scholarly journals C - reactive protein of cerebrospinal fluid, as a sensitive approach for diagnosis of neonatal meningitis

2019 ◽  
Vol 19 (3) ◽  
pp. 2372-2377
Author(s):  
Shima Javadinia ◽  
Mohsen Tabasi ◽  
Mehri Naghdalipour ◽  
Najmosadat Atefi ◽  
Ramin Asgarian ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Great Majority ◽  
Diagnostic Value ◽  
Latex Agglutination ◽  
Neonatal Meningitis ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Permanent Brain Damage

Background: Meningitis, is a potentially life-threatening condition that can rapidly progress to permanent brain damage, neurologic problems, and even death. Bacteria and viruses cause the great majority of meningitis disease in infants and children. CRP is used mainly as a marker of inflammation.Objective: This study was conducted to assess the diagnostic value of CSF-CRP levels for differentiating between septic (bacterial) and aseptic infantile meningitis.Methods: 49 hospitalized infants aged less than two months with suspected meningitis were enrolled in a cross-sectional analytic study. All of patients underwent lumbar puncture to obtain CSF. smears, cultures, cytological and biochemical analysis and latex agglutination testing were carried out on all CSF samples. Latex agglutination test was carried out on all CSF samples using a commercially available kit. CSF-CRP level of all infants was measured using the immunoturbidometric technique.Results: Of 49 infants in this study, 20 and 29 cases were diagnosed as septic and aseptic meningitis, respectively. The CRP levels were obtained as 0.95±0.68 mg/L in septic and 0.16±0.36 mg/L in aseptic meningitis groups and this difference was statistically significant (p<0.001) between the two groups (0.79±0.32 mg/L). Based on the ROC curve, cut off levels for CRP was obtained 0.17 mg/L. At this level, there was 95% sensitivity and 86% specificity to differentiate septic and aseptic meningitis.Conclusion: CSF-CRP has suitable diagnostic value in distinguishing between infantile bacterial from aseptic meningitis especially in cases of negative bacterial culture of the blood and spinal fluid.Keywords: C-reactive protein, cerebrospinal fluid, septic/aseptic meningitis, infant, diagnostic value.

Cerebrospinal fluid C-reactive protein in meningitis: diagnostic value and pathophysiology

1986 ◽  
Vol 145 (4) ◽  
pp. 246-249 ◽  
Author(s):  
E. Ben Gershôm ◽  
G. J. J. Briggeman-Mol ◽  
F. de Zegher
Keyword(s):  
Cerebrospinal Fluid ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Dietary B Vitamins and Serum C-Reactive Protein in Persons With Human Immunodeficiency Virus Infection

2016 ◽  
Vol 37 (4) ◽  
pp. 517-528 ◽  
Author(s):  
Kalpana Poudel-Tandukar ◽  
Ram Krishna Chandyo
Keyword(s):  
Geometric Mean ◽  
Latex Agglutination ◽  
B Vitamins ◽  
C Reactive Protein ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Reactive Protein ◽  
The Mean ◽  
Serum Crp

Background: B vitamins may have beneficial roles in reducing inflammation; however, research on the role of B vitamins in inflammation among HIV-infected persons is lacking. Objective: This study assessed the association between B vitamins and serum C-reactive protein (CRP) concentrations in HIV-infected persons. Methods: A cross-sectional survey was conducted among 314 HIV-infected persons (180 men and 134 women) aged 18 to 60 years residing in the Kathmandu, Nepal. High-sensitive and regular serum CRP concentrations were measured by the latex agglutination nephelometry and latex agglutination turbidimetric method, respectively. Dietary intake was assessed using 2 nonconsecutive 24-hour dietary recalls. The relationships between B vitamins and serum CRP concentrations were assessed using multiple regression analysis. Results: The multivariate-adjusted geometric mean of serum CRP concentrations was significantly decreased with an increasing B vitamins intake across quartiles of niacin ( P for trend = .007), pyridoxine ( P for trend = .042), and cobalamin ( P for trend = .037) in men. In men, the mean serum CRP concentrations in the highest quartiles of niacin, pyridoxine, and cobalamin were 63%, 38%, and 58%, respectively, lower than that in the lowest quartile. In women, the mean serum CRP concentrations in the highest quartiles of riboflavin ( P for trend = .084) and pyridoxine ( P for trend = .093) were 37% and 47%, respectively, lower than that in the lowest quartile. Conclusion: High intake of niacin, pyridoxine, or cobalamin was independently associated with decreased serum CRP concentrations among HIV-infected men. Further prospective studies are warranted to confirm the role of B vitamins in inflammation among HIV-infected persons.

