scholarly journals An unusual course of COVID-19 infection with late increase in C-reactive protein (clinical case reports)

2020 ◽  
Vol 30 (5) ◽  
pp. 709-714
Author(s):  
S. Yu. Chikina ◽  
M. Yu. Brovko ◽  
V. V. Royuk ◽  
S. N. Avdeev
Keyword(s):  
Comprehensive Evaluation ◽  
Case Reports ◽  
Severe Disease ◽  
Clinical Status ◽  
Clinical Signs ◽  
Common Finding ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Antiinflammatory Therapy ◽  
Reactive Protein

Clinical signs of COVID-19 infection are non-specific and diagnosis is typically based on comprehensive evaluation of the patient’s history, clinical status, radiological and laboratory findings. A common finding in COVID-19 patients is increased C-reactive protein (CRP), though in some patients, CRP remains within normal range notwithstanding the presence of other criteria of severe disease. We describe two clinical cases of COVID-19 with severe bilateral pneumonia and late increase in CRP. Similar cases re quite challenging for making the diagnosis and indicating the antiinflammatory therapy.

scholarly journals Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis

2021 ◽  
Vol 10 (10) ◽  
pp. 2077
Author(s):  
Yi-Min Huang ◽  
Chiao Lo ◽  
Chiao-Feng Cheng ◽  
Cheng-Hsun Lu ◽  
Song-Chou Hsieh ◽  
...  
Keyword(s):  
Disease Severity ◽  
Severe Disease ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Serum Biomarkers ◽  
Healthy Controls ◽  
Granulomatous Mastitis ◽  
C Reactive Protein ◽  
Idiopathic Granulomatous Mastitis ◽  
Reactive Protein

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking breast cancer. Limited research has been conducted on the application of serum biomarkers. This study aims to investigate the association of serum biomarkers with disease severity in patients with IGM. From November 2011 to March 2020, medical records of patients with IGM were reviewed. Serum cytokine levels were measured in patients and healthy controls between July 2018 and March 2020. A total of 41 patients with histologically proven IGM were found. Serum interleukin (IL)-6 level was significantly higher in patients with IGM (n = 11) than healthy controls (n = 7). Serum IL-6 and C-reactive protein (CRP) levels were significantly higher in patients with severe disease than mild and moderate disease. Serum IL-6 (Spearman’s ρ = 0.855; p < 0.001) and CRP (Spearman’s ρ = 0.838; p = 0.001) levels were associated with time to resolution. A higher serum CRP level was associated with a longer time to resolution (B = 0.322; p < 0.001) in multiple linear regression analysis. Serum IL-6 and CRP levels can be used as biomarkers for the evaluation of disease severity in IGM. IL-6 may play a crucial role in the immunopathology of IGM.

Study of predictive value of serum C- reactive protein in diagnosis of acute appendicitis

2021 ◽  
Vol 19 (1) ◽  
pp. 31-34
Author(s):  
Pradeep Chandra Sharma ◽  
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Common Finding ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Female Ratio ◽  
Reactive Protein ◽  
Serum Crp

Background: Acute appendicitis is a common surgical condition and the most common cause of acute surgical abdomen. Commonly used tests for diagnosis of acute appendicitis were WBC, CRP ESR and procalcitonin (PCT) levels. In present study we correlated the serum levels of CRP with the histopathology of the removed appendix, to study predictive value of serum C- reactive protein in diagnosis of acute appendicitis. Material and Methods:Present study was conducted in patients with possibility of acute appendicitis, underwent appendicectomy. The histopathology report was considered as the final diagnosis. CRP more than 6 mg/dl was considered to be positive. Results: In present study total 88 patients were included. Male to female ratio was 1.4:1, most common age group was 21-30 years (35.23%) followed by 31-40 years (27.27%). Abdominal pain (92.05%), McBurney tenderness (80.68%), vomiting (76.14%), rebound tenderness (67.05%) and fever (55.68%) were common signs and symptoms noted in present study. On histopathology examination, inflammed appendix (51.14%) was most common finding, others were gangrenous appendix (23.86%), perforated appendix (5.68%) and normal appendix (19.32%). In present study diagnostic efficacy of serum CRP was sensitivity (80%), specificity (84.62%), positive predictive value (96.77%), negative predictive value (42.31%), diagnostic accuracy (80.68%). Conclusion. Serum CRP estimation is useful adjunct in diagnosis of acute appendicitis along with clinical diagnosis. Serum CRP value should be interpreted in combination with clinical findings.

