Increase In C-reactive Protein Levels Research Articles

Serum C-reactive protein in adolescence and risk of schizophrenia in adulthood: A prospective birth cohort study

ObjectiveMeta-analyses of cross-sectional studies confirm an increase in circulating inflammatory markers during acute psychosis. Longitudinal studies are scarce but are needed to understand whether elevated inflammatory markers are a cause or consequence of illness. We report a longitudinal study of serum C-reactive protein (CRP) in adolescence and subsequent risk of schizophrenia and related psychoses in adulthood in the Northern Finland Birth Cohort 1986. MethodSerum high-sensitivity CRP was measured at age 15/16 years in 6362 participants. ICD-10 diagnoses of schizophrenia and related psychoses were obtained from centralised hospital inpatient and outpatient registers up to age 27 years. Logistic regression calculated odds ratios (ORs) for psychotic outcomes associated with baseline CRP levels analysed as both continuous and categorical variables using American Heart Association criteria. Age, sex, body mass index, maternal education, smoking, and alcohol use were included as potential confounders. ResultsBy age 27years, 88 cases of non-affective psychosis (1.38%), of which 22 were schizophrenia (0.35%), were identified. Adolescent CRP was associated with subsequent schizophrenia. The adjusted OR for schizophrenia by age 27yearsfor each standard deviation (SD) increase in CRP levels at age 15/16yearswas 1.25 (95% CI, 1.07–1.46), which was consistent with a linear, dose-response relationship (P-value for quadratic term 0.23). Using CRP as a categorical variable, those with high (>3mg/L) compared with low (<1mg/L) CRP levels at baseline were more likely to develop schizophrenia; adjusted OR 4.25 (95% CI, 1.30–13.93). There was some indication that higher CRP was associated with earlier onset of schizophrenia (rs=−0.40; P=0.07). ConclusionsA longitudinal association between adolescent CRP levels and adult schizophrenia diagnosis indicates a potentially important role of inflammation in the pathogenesis of the illness, although the findings, based on a small number of cases, need to be interpreted with caution and require replication in other samples.

Trends in C-Reactive Protein Levels Are Associated with Neurological Change Twenty-Four Hours after Thrombolysis for Acute Ischemic Stroke

Elevated inflammatory markers such as C-reactive protein (CRP) are associated with worse outcomes in patients thrombolysed for acute ischemic stroke (AIS). To investigate whether changes in CRP levels are associated with neurological change after thrombolysis for AIS. Retrospective analysis of a single-center database of consecutive thrombolysis cases for AIS from October 18, 2011, to June 15, 2015, inclusive. Multivariate regression analysis was used to investigate the relationship between change in CRP 12-24 hours after thrombolysis and change in NIHSS (National Institutes of Health Stroke Scale) score 24 hours after thrombolysis. The other potentially confounding predictor variables included in the model were CRP on admission and NIHSS score before thrombolysis. Complete data were available for 108 out of possible 435 eligible patients. Increases in CRP levels 12-24 hours after thrombolysis were negatively associated with reduction in NIHSS score 24 hours after thrombolysis (coefficient .08, 95% confidence interval .031-.129, P = .002). Thus, on average, for every 12.5 mg/L additional increase in CRP 12-24 hours after thrombolysis, NIHSS score at 24 hours improved by 1 point less. While it was previously known that elevated CRP levels are associated with worse outcomes in patients thrombolysed for AIS, the current work demonstrates that changes in CRP levels after thrombolysis also relate to neurological change, and thus may have scope for use as prognostic markers.

Role of Doppler Ultrasonography and C-Reactive Protein in Patients with Acute Scrotum

This research was designate with an intention to find the role of Doppler ultrasonography (DUS) and C-reactive protein (CRP) in patients with acute scrotum. A sum of 80 (mean age 23±2.1 years) consequential patients were recruited for a period of six months between July 2015 and January 2016 in this prospective study. Collected data confined age, medical history, and clinical symptoms. DUS was performed with a linear array transducer (10-15 MHz) connected to HI vision Avius ultrasound unit; Hitachi. CRP was measured using turbidimetric analysis through the Cobas Integra analyzer system (Test CRPL2, 0-293); Roche Diagnostics. Statistical analysis was accomplished using the standard Statistical Package for the Social Sciences version 20 for Windows; Microsoft. Fitted achievement values for DUS in the diagnosis of testicular torsion, epididymo-orchitis, and varicocele were respectively 100%, 91% and 88% for sensitivity, 92%, 71%, and 90% for specificity, and 94%, 83%, and 89% for accuracy. An increased in the serum CRP level (63.2±40.2 mg/L) was seen in an inflammatory cause of the acute scrotum. In contrast, there was no increase in CRP level (8±3.1 mg/L) in the non-inflammatory cases (P &lt; 0.0001). Scrotal DUS is a highly precise preoperative diagnostic instrument, thereby confirm its course application in the incipient triage of patients with acute scrotum. Serum level of CRP can afford useful advice for differentiation between inflammatory and other reasons of the acute scrotum.