scholarly journals Diagnostic value of C-reactive protein and neutrophil-limphocyte ratio in perforated appendicitis at Hasan Sadikin Hospital Bandung

2017 ◽  
Vol 4 (10) ◽  
pp. 3196 ◽  
Author(s):  
Reno Rudiman ◽  
Tommy Ruchimat ◽  
Yohanes Ferdinand
Keyword(s):  
Surgical Techniques ◽  
Perforated Appendicitis ◽  
The Elderly ◽  
Diagnostic Value ◽  
Surgical Approaches ◽  
C Reactive Protein ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Sensitivity Specificity

Background: The diagnosis of appendicitis depends on the subjective criteria of clinical examination. However, distinguishing acute perforated appendicitis (local peritonitis) and non-perforated is often difficult especially in the elderly population that usually not clinically specific unless it has developed into generalized peritonitis. Between the non-perforated acute appendicitis and perforate should be distinguished because of different surgical approaches. C-reactive protein (CRP) and neutrophil-lymphocyte ratios are known to be associated with various conditions such as malignancy, heart disease, and inflammation, including acute perforated appendicitis. This examination not only is cheaper, but also feasible and available in peripheral hospitals compared to other supports such as ultrasound or CT scan, but this examination has not been routinely used so the purpose of this study is to examine the diagnostic accuracy of both laboratory parameters so as to assist a surgeon to determine whether the case of appendicitis has been perforated or not and can provide information to patients and the families about the diseases and surgical techniques to be performed.Methods: This study used cross sectional analytic in two groups, appendicitis with and without perforation group to know the value of sensitivity, specificity, positive predictor value, negative predictor value, from CRP and RNL in both groups.Results: Of the 46 patients who met the inclusion criteria, the mean age of patients with perforated appendicitis was 33.73±17.101, male sex counted 26 patients (56.5%) and women 20 patients (43.5%). Based on ROC curve analysis, CRP = 76,65 and RNL = 8,825 were obtained, and sensitivity, specificity, positive guess, negative prediction and accuracy value for CRP were 88.0%, 71.4%, 78 %, 5%, 83.3% and 80.4%; While for RNL of 64.0%, 80.9%, 80.0%, NDN, and 71.7%.Conclusions: CRP and RNL have a strong diagnostic value and is moderately strong in cases of perforated appendicitis.

Cerebrospinal fluid C-reactive protein in neonatal meningitis

1983 ◽  
Vol 102 (5) ◽  
pp. 715-717 ◽  
Author(s):  
Alistair G.S. Philip ◽  
Carol J. Baker
Keyword(s):  
Cerebrospinal Fluid ◽  
Neonatal Meningitis ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Cerebrospinal fluid changes and clinical features of aseptic meningitis in patients with Kawasaki disease

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098021
Author(s):  
Fan Hu ◽  
Xiaoqing Shi ◽  
Yang Fan ◽  
Hanmin Liu ◽  
Kaiyu Zhou
Keyword(s):  
Cerebrospinal Fluid ◽  
Kawasaki Disease ◽  
Aseptic Meningitis ◽  
Enzyme Level ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
C Reactive Protein ◽  
Neck Stiffness ◽  
Laboratory Parameters ◽  
Reactive Protein

