE OF VISCERAL FAT IN PATIENTS WITH OBESITY AND ACUTE APPENDICITIS

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020180001e1339 ◽

2018 ◽

Vol 31 (1) ◽

Cited By ~ 2

Author(s):

Adham do Amaral e CASTRO ◽

Thelma Larocca SKARE ◽

Fernando Ide YAMAUCHI ◽

Adriano TACHIBANA ◽

Suheyla Pollyana Pereira RIBEIRO ◽

...

Keyword(s):

Acute Appendicitis ◽

Visceral Fat ◽

Predictive Value ◽

Epidemiological Data ◽

Diagnostic Value ◽

C Reactive Protein ◽

Visceral Fat Area ◽

Reactive Protein ◽

Clinical Records ◽

Sensitivity Specificity

ABSTRACT Background: The C reactive protein (CRP) is one of the most accurate inflammatory markers in acute appendicitis (AA). Obesity leads to a pro-inflammatory state with increased CRP, which may interfere with the interpretation of this laboratory test in AA. Aim: To assess sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CRP in patients with AA and their correlation to body mass index (BMI) and body fat composition. Method: This is a retrospective study based on clinical records and imaging studies of 191 subjects with histopathologically confirmed AA compared to 249 controls who underwent abdominal computed tomography (CT). Clinical and epidemiological data, BMI, and CRP values were extracted from medical records. CT scans were assessed for AA findings and body composition measurements. Results: CRP values increased according to patients’ BMI, with varying sensitivity from 79.78% in subjects with normal or lean BMI, 87.87% in overweight, and 93.5% in individuals with obesity. A similar pattern was observed for NPV: an increase with increasing BMI, 69.3% in individuals with normal or lean BMI, 84.3% in overweight, and 91.3% in individuals with obesity. There was a positive correlation between CRP and visceral fat area in patients with AA. Conclusions: Variations exist for sensitivity, specificity, PPV, and NPV values of CRP in patients with AA, stratified by BMI. An increase in visceral fat area is associated with elevated CRP across the BMI spectrum.

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Diagnostic Value of C-Reactive Protein in Discrimination between Uncomplicated and Complicated Parapneumonic Effusion

Diagnostics ◽

10.3390/diagnostics10100829 ◽

2020 ◽

Vol 10 (10) ◽

pp. 829

Author(s):

Yana Kogan ◽

Edmond Sabo ◽

Majed Odeh

Keyword(s):

Area Under The Curve ◽

Diagnostic Value ◽

Parapneumonic Effusion ◽

C Reactive Protein ◽

Diagnostic Efficacy ◽

Reactive Protein ◽

Significant Difference ◽

Study Population ◽

Complicated Parapneumonic Effusion

Objectives: The role of serum C-reactive protein (CRPs) and pleural fluid CRP (CRPpf) in discriminating uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE) is yet to be validated since most of the previous studies were on small cohorts and with variable results. The role of CRPs and CRPpf gradient (CRPg) and of their ratio (CRPr) in this discrimination has not been previously reported. The study aims to assess the diagnostic efficacy of CRPs, CRPpf, CRPr, and CRPg in discriminating UCPPE from CPPE in a relatively large cohort. Methods: The study population included 146 patients with PPE, 86 with UCPPE and 60 with CPPE. Levels of CRPs and CRPpf were measured, and the CRPg and CRPr were calculated. The values are presented as mean ± SD. Results: Mean levels of CRPs, CRPpf, CRPg, and CRPr of the UCPPE group were 145.3 ± 67.6 mg/L, 58.5 ± 38.5 mg/L, 86.8 ± 37.3 mg/L, and 0.39 ± 0.11, respectively, and for the CPPE group were 302.2 ± 75.6 mg/L, 112 ± 65 mg/L, 188.3 ± 62.3 mg/L, and 0.36 ± 0.19, respectively. Levels of CRPs, CRPpf, and CRPg were significantly higher in the CPPE than in the UCPPE group (p < 0.0001). No significant difference was found between the two groups for levels of CRPr (p = 0.26). The best cut-off value calculated by the receiver operating characteristic (ROC) analysis for discriminating UCPPE from CPPE was for CRPs, 211.5 mg/L with area under the curve (AUC) = 94% and p < 0.0001, for CRPpf, 90.5 mg/L with AUC = 76.3% and p < 0.0001, and for CRPg, 142 mg/L with AUC = 91% and p < 0.0001. Conclusions: CRPs, CRPpf, and CRPg are strong markers for discrimination between UCPPE and CPPE, while CRPr has no role in this discrimination.

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Use of C-reactive protein level in diagnosis of tubercular pleural effusion

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v8i1.25264 ◽

2019 ◽

Vol 8 (1) ◽

pp. 20-23

Author(s):

Subash Pant ◽

Sanjeet Krishna Shrestha ◽

Lucky Sharma ◽

Bibechana Shrestha

Keyword(s):