Association between interleukin 6 -174 G/C promoter gene polymorphism and runners' responses to the dietary ingestion of antioxidant supplementation based on pequi (Caryocar brasiliense Camb.) oil: a before-after study.

Exercise is a double-edged sword: when practiced in moderation, it increases the expression of antioxidant enzymes, but when practiced strenuously it causes oxidative stress and cell damage. In this context, polymorphisms in the interleukin (IL)-6 gene should be investigated better because they can influence performance, at least in exercise that generates oxidative stress and leads to muscular injuries with consequent inflammation. In this work, we investigated the influence of IL-6 –174 G/C polymorphism on tissue damage and inflammation markers, lipid peroxidation, hemogram and lipid profile of runners before and after ingestion of 400 mg of pequi oil in capsules supplied daily for 14 consecutive days. The IL-6 genotypes were associated with significant differences in lipid peroxidation, with the CC mutant having lower values. There were also significant differences among these genotypes in the response to supplementation with pequi oil, exercise-induced damage and C-reactive protein (CRP) levels. The best protection against damage was observed with the heterozygous genotype. Although the CC genotype showed an increase in CRP levels after supplementation, the lack of a positive correlation between triglycerides and high-sensitivity CRP in this mutant genotype after supplementation indicated a protective effect of pequi. These findings deserve further investigation, particularly with regard to the quantification of circulating IL-6 concentrations.

The Role of Mean Platelet Volume in Chronic Obstructive Pulmonary Disease Exacerbation.

Studies have supported the correlation between mean platelet volume and COPD. However, there are limited data on the relationship between COPD exacerbation and mean platelet volume. We aimed to evaluate the mean platelet volume trend in patients with COPD exacerbation. A total of 81 subjects, 62 men and 19 women, who were admitted to the hospital because of exacerbation of COPD during 9 months, were enrolled in this prospective observational study. The levels of mean platelet volume, C-reactive protein, complete blood count, and percent-of-predicted FEV1 were measured in subjects at admission (exacerbation period) and after 3 months (stable period). Thirty-seven age- and sex-matched healthy individuals constituted the control group. Subjects in the exacerbation period had significantly higher levels of C-reactive protein (P = .001), white blood cell count (P = .01), and percentage of neutrophils (P = .01) and lower percent-of-predicted FEV1 than in the stable period (P = .02). Mean platelet volume levels were significantly decreased in the exacerbation period (P = .001). Considering a cut-off point of mean platelet volume levels <8.2 fL for indicating COPD exacerbation showed a sensitivity of 80% and a specificity of 76%. Also, mean platelet volume levels correlated significantly with increase of C-reactive protein level, white blood cell count, and neutrophil percentage in the exacerbation period (P = .01, P = .01, and P = .02, respectively). Mean platelet volume may be an inflammatory marker in exacerbation of COPD, and the measurement of mean platelet volume values may be useful for identifying patients who are at increased risk for exacerbations of illness.

Evaluation correlates C-reactive protein with advanced stage Hodgkin's lymphoma and response to treatment in a tertiary university hospital in Brazil.