Objective To assess the distinguishing features of aseptic meningitis (AM) in patients with Kawasaki disease (KD) compared with bacterial meningitis (BM) patients. Methods Thirty-eight patients with KD and 126 patients with BM were retrospectively investigated. The following clinical manifestations and laboratory parameters were compared between the two groups: duration of fever before lumbar puncture, conjunctival injection, oral cavity changes, rash, cervical lymphadenopathy and extremity changes, vomiting, front fontanel bulging, neck stiffness, leukocyte number, hemoglobin level, platelet number, C-reactive protein level, cerebrospinal fluid (CSF) content, liver enzyme level, and urinalysis. Results Vomiting and neck stiffness were more prevalent in patients with BM. KD patients with AM showed elevated blood leukocyte numbers and C-reactive protein levels in the early febrile stage. CSF glucose was significantly lower in patients with BM compared with KD patients with AM. Receiver operating characteristic curve analysis showed that the optimal cutoff value of CSF glucose for discrimination of BM and AM/KD was 2.945 mmol/L, with a sensitivity of 84.2% and a specificity of 71.4%. Conclusions Detailed investigations of clinical manifestation and laboratory parameters are necessary to distinguish AM and BM in patients with KD. Decreased CSF glucose is a potential indicator of BM.

scholarly journals The cerebrospinal fluid changes and clinical characteristics of aseptic meningitis in Kawasaki disease

2020 ◽  
Author(s):  
Fan Hu ◽  
Xiaoqing Shi ◽  
Yang Fan ◽  
Hanmin Liu ◽  
Kaiyu Zhou
Keyword(s):  
Cerebrospinal Fluid ◽  
Kawasaki Disease ◽  
Aseptic Meningitis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Cervical Lymphadenopathy ◽  
C Reactive Protein ◽  
Neck Stiffness ◽  
Reactive Protein ◽  
Significant Difference

Abstract Background: Aseptic meningitis is not a common feature in Kawasaki disease (KD). However, it could cause difficulty in making correct and in-time diagnosis Methods: We retrospectively investigated patients of KD and bacterial meningitis (BM). Totally 38 KD patients and 126 BM patients were brought into this study. Clinical symptoms, signs and laboratory examinations were compared between the two groups, which included: duration of fever before lumbar puncture, conjunctiva injection, oral cavity change, rash, cervical lymphadenopathy and extremities change, vomiting, front fontanel bulging, neck stiffness, leukocytes, hemoglobin, platelets, C-reactive protein, cerebrospinal fluid examinations, liver function and urinalysis. Results: In clinical signs, vomit and neck stiffness were more prevalent in BM. KD patients showed higher blood leukocyte (p<0.001) and C-reactive protein (p<0.001) in the early febrile stage. Glucose in cerebrospinal fluid of BM patients was significantly lower than KD patients (p=0.003). In ROC curve, the optimal cutoff value of CSF glucose was 2.945mmol/L with the sensitivity of 84.2% and specificity of 71.4%. Pyuria was more prevalent in KD patients (p<0.001). There was no significant difference in front fontanel bulging, hemoglobin, platelet, alanine transaminase, aspartate transaminase, albumin, cerebrospinal fluid leukocytes, cerebrospinal fluid protein and cerebrospinal fluid lactate dehydrogenase. Conclusions ： Full investigation of clinical manifestation and laboratory tests is necessary to distinguish KD with aseptic meningitis and BM. In CSF study, glucose level is more efficient than other items to distinguish these two diseases. Decreased CSF glucose is possibly an indicator of BM rather than KD.

scholarly journals C-reactive protein and total serum bilirubin as a predictor of perforated appendicitis: a cross sectional study

2018 ◽  
Vol 5 (7) ◽  
pp. 2574
Author(s):  
Anil Reddy Pinate ◽  
Shivakumar C. R. ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Sharangouda Patil
Keyword(s):  
Acute Appendicitis ◽  
Serum Bilirubin ◽  
Perforated Appendicitis ◽  
Diagnostic Value ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Perforated Appendix