scholarly journals Clinical, epidemiological, and laboratory characteristics of mild-to-moderate COVID-19 patients in Saudi Arabia: an observational cohort study

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Abbas Al Mutair ◽  
Saad Alhumaid ◽  
Waad N. Alhuqbani ◽  
Abdul Rehman Z. Zaidi ◽  
Safug Alkoraisi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Signs And Symptoms ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Moderate Severity ◽  
Reactive Protein ◽  
X Ray Imaging ◽  
Collaborative Studies ◽  
Observational Cohort ◽  
Treatment Procedures

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) emerged from China in December 2019 and has presented as a substantial and serious threat to global health. We aimed to describe the clinical, epidemiological, and laboratory findings of patients in Saudi Arabia infected with SARS-CoV-2 to direct us in helping prevent and treat coronavirus disease 2019 (COVID-19) across Saudi Arabia and around the world. Materials and methods Clinical, epidemiological, laboratory, and radiological characteristics, treatment, and outcomes of pediatric and adult patients in five hospitals in Riyadh, Saudi Arabia, were surveyed in this study. Results 401 patients (mean age 38.16 ± 13.43 years) were identified to be SARS-CoV-2 positive and 80% of cases were male. 160 patients had moderate severity and 241 were mild in severity. The most common signs and symptoms at presentation were cough, fever, fatigue, and shortness of breath. Neutrophil and lymphocyte counts, aspartate aminotransferase, C-reactive protein, and ferritin were higher in the COVID-19 moderate severity patient group. Mild severity patients spent a shorter duration hospitalized and had slightly higher percentages of abnormal CT scans and X-ray imaging. Conclusions This study provides an understanding of the features of non-ICU COVID-19 patients in Saudi Arabia. Further national collaborative studies are needed to streamline screening and treatment procedures for COVID-19.

scholarly journals The Plasmatic Aldosterone and C-Reactive Protein Levels, and the Severity of Covid-19: The Dyhor-19 Study

2020 ◽  
Vol 9 (7) ◽  
pp. 2315 ◽  
Author(s):  
Orianne Villard ◽  
David Morquin ◽  
Nicolas Molinari ◽  
Isabelle Raingeard ◽  
Nicolas Nagot ◽  
...  
Keyword(s):  
Inflammatory Responses ◽  
Clinical Course ◽  
Clinical Status ◽  
Plasma Renin ◽  
Ordinal Scale ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

Background. The new coronavirus SARS-CoV-2, responsible for the Covid-19 pandemic, uses the angiotensin converting enzyme type 2 (ACE2), a physiological inhibitor of the renin angiotensin aldosterone system (RAAS), as a cellular receptor to infect cells. Since the RAAS can induce and modulate pro-inflammatory responses, it could play a key role in the pathophysiology of Covid-19. Thus, we aimed to determine the levels of plasma renin and aldosterone as indicators of RAAS activation in a series of consecutively admitted patients for Covid-19 in our clinic. Methods. Plasma renin and aldosterone levels were measured, among the miscellaneous investigations needed for Covid-19 management, early after admission in our clinic. Disease severity was assessed using a seven-category ordinal scale. Primary outcome of interest was the severity of patients’ clinical courses. Results. Forty-four patients were included. At inclusion, 12 patients had mild clinical status, 25 moderate clinical status and 7 severe clinical status. In univariate analyses, aldosterone and C-reactive protein (CRP) levels at inclusion were significantly higher in patients with severe clinical course as compared to those with mild or moderate course (p < 0.01 and p = 0.03, respectively). In multivariate analyses, only aldosterone and CRP levels remained positively associated with severity. We also observed a positive significant correlation between aldosterone and CRP levels among patients with an aldosterone level greater than 102.5 pmol/L. Conclusions. Both plasmatic aldosterone and CRP levels at inclusion are associated with the clinical course of Covid-19. Our findings may open new perspectives in the understanding of the possible role of RAAS for Covid-19 outcome.