ObjectiveTo demonstrate a correlation of C-reactive protein levels with disease stage and response to treatment in Hodgkin's lymphoma patients of the Hematology Service of Santa Casa de São Paulo.MethodsA retrospective study based on review of medical records was carried out of 38 patients diagnosed with Hodgkin's lymphoma between October 2010 and December 2012. Three patients met the exclusion criteria, giving a final sample of 35 patients for analysis. C-reactive protein levels >1 mg/dL were considered positive.ResultsAmong the patients analyzed, median age was 29 years, 65% were male and 85% had the classical nodular sclerosis subtype. Twenty-nine (82%) were in the advanced stage and 28% had bulky mass at diagnosis. Seventeen percent had bone marrow invasion by lymphoma. Baseline C-reactive protein levels were associated with both stage (p-value = 0.0035) and presence or absence of B symptoms (p-value = 0.008). The highest C-reactive protein levels were detected in patients with advanced disease while no patients with localized disease had C-reactive protein >5 mg/dL (p-value = 0.02). After the first treatment cycle, C-reactive protein fell to near-normal levels and no direct association with response pattern was found. As the mean follow-up was only 14 months, it was not possible to determine whether relapse was accompanied by a further increase in C-reactive protein.ConclusionBaseline C-reactive protein levels directly correlated with stage and presence or absence of B symptoms, but the degree of improvement with treatment did not correlate with response pattern. After a longer follow-up, it may be possible to assess whether relapse correlates with a further increase in C-reactive protein levels.

C-reactive protein gene variants associated with recurrent pregnancy loss independent of CRP serum levels: A case-control study

The aim of this study is to investigate the association of recurrent pregnancy loss (RPL) with altered C-reactive protein (CRP) serum levels, and genetic variation in CRP gene. This was a retrospective case–control study, involving 275 women with three or more consecutive pregnancy losses, and 290 age-matched control women, who were recruited from outpatient obstetrics/gynecology clinics. CRP serum levels (hs-CRP) were determined by latex-enhanced nephelometry, and CRP genotyping was done by allelic discrimination. Mean serum CRP levels were higher in RPL cases than in control women, and carriage of the (minor) T allele of rs2794520 was associated with significant increase in CRP levels (P=0.017). Minor allele frequency (MAF) of rs7553007 was significantly different between RPL cases and control women, and was associated with reduced risk of RPL after adjusting for BMI and menarche. There was a significant enrichment of minor allele-carrying genotypes of rs1130864 and rs1417938 SNPs, and reduced frequency of minor allele-carrying genotypes of rs876537, rs2794520, and rs7553007 in RPL cases, thus assigning RPL-susceptible and -protective nature to these genotypes, respectively. Carriage of (minor) T allele of only rs2794520 was associated with significant increase in CRP levels. CRP variants that influenced circulating CRP levels in chronic inflammatory conditions are also associated with RPL, pointing to CRP as RPL candidate gene.

Post-effort chances in C-reactive protein level among soccer players at the end of the training season.

Numerous literature data point out the differences in immunological parameters as a result of physical effort and the relation of those changes to the subject's fitness level. This study was aimed at the assessment of soccer players' condition and adaptation to physical effort based on the changes in C-reactive protein (CRP) blood level. C-reactive protein, total protein, and albumin plasma levels before and after 60-minute-long outdoor running were determined among 16 (8 men and 8 women) soccer players. Statistically significant increase in total blood protein level was observed in both studied groups. However, there were no statistically significant changes in albumin level in soccer players' blood. Determination of CRP showed that the exercise test caused changes in its level among both women and men; yet, statistically significant increase in CRP level was found only in women's blood. The different influence of effort on CRP plasma level may be explained by the involvement of various mechanisms in regulation of acute-phase responses in different conditions. It was found in our study that CRP level could be a valuable tool to assess the metabolic response to aerobic exercise.

What is the influence of hormone therapy on homocysteine and crp levels in postmenopausal women?

OBJECTIVE:To evaluate the influence of estrogen therapy and estrogen-progestin therapy on homocysteine and C-reactive protein levels in postmenopausal women.METHODS:In total, 99 postmenopausal women were included in this double-blind, randomized clinical trial and divided into three groups: Group A used estrogen therapy alone (2.0 mg of 17β-estradiol), Group B received estrogen-progestin therapy (2.0 mg of 17 β-estradiol +1.0 mg of norethisterone acetate) and Group C received a placebo (control). The length of treatment was six months. Serum measurements of homocysteine and C-reactive protein were carried out prior to the onset of treatment and following six months of therapy.RESULTS:After six months of treatment, there was a 20.7% reduction in homocysteine levels and a 100.5% increase in C-reactive protein levels in the group of women who used estrogen therapy. With respect to the estrogen-progestin group, there was a 12.2% decrease in homocysteine levels and a 93.5% increase in C-reactive protein levels.CONCLUSION:Our data suggested that hormone therapy (unopposed estrogen or estrogen associated with progestin) may have a positive influence on decreasing cardiovascular risk due to a significant reduction in homocysteine levels.

