scholarly journals The role of C1 inhibitor and complement as acute phase reactants: are we missing the diagnosis of hereditary angioedema?

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Peter Stepaniuk ◽  
Ana-Maria Bosonea ◽  
Persia Pourshahnazari ◽  
Adrienne Roos ◽  
Amin Kanani
Keyword(s):  
Acute Phase ◽  
Hereditary Angioedema ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Upper Respiratory Tract ◽  
C1 Inhibitor ◽  
Acute Phase Reactants ◽  
Reactive Protein ◽  
Clinically Significant ◽  
Complement 4

Abstract Background C1 inhibitor (C1-INH) and complement 4 (C4) have historically been referred to as positive acute phase reactants, however this has never been evaluated in hereditary angioedema (HAE) patients. Low function of C1-INH and low levels of C4 are important in the diagnosis of HAE type 1 and 2. If C1-INH and/or C4 are significant acute phase reactants, their levels may be falsely “normal” in patients with HAE when measured during times of infection or inflammation resulting in missed or delayed diagnosis. Case presentation We present a case series of four HAE patients who had C4, C1-INH, c-reactive protein (CRP) and ferritin measured at baseline and again during a self-reported upper respiratory tract infection (URTI) or flu-like illness. We did not identify any HAE patients who had a significant change in their C1-INH functional level in the context of a mild infection. However, the C4 level did increase into the normal range on three occasions (2 patients, with 1 patient having elevation during two separate illnesses). Conclusions C1 inhibitor may not be a clinically significant acute phase protein and appears to still be a reliable diagnostic marker of hereditary angioedema, even in times of modest acute inflammation, unlike complement C4 which can be elevated in this setting.

Delayed diagnosis of hereditary angioedema with C1‐inhibitor deficiency in iranian children and adolescents

2019 ◽  
Vol 30 (3) ◽  
pp. 395-398 ◽  
Author(s):  
Maryam Ayazi ◽  
Mohammad Reza Fazlollahi ◽  
Iraj Mohammadzadeh ◽  
Abbas Fayezi ◽  
Mohammad Nabavi ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Hereditary Angioedema ◽  
Delayed Diagnosis ◽  
C1 Inhibitor ◽  
C1 Inhibitor Deficiency ◽  
Iranian Children

scholarly journals Acute Phase Reactants in Infections: Evidence-Based Review and a Guide for Clinicians

2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Anurag Markanday
Keyword(s):  
Acute Phase ◽  
English Language ◽  
Biological Marker ◽  
Acute Phase Reactants ◽  
Medline Search ◽  
Reactive Protein ◽  
Guidance Strategies ◽  
Published Evidence ◽  
Meta Analyses

Abstract Acute-phase reactants such as erythrocyte sedimentation rate and C-reactive protein have traditionally been used as markers for inflammation and as a measure of “sickness index” in infectious and noninfectious conditions. In the last decade, more data have become available on the wider and more specific role for these markers in the management of complex infections. This includes the potential role in early diagnosis, in differentiating infectious from noninfectious causes, as a prognostic marker, and in antibiotic guidance strategies. A better defined role for biological markers as a supplement to clinical assessment may lead to more judicious antibiotic prescriptions, and it has the potential for a long-term favorable impact on antimicrobial stewardship and antibiotic resistance. Procalcitonin as a biological marker has been of particular interest in this regard. This review examines the current published evidence and summarizes the role of various acute-phase markers in infections. A MEDLINE search of English-language articles on acute-phase reactants and infections published between 1986 and March 2015 was conducted. Additional articles were also identified through a search of references from the retrieved articles, published guidelines, systematic reviews, and meta-analyses.

scholarly journals Combined C-Reactive Protein and Novel Inflammatory Parameters as a Predictor in Cancer—What Can We Learn from the Hematological Experience?

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1966 ◽  
Author(s):  
Øystein Bruserud ◽  
Helene Hersvik Aarstad ◽  
Tor Henrik Anderson Tvedt
Keyword(s):  
Acute Phase ◽  
Hematological Malignancies ◽  
Phase Reaction ◽  
C Reactive Protein ◽  
Acute Phase Reactants ◽  
Reactive Protein ◽  
Inflammatory Parameters ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
White Blood Cell Counts

