The value of serum C reactive protein in the assessment of severity of HIV infection among children in a resource limited setting

Background: Human immuno-deficiency virus (HIV) infection has devastating impact especially on well-being of children. Management of HIV infected children in resource-limited countries poses significant difficulties. The role of C-reactive protein as a potentially useful/cost-effective tool for assessing severity of HIV infection is yet to be established. The relationship between serum C-reactive protein and severity of HIV infection among children aged 6 months to 12 years was evaluated.Methods: Authors recruited 85 children each on combined antiretrovirals for ≥3 months, and apparently healthy HIV-negative controls. Severity of HIV infection was assessed by classification into immunologic categories 1, 2, 3 and clinical categories N, A, B, C according to the Centre for Disease Control revised classification system. Enzyme linked immunosorbent assay (ELISA) was used for serum CRP estimation. CD4 count was estimated by flow cytometry. Data analysis was with Statistical Package for Social Sciences version 20.Results: Response rate was 160 (94.1%) with mean age of participants being 8.50±3.36 years. Male to female ratio was 1.35:1. Lymphadenopathy was the commonest clinical feature in 26 (32.50%) participants, 59 (73.75%) participants were asymptomatic, and 52 (65.00%) were immunologic stage 1. Median serum CRP of HIV infected group and controls were 4.2 (1-13.9) mg/l and 0.5 (0.2-1.9) mg/l respectively. There was an association between Clinical and immunolological stages of infection and levels of serum CRP, p values = 0.001 and 0.002 respectively.Conclusions: The serum level of CRP may predict the severity of HIV infection among children.

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

Medpusle International Journal of Surgery ◽

10.26611/1061918 ◽

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.

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Serum C - Reactive Protein Level and Peripheral Blood Picture in Children with Pneumonia

Paediatrica Indonesiana ◽

10.14238/pi38.3-4.1998.62-7 ◽

2017 ◽

Vol 38 (3-4) ◽

pp. 62

Author(s):

IGL Sidiartha ◽

BNP Arhana ◽

P Suwendra ◽

Sudaryat S

Keyword(s):

Body Temperature ◽

Peripheral Blood ◽

Cross Sectional Study ◽

C Reactive Protein ◽

Blood Picture ◽

Cross Sectional ◽

Female Ratio ◽

Reactive Protein ◽

Significant Difference ◽

Serum Crp

This cross sectional study aimed to determine the relation between serum C-reactive protein (CRP) levels and peripheral blood picture in children with bronchopneumonia, conducted at the Division of Pulmonology, Sanglah Hospital, Denpasar during 3 months (December 1996 to February 1997). Serum CRP levels, hemoglobin, leukocyte count, neutrophil count and ESR values in 30 cases between 1 month and 4.5 years (20 male and 10 female) were measured. Bronchopneumonia was mostly found in < 1 year old (67%) and with male to female ratio of 2:1. High CRP serum level (>12 microgram/ml) was found in 33% of 30 cases. Anemia was found in 37%, leukocytosis in 50%, increase segment neutrophil ratio in 30%, increase of ESR in 40% and increase of body temperature more than 38°C in 4 7% of the cases. Neutrophilia, increase of ESR and increase of body temperature were found statistically significant difference between the positive CRP and negative CRP group. Most bronchopneumonia patients in this study were probably caused by non bacteria. Neutrophilia, higher ESR and higher body temperature could be used as an indicator of bacterial infection besides the increase of serum CRP levels.

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Serum C-Reactive Protein Is Negatively Associated With Olfactory Identification Ability in Older Adults

i-Perception ◽

10.1177/20416695211009928 ◽

2021 ◽

Vol 12 (2) ◽

pp. 204166952110099

Author(s):

Ingrid Ekström ◽

Davide Liborio Vetrano ◽

Goran Papenberg ◽

Erika J. Laukka

Keyword(s):