Background: C-reactive protein (CRP) and bilirubin have been used as adjuncts for diagnosis of appendicitis. This study assessed the diagnostic value of these markers in patients with suspected acute appendicitis.Methods: CRP values and total serum bilirubin among the patients who presented with acute appendicitis were compared among patients who had perforated appendix and non- perforated appendix. The diagnostic value of CRP and TSB markers as a predictor for perforation were compared in terms of Sensitivity, specificity, PPVs and NPV and the diagnostic accuracy assessed by AUC using receiver operating characteristic (ROC) curve analysis.Results: This study showed sensitivity is 72.50%, specificity of 92.23%, positive predictive value of 78.38% for a raised CRP. The sensitivity of TSB for predicting perforation is 77.50 and the values of specificity, PPV and NPV of the same are 87.38 %, 70.45% and 90.91% respectively. The area under curve was more for CRP than TSB indicating that CRP is better predictor for perforation in appendicitis as compared to the TSB.Conclusions: Thus, serum CRP and total serum bilirubin (TSB) can be used as useful markers for early diagnosis and prediction of perforation in cases of acute appendicitis.

scholarly journals Nocturnal intermittent hypoxia and C reactive protein among middle-aged community residents: a cross-sectional survey

Thorax ◽  
2010 ◽  
Vol 65 (6) ◽  
pp. 523-527 ◽  
Author(s):  
I. Muraki ◽  
T. Tanigawa ◽  
K. Yamagishi ◽  
S. Sakurai ◽  
T. Ohira ◽  
...  
Keyword(s):  
Intermittent Hypoxia ◽  
C Reactive Protein ◽  
Middle Aged ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Community Residents

Diagnostic value of procalcitonin, erythrocyte sedimentation rate (ESR), quantitative C-reactive protein (CRP) and clinical findings associated with osteomyelitis in patients with diabetic foot

2021 ◽  
pp. 1-7
Author(s):  
Zahra Soleimani ◽  
Fatemeh Amighi ◽  
Zarichehr Vakili ◽  
Mansooreh Momen-Heravi ◽  
Seyyed Alireza Moravveji
Keyword(s):  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Roc Curve ◽  
Diabetic Foot ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Diabetic Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation

BACKGROUND: The diagnosis of osteomyelitis is a key step of diabetic foot management. Procalcitonin (PCT) is a novel infection marker. This study aimed to investigate the diagnostic value of procalcitonin and other conventional infection markers and clinical findings in diagnosis of osteomyelitis in diabetic foot patients. METHODS AND MATERIALS: This diagnostic value study was carried out on ninety patients with diabetic infected foot ulcers admitted in Kashan Beheshti Hospital, 2016. After obtaining consent, 10 cc blood sample was taken for measuring serum PCT, CBC, ESR, CRP and FBS. Clinical characteristics of the wounds were noted. Magnetic resonance imaging of the foot was performed in all patients to diagnose osteomyelitis. All statistical analyses were done with the use of SPSS-16. RESULTS: PCT levels were 0.13 ± 0.02 ng/mili patients with osteomyelitis (n= 45) and 0.04 ± 0.02 ng/ml in patients without osteomyelitis (n= 45). PCT, Erythrocyte sedimentation rate and C-reactive protein was found significantly higher in patients with osteomyelitis (p< 0.001). The ROC curve was calculated for PCT. The area under the ROC curve for infection identification was 1 (p< 0.001). The best cut-off value for PCT was 0.085 ng/ml. Sensitivity, specificity, and positive and negative predictive values were 100%, 97.8%,97.8% and 100%, respectively. CONCLUSION: In this group of patients, PCT was useful to discriminate patients with bone infection. Also, Erythrocyte sedimentation rate and C-reactive protein can be used as a marker of osteomyelitis in diabetic patients.

scholarly journals POS0765 LABORATORY RATIOS: A SUBROGATE BIOMARKER FOR DETECTION OF INFECTION IN SLE PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 636.1-636
Author(s):  
Y. Santamaria-Alza ◽  
J. Sanchez-Bautista ◽  
T. Urrego Callejas ◽  
J. Moreno ◽  
F. Jaimes ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Logistic Regression ◽  
Roc Curve ◽  
Lupus Erythematosus ◽  
Statistical Significance ◽  
C Reactive Protein ◽  
Systemic Lupus ◽  
Predictive Capacity ◽  
Cross Sectional ◽  
Reactive Protein