scholarly journals The Reliability of Diagnosis of Infection during Revision Arthroplasties

2002 ◽  
Vol 91 (2) ◽  
pp. 178-181 ◽  
Author(s):  
P. Virolainen ◽  
H. Lähteenmäki ◽  
A. Hiltunen ◽  
E. Sipola ◽  
O. Meurman ◽  
...  
Keyword(s):  
Protein Level ◽  
Tissue Sample ◽  
False Negative ◽  
Clinical Signs ◽  
Low Grade ◽  
Single Test ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Revision Arthroplasties ◽  
Radiological Evidence

Background: Follow up studies have shown that 0.5 to 4 % of the total joint arthroplasties will be complicated by infection. Distinction between aseptic loosening and infection is important for prediction of the final outcome after revision arhtroplasty but also for the choice of operative treatment. However, diagnosis of low grade chronic infection is extremely demanding. Materials and Methods: 68 hip and knee revision arthroplasties were reviewed retrospectively in order to evaluate the reliability of pre- and perioperative analysis of infection during total joint revision arthroplasties. The sensitivity and specificity for clinical signs, blood white-cell count, C-reactive protein level, radiographic analysis, bone and leukocyte scans, joint aspirations, and gram staining were determined. Tissue sample were harvested and cultured in all cases. Positive cultures were regarded as a true infection. Results: We were not able to characterize the infection by clinical signs. Also no single test was able to show the presence of infection in all cases. The best results were obtained from pre- and perioperative joint aspirations. Joint aspiration showed 1.0 specificity and 0.75 sensitivity. Conclusion: It is clear from this study that no single test is able to show the presence of infection in every case. Classical clinical signs, laboratory tests, special imaging studies and joint aspirations have all yielded a notable rate of false negative results. Therefore, we recommend that, if arthroplasty patients have pain in prosthetic joint without clear radiological evidence of loosening, bone scans and preoperative joint aspirations should be undertaken. Also, if radiological evidence of loosening is accompanied with one or more of following criteria; C-reactive protein level elevated, radiologic evidence of infection, loosening within the first five years after implantation. In case of infection a delayed two-stage reconstruction should be managed.

scholarly journals Stroke as the Sole Manifestation of Takayasu Arteritis in a 15-Year-Old Boy with Latent Tuberculosis

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Espen Benjaminsen ◽  
Anne Reigstad ◽  
Vanja Cengija ◽  
Vibke Lilleby ◽  
Maria Carlsson
Keyword(s):  
Carotid Artery ◽  
Takayasu Arteritis ◽  
Common Carotid Artery ◽  
Right Hemisphere ◽  
Latent Tuberculosis ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Case Presentation ◽  
Reactive Protein ◽  
The Right

Introduction. Takayasu arteritis is a rare disease affecting the aorta and its main branches, causing arterial claudication and end-organ ischemia, including stroke. The etiology is unknown but is believed to be autoimmune. An association between Takayasu arteritis and tuberculosis has been suggested, but the possible relation is unclear.Case Presentation. A 15-year-old Somali boy was diagnosed with latent tuberculosis. He had a lesion in the right lung, and both the tuberculin skin test by the Mantoux method and Quantiferon GOLD test turned out positive. After he suffered a cerebral infarct in the right hemisphere, childhood Takayasu arteritis was diagnosed. The diagnosis was based on diagnostic imaging showing a high-grade stenosis of the origin of the right common carotid artery, an occluded common carotid artery on the left side, a circumferential thickening of the vessel walls in the right and left common carotid artery, and laboratory findings with elevated C-reactive protein.Conclusion. Takayasu arteritis is an uncommon cause of stroke. It should however be kept in mind as a cause of cerebrovascular disease, especially in the young.