Statistical Significance ◽

Population Based ◽

Rate Of Change ◽

Odor Identification ◽

Sensitivity Analyses ◽

C Reactive Protein ◽

Reactive Protein ◽

Olfactory Identification ◽

Olfactory Ability ◽

Serum Crp

Importance Olfactory deficits are common in aging and associated with several conditions linked to inflammation. A few studies suggest that increased concentration of pro-inflammatory biomarkers may be related to olfactory deficits, but these associations are understudied in population-based samples. Objective To investigate the association between serum concentrations of C-reactive protein (CRP) and olfactory identification level as well as rate of change in aging. Methods We included 1,721 participants (mean age 70.5 years; 61.9% female) with at least two olfactory assessments across the 12-year follow-up. Baseline level and change in odor identification were estimated with linear mixed models as a function of CRP levels, derived from blood plasma at baseline. Results Results indicated a negative dose–response association between CRP level and odor identification scores at baseline, after adjustment for demographic, cognitive, health, and lifestyle factors. CRP levels ranging between 11 and 20 mg/L were significantly related to lower olfactory ability (β = −0.811, 95% confidence interval [CI] [−1.503 to −0.118]; p = .022). Likewise, CRP values above 20 mg/L were related to lower olfactory scores, an association that approached statistical significance (β = −0.996, 95% CI [−2.045 to 0.054]; p = .063). We found no associations between CRP and olfactory change ( ps > .368). Sensitivity analyses showed that associations between CRP and olfaction were confined to younger participants (age ≤72 years) and men ( ps < .034). Conclusions Our findings suggest a negative association between serum CRP levels and olfactory identification ability in aging that may be dependent on age and sex.

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The role of serum C-reactive protein in the diagnosis of periprosthetic shoulder infection

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03779-2 ◽

2021 ◽

Author(s):

Doruk Akgün ◽

Mats Wiethölter ◽

Paul Siegert ◽

Victor Danzinger ◽

Marvin Minkus ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Joint Infection ◽

Receiver Operating Curve ◽

C Reactive Protein ◽

Level Of Evidence ◽

Reactive Protein ◽

Median Serum ◽

Cutibacterium Acnes ◽

Serum Crp ◽

Receiver Operating

Abstract Introduction There is a paucity of literature regarding serum C-reactive protein (CRP) in the evaluation of a shoulder periprosthetic joint infection (PJI). The purpose of the current study was to establish cutoff values for diagnosing shoulder PJI and evaluate the influence of the type of infecting microorganism and the classification subgroups according to last proposed International Consensus Meeting (ICM) criteria on the CRP level. Materials and methods A retrospective analysis of all 136 patients, who underwent septic or aseptic revision shoulder arthroplasty in our institution between January 2010 and December 2019, was performed. Shoulder PJI was defined according to the last proposed definition criteria of the ICM. Serum CRP levels were compared between infected and non-infected cases, between infection subgroups, as well as between different species of infecting microorganisms. A receiver-operating characteristic (ROC) analysis was performed to display sensitivity and specificity of serum CRP level for shoulder PJI. Results A total of 52 patients (38%) were classified as infected, 18 meeting the criteria for definitive infection, 26 for probable infection and 8 for possible infection. According to the ROC curve, an optimized serum CRP threshold of 7.2 mg/l had a sensitivity of 69% and specificity of 74% (area under curve = 0.72). Patients with definitive infection group demonstrated significantly higher median serum CRP levels (24.3 mg/l), when compared to probable, possible infection groups and PJI unlikely group (8 mg/l, 8.3 mg/l, 3.6 mg/l, respectively, p < 0.05). The most common isolated microorganism was Cutibacterium acnes in 25 patients (48%) followed by coagulase-negative staphylococci (CNS) in 20 patients (39%). Patients with a PJI caused by high-virulent microorganisms had a significantly higher median serum CRP level compared to patients with PJI caused by low-virulent microorganisms (48 mg/l vs. 11.3 mg/l, p = 0.04). Conclusions Serum CRP showed a low sensitivity and specificity for the diagnosis of shoulder PJI, even applying cutoffs optimized by receiver-operating curve analysis. Low-virulent microorganisms and patients with probable and possible infections are associated with lower CRP levels compared to patients with definitive infection and infections caused by high-virulent microorganisms. Level of evidence Diagnostic Level III.

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MO477SERUM C-REACTIVE PROTEIN AND PROCALCITONIN LEVELS IN HEMODIALYSIS AND INTRADIALYTIC ALTERATIONS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab090.0039 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Makrouhi Sonikian ◽

Aggeliki Barbatsi ◽

Eugenia Karakou ◽

Theodoros Chiras ◽

Jacob Skarakis ◽

...