Effect of inflammatory factor-induced cyclo-oxygenase expression on the development of reperfusion-related no-reflow phenomenon in acute myocardial infarction.

No reflow after reperfusion therapy for myocardial infarction is a strong predictor of clinical outcome. Increased levels of inflammatory factors, including C-reactive protein (CRP), in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) may affect myocardial perfusion. However, why the no-reflow phenomenon increases in inflammation stress after PCI is not clear. The aim of the present study was to determine the effects and molecular mechanisms underlying the effects of CRP on the expression of cyclo-oxygenase (COX) on the development of the no-reflow phenomenon. There was a significant increase in plasma levels of CRP and interleukin (IL)-6 in no-reflow patients, suggesting that inflammatory factors play an important role in the development of the no-reflow phenomenon. The mechanisms involved were further evaluated after reperfusion in a rat model mimicking the no-reflow phenomenon. Compared with normal reflow rats, there were significant increases in both COX-1 and COX-2 in cardiac tissue from no-reflow rats. The COX inhibitor indomethacin (5 mg/kg, i.p.) significantly reduced the no-reflow area. In another series of experiments, human coronary artery endothelial cells (HCAEC) were treated with CRP at clinically relevant concentrations (5-25 μg/mL). C-Reactive protein significantly increased COX-1 and COX-2 levels in a time- and concentration-dependent manner. In addition, extracellular signal-regulated kinase (ERK) and Jun N-terminal kinase (JNK) were activated in CRP (5, 10, 25 μg/mL)-treated HCAEC cultures. Furthermore, the ERK inhibitor pd98059 (30 μmol/L) and the JNK inhibitor sp600125 (10 μmol/L) blocked CRP-induced COX-1 and COX-2 expression for 12 h. Together, the findings of the present study suggest that CRP can promote the development of the no-reflow phenomenon by increasing COX-1 and COX-2 expression, which is regulated, in part, via ERK and JNK activity.

C-reactive protein estimation: a quantitative analysis for three nonsteroidal anti-inflammatory drugs: a randomized control trial.

C-reactive protein (CRP) estimation for quantitative analysis to assess anti-inflammatory action of nonsteroidal anti-inflammatory drugs (NSAIDs) after surgery in maxillofacial surgery. This study was to evaluate the efficacy of CRP as a quantitative analysis for objective assessment of efficacy of three NSAIDs in postoperative inflammation and pain control. The parallel study group design of randomization was done. Totally 60 patients were divided into three groups. CRP was evaluated at baseline and postoperatively (immediate and 72 h) after surgical removal of impacted lower third molar. The respective group received the drugs by random coding postoperatively. The assessment of pain control and inflammation using NSAIDs postoperatively after surgical removal of impacted lower third molar was qualitatively and quantitatively assessed with CRP levels. The blood sample of the patient was assessed immediate postoperatively and after 72 h. The visual analog scale (VAS) was used for assessment of pain and its correlation with CRP levels. Comparison of difference in levels of CRP levels had P < 0.05 with immediate postoperative and baseline levels. The duration of surgery with association of CRP levels P = 0.425 which was nonsignificant. The pain score was increased with mefenamic acid (P = 0.003), which was significant on VAS. Diclofenac had the best anti-inflammatory action. There was a significant increase in CRP levels in immediate postoperative values and 72 h. CRP test proved to be a useful indicator as a quantitative assessment tool for monitoring postsurgical inflammation and therapeutic effects of various anti-inflammatory drugs. CRP test is a useful indicator for quantitative assessment for comparative evaluation of NSAIDs.

Alterations in Lipid Metabolism and Antioxidant Status in Lichen Planus.