Background:The most common complication in patients with SLE is infection, and its clinical presentation is often indistinguishable from SLE flares. Therefore, laboratory ratios have been evaluated to differentiate between those events. Among them, ESR/CRP1, neutrophil/lymphocyte (NLR)2, and platelet/lymphocyte (PLR)3 ratios have been previously assessed with acceptable performance; however, there is no validation of those ratios in our SLE population.Objectives:To examine the predictive capacity of infection of the lymphocyte/C4 (LC4R), lymphocyte/C3 (LC3R), and ferritin/ESR (FER) ratios in SLE patients, and to evaluate the performance of ESR/CRP, NLR, AND PLR ratios in our SLE population.Methods:We conducted a cross-sectional study of SLE patients admitted to the emergency service at Hospital San Vicente Fundación (HSVF). The HSVF ethics committee approved the execution of the project.Patients were categorized into four groups according to the main cause of hospitalization: (1) infection, (2) flare, (3) infection and flare and, (4) neither infection nor flare.We calculated the median values of the ratios and their respective interquartile ranges for each group. Then, we compared those summary measures using the Kruskal-Wallis test. Subsequently, we assessed the predictive capacity of infection of each ratio using ROC curve. Finally, we carried out a logistic regression model.Results:A total of 246 patients were included, among them 90.7% were women. The median age was 28 years (IQR: 20-35 years). Regarding the outcomes, 37.0% of the patients had flares, 30.9% had neither infection nor flare, 16.7% had an infection and, 15.5% had simultaneously infection and flare. When compared the four groups, statistical significance (p<0.05) was observed. Area under the ROC curve (AUC) for infection prediction was as follows: 0.752 (sensitivity 60.5%, specificity 80.5%) for LC4R, 0.740 (sensitivity 73.2%, specificity 68.3%) for FER, 0.731 (sensitivity 77.6%, specificity 80.5%) for LC3R.In the logistic regression modeling, we observed that an increase in the risk of infection was associated with an LC4R below 66.7 (OR: 6.3, CI: 2.7 – 14.3, p <0.0001), a FER greater than 13.6 (OR: 5.9, CI: 2.8 – 12.1, p <0.0001) and an LC3R below 11.2 (OR: 4.9, CI: 2.4 – 9.8, p <0.0001).The ESR/CRP and PLR performed poorly with an AUC of 0.580 and 0.655, respectively. In contrast, the NLR showed better performance (AUC of 0.709, with a sensitivity of 80.2% and specificity of 55.7%).Figure 1.ROC curves of the evaluated ratiosConclusion:These laboratory ratios could be easy to assay and inexpensive biomarkers to differentiate between infection and activity in SLE patients. The LC4R, FER, and LC3R have a significant diagnostic performance for detecting infection among SLE patients. Of the ratios previously evaluated, ESR/CRP, LPR, NLR, only the latest has an adequate performance in our population.References:[1]Littlejohn E, Marder W, Lewis E, et al. The ratio of erythrocyte sedimentation rate to C-reactive protein is useful in distinguishing infection from flare in systemic lupus erythematosus patients presenting with fever. Lupus. 2018;27(7):1123-1129.[2]Broca-Garcia BE, Saavedra MA, Martínez-Bencomo MA, et al. Utility of neutrophil-to-lymphocyte ratio plus C-reactive protein for infection in systemic lupus erythematosus. Lupus. 2019;28(2):217-222.[3]Soliman WM, Sherif NM, Ghanima IM, EL-Badawy MA. Neutrophil to lymphocyte and platelet to lymphocyte ratios in systemic lupus erythematosus: Relation with disease activity and lupus nephritis. Reumatol Clin. 2020;16(4):255-261s.Disclosure of Interests:None declared

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