Keyword(s):

Healthy Subjects ◽

Control Group ◽

Healthy Controls ◽

C Reactive Protein ◽

Polysulfone Membrane ◽

Reactive Protein ◽

Markers Of Inflammation ◽

Dialysate Flow Rate ◽

Significant Difference ◽

Serum Crp

Abstract Introduction C-reactive protein (CRP) and procalcitonin (PCT) are widely used as markers of inflammation and infection in general population and in chronic hemodialysis (HD) as well. However, in dialysis (D) patients, serum CRP and PCT levels may be elevated even in the absence of inflammatory or infectious disease and diagnostic process is a challenge in such cases. We studied HD patients' laboratory profile concerning CRP and PCT. Subjects and Methods We studied 25 stable HD patients, M/F=22/3, aged 68(44-89) years, dialyzed thrice weekly for 55(6-274) months with a dialysate flow rate of 700 ml/min, with a residual daily diuresis less than 200 ml, Kt/V values of 1,44±0,3 and no signs of infection. Patients were classified in two groups. Group A included 10 patients on pre-dilution online hemodiafiltration (HDF). Group B consisted of 15 patients on conventional HD with low-flux polysulfone membrane. Twenty healthy subjects formed a control group C. Serum CRP and PCT levels were measured in duplicate in A and B groups before and at the end of mid-week dialysis sessions and also in C group. Results Pre-D serum CRP values in the total of patients were higher than those in healthy controls (10,89±19,29 vs 2,54±1,28 mg/L-p=0,004). Compared with group C, pre-D CRP values were higher only in B group (15,98±24,54 mg/L-p=0,001) but not in A group (4,09±3,33 mg/L-p=NS). There was a significant difference in pre-D serum CRP values between A and B groups (p=0,028). At the end of D session serum CRP values showed a tendency to increase in both groups A (5,16±4,81 mg/L) and B (17,00±27,00 mg/L) but differences were not significant. Pre-D serum PCT values in the total of patients were higher than those in healthy controls (0,82±0,9 vs 0,29±0,55 ng/ml-p<0,001). Compared with group C, pre-D PCT values were higher in both A group (0,52±0,15 ng/ml-p<0,001) and B group (1,01±1,13 ng/ml-p=0,006). There was no significant difference in pre-D serum PCT values between A and B groups (p=0,261). At the end of D session serum PCT values decreased in A group (0,32±0,11 ng/ml-p<0,001) and increased in B group (1,12±1,21 ng/ml-p=0,014). Conclusions In patients on both conventional low-flux HD and online HDF pre-D serum CRP and PCT levels were higher than those in healthy subjects. Dialysis modality and membrane flux did not affect post-D serum CRP values, but post-PCT values decreased in online HDF. PCT usefulness might be limited in dialysis with high-flux membranes. Cut-off values have to be established for both markers to eliminate confusion in diagnosis of inflammatory and infectious diseases in hemodialyzed patients.

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Cost-Effectiveness Analysis of the Use of Point-of-Care C-Reactive Protein Testing to Reduce Antibiotic Prescribing in Primary Care

Antibiotics ◽

10.3390/antibiotics7040106 ◽

2018 ◽

Vol 7 (4) ◽

pp. 106 ◽

Cited By ~ 6

Author(s):

Emily Holmes ◽

Sharman Harris ◽

Alison Hughes ◽

Noel Craine ◽

Dyfrig Hughes

Keyword(s):

Primary Care ◽

Cost Effectiveness ◽

Respiratory Tract ◽

Clinical Guidelines ◽

Antibiotic Prescription ◽

Point Of Care ◽

Cost Effective ◽

Routine Practice ◽

C Reactive Protein ◽

Reactive Protein

More appropriate and measured use of antibiotics may be achieved using point-of-care (POC) C-reactive protein (CRP) testing, but there is limited evidence of cost-effectiveness in routine practice. A decision analytic model was developed to estimate the cost-effectiveness of testing, compared with standard care, in adults presenting in primary care with symptoms of acute respiratory tract infection (ARTI). Analyses considered (1) pragmatic use of testing, reflective of routine clinical practice, and (2) testing according to clinical guidelines. Threshold and scenario analysis were performed to identify cost-effective scenarios. In patients with symptoms of ARTI and based on routine practice, the incremental cost-effectiveness ratios of CRP testing were £19,705 per quality-adjusted-life-year (QALY) gained and £16.07 per antibiotic prescription avoided. Following clinical guideline, CRP testing in patients with lower respiratory tract infections (LRTIs) cost £4390 per QALY gained and £9.31 per antibiotic prescription avoided. At a threshold of £20,000 per QALY, the probabilities of POC CRP testing being cost-effective were 0.49 (ARTI) and 0.84 (LRTI). POC CRP testing as implemented in routine practice is appreciably less cost-effective than when adhering to clinical guidelines. The implications for antibiotic resistance and Clostridium difficile infection warrant further investigation.