Background:Lichen planus (LP), a T-cell-mediated inflammatory disorder, wherein inflammation produces lipid metabolism disturbances, is linked to increase in cardiovascular (CV) risk with dyslipidemia. Increased reactive oxygen species and lipid peroxides have also been implicated in its pathogenesis.Aim and Objective:The aim of the study was to evaluate the status on lipid disturbances, oxidative stress, and inflammation in LP patients.Materials and Methods:The study was initiated after obtaining Institutional Ethics Committee permission and written informed consent from participants. The study included 125 patients (74 LP patients and 51 age and sex-matched controls) visiting the outpatient clinic in the dermatology department of our hospital. Variables analyzed included lipid profile, C-reactive protein (CRP), malondialdehyde (MDA), and catalase (CAT) activity.Results:Analysis of lipid parameters revealed significantly higher levels of total cholesterol (TC), triglycerides, and low-density lipoprotein cholesterol (LDL-C) along with decreased levels of high-density lipoprotein cholesterol (HDL-C) in LP patients as compared to their respective controls. LP patients also presented with a significantly higher atherogenic index that is, (TC/HDL-C) and LDL-C/HDL-C ratios than the controls. A significant increase in CRP levels was observed among the LP patients. There was a statistically significant increase in the serum levels of the lipid peroxidation product, MDA and a statistically significant decrease in CAT activity in LP patients as compared to their respective controls. A statistically significant positive correlation (r = 0.96) was observed between serum MDA levels and duration of LP whereas a significantly negative correlation (r = −0.76) was seen between CAT activity and LP duration.Conclusion:Chronic inflammation in patients with LP may explain the association with dyslipidemia and CV risk. Our findings also suggest that an increase in oxidative stress and imbalance in the antioxidant defense mechanisms in LP may play a role in the pathogenesis of LP.

Monitoring C-reactive protein levels during medical management of acute appendicitis to predict the need for surgery.

To clarify the role of medical treatment in the management of acute appendicitis and the value of C-reactive protein (CRP) for predicting its failure. Patients with clinically diagnosed acute appendicitis, confirmed by imaging studies, were enrolled in this study. We measured leukocyte counts and CRP levels and recorded success and recurrence rates and the efficiency of medical treatment during follow-up. The efficiency of CRP values to predict failure of medical treatment was evaluated using receiver operating characteristics (ROC) curve analysis. The subjects comprised 193 patients (mean age 30.9 years) who received medical treatment for acute appendicitis. The mean follow-up period was 12.3 (6-24) months and the early success rate of medical treatment was 86.5 % (160/185). Fifteen (9.3 %) patients suffered recurrence during follow-up. The leukocyte and CRP levels in these two groups of patients were not significantly different at the beginning of the treatment, but the increase in the CRP value differed significantly between the two groups during the follow-up period (p < 0.001). ROC curve analysis suggested that the optimum CRP cut-off point for unsuccessful medical treatment was 80.8 mg/L, with 81.82 % sensitivity and 84.34 % specificity (p < 0.001). The success rate for treating acute appendicitis medically is high, with antibiotic treatment being effective as the firstline therapy for many unselected patients. An increase in CRP levels to 80.8 mg/L and above seems to be a meaningful parameter for determining a lack of response to medical treatment.

Pure Single-Port Laparoscopic Distal Gastrectomy for Early Gastric Cancer: Comparative Study with Multi-Port Laparoscopic Distal Gastrectomy

The purpose of this study was to show the feasibility and safety of pure single-port laparoscopic distal gastrectomy (SDG) by comparing its short-term outcomes with those of conventional multiport totally laparoscopic distal gastrectomy (TLDG). Prospectively collected data of 50 gastric cancer patients who underwent pure SDG from November 2011 through October 2013 were compared with the matched data of 50 TLDG patients. Mean operation time (144.5 vs 140.3 minutes; p= 0.561) and number of harvested lymph nodes (51.7 ± 16.3 vs 52.4 ± 17.9; p= 0.836) were comparable. Estimated blood loss was lower in the SDG patients (50.5 ± 31.5 mL vs 87.5 ± 79.6 mL; p= 0.007). Postoperative recovery was faster in the SDG patients in terms of lower maximum pain score on the operative day (6.1 ± 1.4 vs 6.9 ± 1.5; p= 0.015) and postoperative day 1 (4.6 ± 1.0 vs 5.5 ± 1.4; p < 0.001), less use of parenteral analgesics (0.8 ± 1.0 vs 1.4 ± 1.0; p= 0.020), and less increase in C-reactive protein level on postoperative day 5 (4.57 ± 6.26 mg/L vs 8.51 ± 5.25 mg/L; p= 0.008). Postoperative morbidity occurred in 6 (12%) and 5 (10%) patients in the SDG and TLDG group, respectively. This study showed that pure SDG is both safe and feasible for early gastric cancer, with similar operation time and better short-term outcomes than TLDG in terms of postoperative pain, estimated blood loss, inflammatory reaction, and cosmetic result.

FRI0067 Anti-Citrullinated Protein Antibodies and Generalised Bone Loss in Patients with Early Rheumatoid Arthritis: A Causal Relationship?