scholarly journals CO-RADS versus CT-SS scores in predicting severe COVID-19 patients: retrospective comparative study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Niveen E. Zayed ◽  
Manar A. Bessar ◽  
Samah Lutfy
Keyword(s):  
Comparative Study ◽  
Severe Disease ◽  
Scoring Systems ◽  
Rt Pcr ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Polymerase Chain ◽  
Retrospective Comparative Study ◽  
Rule Out

Abstract Background The role of CT in assessing and plotting viral pulmonary affection land marking is its potential among other investigation tools, and the aim of the study was to compare the ability of two different CT-based scoring systems in discriminating severe COVID-19 disease. Results Retrospective comparative study included 142 confirmed COVID-19 patients by real-time polymerase chain reaction (RT-PCR) test, with different degrees of disease (mild to severe), the data of patients collected from medical records, and patients with their first CT chest read for calculating CO-RADS and severity scoring system (CT-SS) score. The patients with severe COVID-19 disease were significantly older and had different comorbidities. The level of C-reactive protein, ESR, ferritin, and LDH were significantly higher in severe disease, P < 0.001. The ability of CT chest and its score bases (CT-SS and CO-RADS) were accurate in differentiation between mild/moderate and severe disease; AUC were 89% and 97%, respectively. The cutoff value of less than 7.5 and 4.5 for CT-SS and CO-RADS, respectively, can rule out severe COVID-19 by 90% and 97%, respectively. Conclusions CT chest play a segregate role in COVID-19 disease, add on an advantage in clinical data in triage, and highlight the decision of hospital admission.

scholarly journals Expression of ICAM1 and VCAM1 Serum Levels in Rheumatoid Arthritis Clinical Activity. Association with Genetic Polymorphisms

2009 ◽  
Vol 26 (3) ◽  
pp. 119-126 ◽  
Author(s):  
Rosa Elena Navarro-Hernández ◽  
Edith Oregon-Romero ◽  
Mónica Vázquez-Del Mercado ◽  
Héctor Rangel-Villalobos ◽  
Claudia Azucena Palafox-Sánchez ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Status ◽  
Serum Levels ◽  
Clinical Activity ◽  
C Reactive Protein ◽  
Soluble Adhesion Molecules ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Pcr Rflp ◽  
Elisa Technique

To investigate the association of sICAM-1 and sVCAM-1 with ICAM1 721G>A and VCAM1 1238G>C polymorphisms and rheumatoid arthritis (RA) clinical activity, sixty RA patients and 60 healthy non-related subjects (HS) matched for age and sex were recruited. Soluble adhesion molecules were determined by ELISA technique. Rheumatoid factor (RF), C reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were measured by routine methods. Disability and clinical activity was measured with Spanish-HAQ-DI and DAS28 scores, respectively. The ICAM1 and VCAM1 polymorphism were identified using the PCR-RFLP procedure. Inter-group comparison showed increased levels of sICAM-1 and sVCAM-1 in RA patients (284 and 481 ng/mL) versus HS (132 and 280 ng/mL); in the RA group, significant correlations between sVCAM-1 and RF (r= 0.402), ESR (r= 0.426), Spanish-HAQ-DI (r= 0.276), and DAS28 (r= 0.342) were found, whereas sICAM-1 only correlated with RF (r= 0.445). In RA patients, a significant association with the 721A allele of ICAM1 polymorphism (p= 0.04), was found. In addition, the allele impact (G/A+A/A) of this polymorphism was confirmed, (p= 0.038, OR = 2.3, C.I. 1.1–5.0). sVCAM-1 and sICAM-1 serum levels reflected the clinical status in RA, independently of the ICAM1 and VCAM1 polymorphism. However, the ICAM1 721A allele could be a genetic marker to RA susceptibility.

scholarly journals Endothelial function in men with type 2 diabetes without clinical signs of cardiovascular disease