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The serum level of C-reactive protein alone cannot be used for the diagnosis of prosthetic joint infections, especially in those caused by organisms of low virulence

The Bone & Joint Journal ◽

10.1302/0301-620x.100b11.bjj-2018-0514.r1 ◽

2018 ◽

Vol 100-B (11) ◽

pp. 1482-1486 ◽

Cited By ~ 24

Author(s):

D. Akgün ◽

M. Müller ◽

C. Perka ◽

T. Winkler

Keyword(s):

Correlation Coefficient ◽

False Negative ◽

Causative Organism ◽

Spearman Correlation ◽

C Reactive Protein ◽

Reactive Protein ◽

Prosthetic Joint ◽

Median Serum ◽

Prosthetic Joint Infections ◽

Serum Crp

Aims The aim of this study was to determine the prevalence and characteristics of C-reactive protein (CRP)-negative prosthetic joint infection (PJI) and evaluate the influence of the type of infecting organism on the CRP level. Patients and Methods A retrospective analysis of all PJIs affecting the hip or knee that were diagnosed in our institution between March 2013 and December 2016 was performed. A total of 215 patients were included. Their mean age was 71 years (sd 11) and there were 118 women (55%). The median serum CRP levels were calculated for various species of organism and for patients with acute postoperative, acute haematogenous, and chronic infections. These were compared using the Kruskal–Wallis test, adjusting for multiple comparisons with Dunn’s test. The correlation between the number of positive cultures and serum CRP levels was estimated using Spearman correlation coefficient. Results Preoperative CRP levels were normal (< 10 mg/l) in 77 patients (35.8%) with positive cultures. Low-virulent organisms were isolated in 66 PJIs (85.7%) with normal CRP levels. When grouping organisms by species, patients with an infection caused by Propionibacterium spp., coagulase-negative staphylococci (CNS), and Enterococcus faecalis had significantly lower median serum CRP levels (5.4 mg/l, 12.2 mg/l, and 23.7 mg/l, respectively), compared with those with infections caused by Staphylococcus aureus and Streptococcus spp. (194 mg/l and 89.3 mg/l, respectively; p < 0.001). Those with a chronic PJI had statistically lower median serum CRP levels (10.6 mg/l) than those with acute postoperative and acute haematogenous infections (83.7 mg/l and 149.4 mg/l, respectively; p < 0.001). There was a significant correlation between the number of positive cultures and serum CRP levels (Spearman correlation coefficient, 0.456; p < 0.001). Conclusion The CRP level alone is not accurate as a screening tool for PJI and may yield high false-negative rates, especially if the causative organism has low virulence. Aspiration of the joint should be used for the diagnosis of PJI in patients with a chronic painful arthroplasty, irrespective of CRP level. Cite this article: Bone Joint J 2018;100-B:1482–86.

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Serum C reactive protein levels and genetic variation in the CRP gene are not associated with the prevalence, incidence or progression of osteoarthritis independent of body mass index

Annals of the Rheumatic Diseases ◽

10.1136/ard.2009.125260 ◽

2010 ◽

Vol 69 (11) ◽

pp. 1976-1982 ◽

Cited By ~ 46

Author(s):

Hanneke J M Kerkhof ◽

Sita M A Bierma-Zeinstra ◽

Martha C Castano-Betancourt ◽

Moniek P de Maat ◽

Albert Hofman ◽

...