BackgroundAnti-citrullinated protein antibodies (ACPA) are a major risk factor for bone destruction in rheumatoid arthritis (RA). ACPA may directly induce bone loss by stimulating osteoclast differentiation [1]. Accordingly, the trabecular...

The relationship between C-reactive protein and the lapse of time since the onset of the symptoms after acute myocardial infarction: an prospective-observational study.

It is important to know the elapsed symptom-to-door (StD) time between the emergence of ST-elevation myocardial infarction (STEMI) symptoms and admission to the hospital in terms of the selection of appropriate treatment and prognosis. In this study, we aimed to assess the relationship between serum C-reactive protein (CRP) and StD time after STEMI. 436 of the patients admitted to our center with STEMI between August 2012-February 2013 (338 male, mean age, 63.9±12.8) were included in this prospective-observational cohort study. Blood samples were obtained from laboratory results of the first reference period. Patients were divided into four groups according to the duration of StD time [0-1. hour; group 1 (G1), 1-3. hour; group 2 (G2), 3-6. hour; group 3 (G3), 6-12. hour; group 4 (G4)]. Statistical analysis was performed via chi-squre test, ANOVA test, Pearson's correlation analysis and receiver operator charecteristic (ROC) analysis. As the time progressed, an increase in CRP levels was observed. The difference among the means of the G1-G3 (p=0.002), G1-G4 (p<0.001), G2-G4 (p<0.001) and G3-G4 (p<0.001) groups was found to be statistically significant. There was a good correlation between the StD time and CRP levels (r=0.676). ROC analysis of the predictive value of CRP for the third hour was determined as 0.78 mg/dL, respectively (AUC was 0.824; 95% C.I. was 0.785-0.859; 73.9% sensitivity, 78.1% specificity). According to serum CRP levels after STEMI at hospital admission, StD time can be estimated.

Lupus Mesenteric Vasculitis With GI and Genitourinary Tract Involvement

A53-year-old woman presented with watery diarrhea of 6 months’ duration. She had no systemic disease or surgical history and did not take any medications. The associated symptoms included nausea, vomiting, dull abdominal pain without radiation, urinary urgency, frequency, and incontinence, and marked body weight loss (21 kg in 6 months). On admission, the physical examination showed hypoactive bowel sounds with slight periumbilical tenderness. Neither rebound tenderness nor guarding was elicited. No leg edema or skin rash was noted. Laboratory data showed no leukocytosis, mild increase of C-reactive protein level (1.69 mg/dL), mildly increased liver function tests (aspartate aminotransferase, 84 IU/L; alanine aminotransferase, 59 IU/L), and hypoalbuminemia (2.1 g/dL). Urine analysis showed proteinuria and pyuria. Routine stool analysis showed no evidence of infection or bleeding. Enhanced computed tomography of the abdomen showed diffuse wall thickening of stomach, small bowel, colon, and rectum (Figure A, target sign, arrow) and prominent engorgement of the mesenteric vessels with a palisade pattern (Figure B, comb sign, arrow). Bilateral hydroureteronephrosis and swelling of the bladder wall also were noted (Figure C, arrow). Further laboratory studies showed increased antinuclear antibody level (1:320, diffuse type), increased anti–double-stranded DNA (85 IU/mL), and low complement level (C3, 32 mg/dL; C4, 5.87 mg/dL). The clinical presentation and computed tomography image were compatible with lupus mesenteric vasculitis and lupus cystitis. The patient received cyclophosphamide and methylprednisolone pulse therapy, followed by steroid maintenance treatment. The patient’s clinical condition and follow-up computed tomography 17 days after admission showed significant improvement. Lupus mesenteric vasculitis is a rare presentation (0.2%–9.7%) among patients with systemic lupus erythematosus (SLE), but it is more common in SLE patients with abdominal pain (29%–65%). Typical image findings of lupus mesenteric vasculitis include focal or diffuse bowel-wall thickening with target sign, prominent engorgement of mesenteric vessels with comb sign, and ascites. Lupus cystitis frequently is associatedwith bowel involvement. Edema of the vesical triangle resulted in hydronephrosis and contraction of the bladder, and further induced urinary frequency and inflammation of the bladder. It is worthwhile to note that vasculitis and cystitis can be the initial manifestations of SLE.

The diagnostic value of C-reactive protein in bacterial translocation in experimental biliary obstruction.