The acute phase reaction is a systemic response to acute or chronic inflammation. The serum level of C-reactive protein (CRP) is the only acute phase biomarker widely used in routine clinical practice, including its uses for prognostics and therapy monitoring in cancer patients. Although Interleukin 6 (IL6) is a main trigger of the acute phase reactions, a series of acute phase reactants can contribute (e.g., other members in IL6 family or IL1 subfamily, and tumor necrosis factor α). However, the experience from patients receiving intensive chemotherapy for hematological malignancies has shown that, besides CRP, other biomarkers (e.g., cytokines, soluble cytokine receptors, soluble adhesion molecules) also have altered systemic levels as a part of the acute phase reaction in these immunocompromised patients. Furthermore, CRP and white blood cell counts can serve as a dual prognostic predictor in solid tumors and hematological malignancies. Recent studies also suggest that biomarker profiles as well as alternative inflammatory mediators should be further developed to optimize the predictive utility in cancer patients. Finally, the experience from allogeneic stem cell transplantation suggests that selected acute phase reactants together with specific markers of organ damages are useful for predicting or diagnosing graft versus host disease. Acute phase proteins may also be useful to identify patients (at risk of) developing severe immune-mediated toxicity after anticancer immunotherapy. To conclude, future studies of acute phase predictors in human malignancies should not only investigate the conventional inflammatory mediators (e.g., CRP, white blood cell counts) but also combinations of novel inflammatory parameters with specific markers of organ damages.

scholarly journals Relationship of Acute Phase Reactants and Fat Accumulation during Treatment for Tuberculosis

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Alejandro Sanchez ◽  
Colleen Azen ◽  
Brenda Jones ◽  
Stan Louie ◽  
Fred Sattler
Keyword(s):  
Acute Phase ◽  
Muscle Wasting ◽  
Cell Mass ◽  
Fat Free Mass ◽  
C Reactive Protein ◽  
Acute Phase Reactants ◽  
Reactive Protein ◽  
Low Levels ◽  
Beta 2 Microglobulin ◽  
Relationship Of

Background. Tuberculosis causes inflammation and muscle wasting. We investigated how attenuation of inflammation relates to repletion of body composition during treatment in an underserved population.Design. Twenty-four patients (23 to 79 years old) with pulmonary tuberculosis and inflammation (pretreatment albumin  g/dL, C-reactive protein [CRP]  μg/dL, and beta-2-microglobulin  μg/L) were evaluated and had BIA over 24 weeks.Results. Weight increased by  kg (5.5%; ) at week 4 and by  kg (15.6%; ) at week 24. Repletion of body mass was primarily fat, which increased by  kg at week 4 and  kg at week 24 ( and versus baseline). Fat-free mass (FFM), body cell mass (BCM), and phase angle did not increase until study week 8. Albumin rose to  g/dL by week 4 () and slowly increased thereafter. CRP levels declined by~50% at each interval visit.Conclusions. During the initial treatment, acute phase reactants returned towards normal. The predominant accrual of fat mass probably reflects ongoing, low levels of inflammation.

scholarly journals PROCALCITONIN, C-REACTIVE PROTEIN AND FIBRINOGEN LEVELS IN CASES WITH MECHANIC BOWEL OBSTRUCTION AND THEIR CHANGE IN RELATION TO THE DURATION OF OBSTRUCTION: AN EXPERIMENTAL STUDY

2017 ◽  
Author(s):  
Hakan Guzel ◽  
Sahin Kahramanca ◽  
Oskay Kaya ◽  
Gulay Ozgehan ◽  
Demet Yilmazer ◽  
...  
Keyword(s):  
Acute Phase ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Late Phase ◽  
Study Groups ◽  
Control Group ◽  
C Reactive Protein ◽  
Acute Phase Reactants ◽  
Reactive Protein ◽  
Mechanical Bowel Obstruction

The need and timing of surgical intervention in patients with adhesive bowel obstruction is a dilemma. We aimed to investigate the role of three acute-phase reactants, namely procalcitonin (PCT), fibrinogen and C-reactive protein (CRP) in this clinical condition We chose a rat model whose mechanical bowel obstruction was created with caecum ligation. There were two study groups and one control group. Each group contained ten subjects. The study groups had and six-hour obstruction samples. Blood PCT, fibrinogen and CRP levels were measured before and after the surgical procedure. These parameters were compared between the groups and they were also evaluated with the degree of histopathological changes occurred in terminal ileal tissue samples. Compared with the control group, PCT measurements showed a mild decrease in the early phase of obstruction but a significant elevation in the late phase (p: 0,977 and p: 0,001). Unlike PCT, fibrinogen levels increased at first but decreased later (p: 0,978 and p: 0,326). We observed an increase in CRP levels parallel to the prolonged duration of obstruction (p: 0,987 and p: 0,134). With regard to mucosal injury, PCT levels increased at first, and then decreased (p: 0,003). On the other hand, fibrinogen and CRP levels decreased at first, and then increased (p: 0,139 and p: 0,102). The acute-phase reactants PCT, fibrinogen and CRP associated with the duration of obstruction may help to determine the time of surgical intervention in patients with adhesive mechanical bowel obstruction.

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