2016 ◽  
Vol 19 (5) ◽  
pp. 383-387 ◽  
Author(s):  
Irina Alexandrovna Khripun ◽  
Sergey Vladislavovich Vorobyev ◽  
Maxim Nikolaevich Morgunov ◽  
Michail Iosifovich Kogan
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Clinical Signs ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group 2 ◽  
Group 1

Type 2 diabetes mellitus (T2DM) increases the risk of cardiovascular disease that is based on endothelial dysfunction (ED). Currently, conventional diagnostic methods are unreliable, especially at early stages of disease.Aims. The aim of this work was to assess endothelial function in men with T2DM without clinical signs of cardiovascular disease.Materials and methods. The study included 100 patients (mean age, 54.3 ± 5.3 years) with a T2DM duration of less than 10 years and without signs of cardiovascular disease. The patients were divided into two groups: group 1 consisted of 60 patients with a T2DM duration of less than five years. Group 2 included 40 men with a history of diabetes between 5 and 10 years. Endothelial function was assessed by the levels of nitric oxide (NO), endothelial NO synthase type 3 (eNOS3), ICAM-1, VCAM-1, E-selectin, P-selectin, resistin and C-reactive protein and the arterial vasoreactivity of the brachial artery (BA) using the D. Celermajer method.Results. Results revealed decreases in levels of both eNOS3 by 2.5 fold (P = 0.0005) and NO by 1.9 fold (P = 0.043) in group 2 patients, compared to those in group 1 patients. When the duration of diabetes was greater than five years, levels of VCAM-1, resistin and C-reactive protein increased by 12.1% (P = 0.048), 62% (P = 0.01) and 45.6%, respectively. Additionally, the time until maximal BA vasodilatation during reactive hyperemia was observed to be higher in group 2 [105 (90; 180) seconds] than those in group 1 [90 (60; 120) seconds].Conclusions. Biochemical and imaging signs of ED begin to appear in the first five years of T2DM, long before clinical manifestations. The earliest symptoms are decreases in eNOS3 and NO levels, increases in VCAM-1 and resistin concentrations and increased time until maximal BA vasodilatation during reactive hyperemia.

scholarly journals Epidemiological and Clinical Characteristics of Patients with COVID-19 in Arak, Iran

2020 ◽  
Vol 13 (1) ◽  
pp. 712-717
Author(s):  
Morteza Mousavi-Hasanzadeh ◽  
Hossein Sarmadian ◽  
Fatemeh Safi ◽  
Mohammad Jamalian ◽  
Amir Almasi-Hashiani
Keyword(s):  
Clinical Characteristics ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The Mean ◽  
Mixed Ground ◽  
Taste And Smell ◽  
Muscle Ache

Background: The number of confirmed cases of COVID-19 is increasing. Here we present the clinical characteristics and outcomes of COVID-19 in Arak, Iran. Methods: In this study, 139 COVID-19 confirmed cases from 15 February to 15 March 2020 in Arak, Iran, were investigated. The clinical signs, symptoms, laboratory and radiological findings and outcomes were analyzed. Results: The mean age of the patients was 55.41 years (S.D.: 17.11) and 55.40% of them were males. 26.81% of patients had recently traveled to other epidemic cities. The most common clinical manifestations were fever (71.64%), cough (67.16%), shortness of breath (55.22%), muscle ache (50.00%) and the most prevalent complications were taste and smell disruption (29.5%), weakness (22.3%), anorexia (20.1%) and acute respiratory distress syndrome (ARDS) (15.8%). Almost half of the patients had lymphopenia, an elevated level of erythrocyte sedimentation rate (ESR) and C - reactive protein (CRP). In terms of outcome, 9.3% of patients needed an ICU admission as a result of ARDS in which 15.32% were directly admitted to the ICU. 43.2% of patients have been discharged and the case fatality rate (CFR) was estimated as 11.5%. Conclusion: COVID-19 pneumonia usually occurred at an age older than 50 years and in the male gender. The most common initial clinical laboratories and radiological presentations are fever, cough, lymphopenia with elevated CRP and ESR and Bilateral mixed ground-glass opacities with consolidation.

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