Keyword(s):

Systematic Review ◽

Body Mass Index ◽

Genetic Variation ◽

Body Mass ◽

Analysis Of Covariance ◽

C Reactive Protein ◽

Knee Oa ◽

Reactive Protein ◽

Serum Crp ◽

The Relationship

ObjectiveTo study the relationship between serum C reactive protein (CRP) levels, genetic variation in the CRP gene and the prevalence, incidence and progression of radiographic osteoarthritis (ROA) in the Rotterdam Study-I (RS-I). A systematic review of studies assessing the relationship between osteoarthritis (OA) and CRP levels was also performed.MethodsThe association between CRP levels and genetic variation in the CRP gene and ROA was examined in 861 patients with hand OA, 718 with knee OA, 349 with hip OA and 2806 controls in the RS-I using one-way analysis of covariance and logistic regression, respectively. PubMed was searched for articles published between January 1992 and August 2009 assessing the relationship between CRP levels and OA.ResultsIn RS-I the prevalence of knee OA, but not hip OA or hand OA, was associated with 14% higher serum CRP levels compared with controls (p=0.001). This association disappeared after adjustment for age and especially body mass index (BMI) (p=0.33). Genetic variation of the CRP gene was not consistently associated with the prevalence, incidence or progression of OA within RS-I. The systematic review included 18 studies (including RS-I) on serum CRP levels and the prevalence, incidence or progression of OA. Consistently higher crude CRP levels were found in cases of prevalent knee OA compared with controls. No association was observed between serum CRP levels and the prevalence of knee OA following adjustment for BMI (n=3 studies, meta-analysis p value=0.61).ConclusionThere is no evidence of association between serum CRP levels or genetic variation in the CRP gene with the prevalence, incidence or progression of OA independent of BMI.

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Kawasaki syndrome: the Iranian experience

Eastern Mediterranean Health Journal ◽

10.26719/2001.7.1-2.16 ◽

2001 ◽

Vol 7 (1-2) ◽

pp. 16-25 ◽

Cited By ~ 1

Author(s):

E. Sadeghi ◽

R. Amin ◽

G. H. Ajamee

Keyword(s):

Clinical Evidence ◽

Significant Risk ◽

Kawasaki Syndrome ◽

C Reactive Protein ◽

Female Ratio ◽

Reactive Protein ◽

Male Female Ratio ◽

Infection And Inflammation ◽

Islamic Republic Of Iran ◽

Artery Disease

Experience with 50 cases of Kawasaki syndrome in the Islamic Republic of Iran is presented. The syndrome occurred mostly in winter and spring with a 2.1: 1 male: female ratio. In 72% of cases, the disease occurred between 1 and 5 years of age, and 80% had an antecedent viral or bacterial illness. Eight patients [16%] had microbiological evidence of infection and 19 [38%] had clinical evidence. Five patients had clinical and radiological evidence of sinusitis. Leukocytosis, neutrophilia, bandaemia, elevated erythrocyte sedimentation rate, positive C-reactive protein, reversed albumin/globulin ratio and increased antistreptolysin O titre were other indications of infection and inflammation. Male gender, prolonged fever, white blood cell count > 15, 000/mm3 and absolute granulocyte count > 10, 000/mm3 were significant risk factors for the development of coronary artery disease [10 patients].

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Cytokine status in patients with myocardial infarction as a possible predictor of coronary atherosclerosis severity

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2020-2316 ◽

2020 ◽

Vol 19 (3) ◽

pp. 2316

Author(s):

O. V. Khlynova ◽

E. A. Shishkina ◽

N. I. Abgaryan

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Coronary Atherosclerosis ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

C Reactive Protein ◽

Reactive Protein ◽

Coronary Artery Atherosclerosis ◽

Tnf Α ◽

Atherosclerosis Severity

Aim. To study the association of cytokine status with coronary atherosclerosis severity in patients with myocardial infarction (MI).Material and methods. Between 11.2018 and 07.2019, 92 patients hospitalized with MI in Perm Clinical Cardiology Dispensary were included in the study. The control group consisted of 23 patients with stable coronary artery disease. In addition to the standard examination, enzyme-linked immunosorbent assay was used to determine the levels of interleukins (IL)-6, -10, tumor necrosis factor alpha (TNF-α), C-reactive protein.Results. Significant increase in plasma IL-6, TNF-α and C-reactive protein levels in MI patients compared with the control group. The increase in the concentration of IL-6, TNF-α, as well as the IL-6/IL-10 ratio occurs in proportion to coronary atherosclerosis severity. A direct correlation of Gensini score with IL-6, TNF-α, and IL-6/IL-10 ratio was established.Conclusion. Further study of cytokine profile parameters in MI patients will help a clearer understanding pathogenesis of coronary artery atherosclerosis. An increase in concentrations of IL-6, TNF-α, and IL-6/IL-10 ratio is associated with an increase in coronary atherosclerosis severity and can be used in practice for its prediction.

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