Pleural Effusion ◽

Pleural Fluid ◽

Protein Level ◽

College Teaching ◽

C Reactive Protein ◽

Biochemical Tests ◽

Cross Sectional ◽

Female Ratio ◽

Protein Levels ◽

Reactive Protein

Background: C-reactive protein in both pleural fluid and serum has been found to be higher in tubercular pleural effusion than in other causes of pleural effusion. Objectives: The main aim of this study was to find out the diagnostic value of C-reactive protein in patients withlymphocytic pleural effusion. Methodology: A cross-sectional study was conducted in 90 patients with pleural effusion who underwent thoracocentesis at Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal. The complete biochemical tests of pleural fluid and serum were performed. The C-reactive protein concentrations of both pleural fluid and serum were then measured from samples from patients with lymphocytic exudative pleural effusion. Results: Ninety patients with exudative lymphocytic pleural effusion were included. Male patients were 56 (62.2%) and female were 34 (37.8%) with the male to female ratio of 1.64. Mean age of the patients was 51±21.54 (Mean ± Standard Deviation). The pleural fluid C-reactive protein levels in tubercular pleural effusion were higher (48.87±24.19 mg/dl) compared to non-tubercular group (38.30±17 mg/dl; p<0.001). Similarly, the serum fluid C-reactive protein levels in tubercular pleural effusion were higher (29.60±13mg/dl) compared to non-tubercular group (18.14±9.2mg/dl; p< 0.001). The sensitivity of pleural fluid C-reactive protein level in diagnosing tubercular pleural effusion was 86%. Conclusion: Simple and inexpensive test like C-reactive protein is useful in the diagnostic workup of lymphocytic pleural effusions. High C-reactive protein levels are very suggestive of tubercular pleural effusion.

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Predictive value of high sensitivity C-reactive protein on progression to heart failure occurring after the first myocardial infarction

Vascular Health and Risk Management ◽

10.2147/vhrm.s198452 ◽

2019 ◽

Vol Volume 15 ◽

pp. 221-227 ◽

Cited By ~ 5

Author(s):

Zohair Al Aseri ◽

Syed Shahid Habib ◽

Ameer Marzouk

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Predictive Value ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

First Myocardial Infarction

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Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters

BioMed Research International ◽

10.1155/2016/5697692 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 10

Author(s):

Fanny Löfvenberg ◽

Martin Salö

Keyword(s):

Predictive Value ◽

Negative Likelihood Ratio ◽

C Reactive Protein ◽

Suspected Appendicitis ◽

Reactive Protein ◽

First Choice ◽

Sensitivity Specificity ◽

Surgery Center ◽

Appendicitis Score ◽

Higher Sensitivity

Objective. To evaluate the performance of ultrasound in pediatric appendicitis and the integration of US with the pediatric appendicitis score (PAS) and C-reactive protein (CRP).Method. An institution-based, retrospective study of children who underwent abdominal US for suspected appendicitis between 2012 and 2015 at a tertiary pediatric surgery center. US results were dichotomized, with a nonvisualized appendix considered as a negative examination.Results. In total, 438 children were included (mean 8.5 years, 54% boys), with an appendicitis rate of 29%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US were 82%, 97%, 92%, and 93%, respectively, without significant age or gender differences. Pediatric radiologists had significantly higher sensitivity compared to general radiologists, 88% and 71%, respectively (p<0.01), but no differences were seen for specificity, PPV, and NPV. The sensitivity, NPV, and negative likelihood ratio for the combination of negative US, PAS < 5, and CRP < 5 mg/L were 98%, 98%, and 0.05 (95% CI 0.03–0.15).Conclusion. US may be a useful tool for evaluating children with suspected appendicitis, regardless of age or gender, and should be the first choice of imaging modalities. Combining US with PAS and CRP may reduce several unnecessary admissions for in-hospital observation.

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An Evaluation of Levels of C - reactive protein in Serum and Pleural Fluid of Pleural Effusion of Different Etiology

IOSR Journal of Dental and Medical Sciences ◽

10.9790/0853-1509111923 ◽

2016 ◽

Vol 15 (09) ◽

pp. 19-23

Author(s):

Dr. Upendra Kumar Verma ◽

Dr. Shiv Shanker Tripathi ◽

Dr. Rajiv Ratan Singh Yadav ◽

Dr. Sachin Avasthi

Keyword(s):

Pleural Effusion ◽

Pleural Fluid ◽

C Reactive Protein ◽

Reactive Protein

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Diagnostic Value of Urine sTREM-1 and Urine C-reactive Protein for Infants with Late Onset Neonatal Sepsis

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0039-3400468 ◽

2019 ◽

Vol 15 (02) ◽

pp. 072-078

Author(s):

Senem Alkan Ozdemir ◽

Ruya Colak ◽

Ezgi Yangin Ergon ◽

Sebnem Calkavur

Keyword(s):

Neonatal Sepsis ◽

Predictive Value ◽

Late Onset ◽

Diagnostic Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Late Onset Sepsis ◽

Noninvasive Markers ◽

Serum Crp ◽

Sepsis Detection

Abstract Objective Noninvasive markers have been increasingly used as a diagnostic marker for sepsis detection and monitoring of the disease. The aim of this observational, prospective pilot study was to investigate the diagnostic performance of urinary soluble triggering receptor expressed on myeloid cells (sTREM-1) and urine C-reactive protein (CRP) levels in the late onset neonatal sepsis and to compare them with serum CRP levels. Materials and Methods Sixty-six infants with clinical sepsis were included. Urine sTREM-1 and urine CRP were collected at the diagnosis of late-onset sepsis. All laboratory investigations were also noted from the infants. Results There were no significant differences between characteristics of the infants. Culture-positive neonates had significantly higher urine sTREM-1 than culture-negative neonates (p < 0.001). Using a cut-off point for urine sTREM-1 of 129 pg/mL, the sensitivity was 0.63, the specificity was 0.84, positive predictive value was 0.80, negative predictive value was 0.70. Urine sTREM-1 and urine CRP were recollected on the seventh day of sepsis treatment and it was found that the levels of sTREM-1 and CRP decreased. Conclusion This is the first study in the literature which evaluates the place of urine sTREM-1 and urine CRP in the diagnosis of neonatal sepsis. Urine sTREM-1 and urine CRP may be useful in the diagnosis of sepsis and in evaluating the effect of antibiotic treatment.

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