Many experimental studies have verified that obstructive jaundice (OJ) causes bacterial translocation (BT). The aim of this study was to assess to whether C-Reactive Protein (CRP) can be used to detect bacterial translocation induced by biliary obstruction. Twenty rats were divided into two groups containing 10 rats each: sham-operated controls and the obstructive jaundice (OJ) group. All procedures were performed aseptically. After an upper midline incision, the common bile duct (CBD) was identified, mobilized, ligated and divided. The sham-operated animals had a similar incision, followed by mobilization of the CBD, without ligation or division. Ten days after the first operation, a second laparotomy was performed. Blood samples were collected for culture and serum CRP analysis. In addition, liver, spleen, and mesenteric lymph node (MLN) specimens were taken for microbiological culture to determine the presence of BT. BT was considered positive if there was any bacterial growth in the MLN, liver, spleen, or blood cultures; a lack of bacterial growth indicated a negative BT. The OJ group had significantly higher rates of bacterial translocation than the sham-operated group (p = 0.002). Mean CRP levels (ng/mL) were 8.7 ± 11.8 and 18.6 ± 17.2 in the sham-operated group and the OJ group respectively. There was no significant difference in mean CRP levels between the two groups (p = 0.257). Mean CRP levels were 4.5 ± 4.3 and 24.9 ± 16.4 in the BT (-) and BT (+) groups respectively (p = 0.003). A marked increase in CRP levels paralleled an increase in BT. This study has demonstrated a direct relationship between BT and CRP levels in an experimental OJ model.

The Investigation Of Relationship Between Joint Findings and Serum Angiogenic and Inflammatory Factor Levels In Severe Hemophilia A Patients

Despite the use of early prophylactic Factor VIII replacement in severe hemophilia A patients, bleeding into joints cannot be prevented completely and permanent joint damage remains to occur as a result. Early diagnosis and treatment of the joint bleeedings are important for prevention of permanent joint damage. Today, the early detection of the joint bleeding at the beginning of the episode is not possible with clinical signs and current laboratory and radiologic imaging methods. Recent studies have shown that neoangiogenesis plays an important role in development of synovitis after recurrent joint bleedings and the histological abnormalities and findings of neoangiogenesis in hemophiliac arthropathy are similar to those in other joint diseases. This study aimed to investigate the relationship between joint findings and levels of plasma angiogenic and inflammatory factors in severe hemophilia A patients.Severe, inhibitor negative, hemophilia A patients from four hemophilia centers were included into the study. The patient groups consisted of 10 severe hemophilia A patients with acute joint bleeding and joint damage and 25 severe hemophilia A patients with no acute joint bleeding (with or without joint damage). The control group consisted of 22 healthy male children. Each group of patients were further subdivided into two groups with respect to degree of joint damage as presence of mild or severe joint damage. Complete blood count analysis, C-reactive protein (CRP), serum ferritin, lactic acid and ELISA based detection of vascular endhotelial growth factor (VEGF), intercellular adhesion molecule-1, thrombomodulin (TM), macrophage inhibitory factor (MIF), and endostatin levels were detected from the peripheral blood samples of the patient and the control groups. The joint findings of hemophilia A patients were evaluated clinically by hemophilia joint health score and radiologically by Petterson scoring and Denver magnetic resonance imaging scoring methods.Serum ferritin, CRP, and lactic acid levels were found to be increased in hemophilia A patients compared to the control group. CRP was significantly increased in hemophilia patients with joint damage compared to hemophiliacs without joint damage. The increase in levels of CRP and MIF were detected significantly higher in patients with acute joint bleeding. There was a positive correlation between serum TM,VEGF, and MIF levels.The finding of increased levels of CRP and MIF in acute bleeding period supports the presence of bleeding, regardless of the degree of the joint damage. The present findings show that investigation of the levels of these angiogenic factors in large number of severe hemophilia A patients with acute bleeding episodes may give further information about early joint damage. Disclosures:No relevant conflicts of interest to declare.

Plasma levels of high‐sensitive C‐reactive protein do not correlate with inflammatory activity in carotid atherosclerotic plaques

It is well established that subjects with moderately elevated plasma levels of C-reactive protein (CRP) have an increased risk of development of cardiovascular events. As atherosclerosis is a disease characterized by chronic arterial inflammation, it is possible that moderate increases in CRP level reflect the presence of plaque inflammation. To investigate this possibility, we compared plasma levels of hsCRP the day before carotid endarterectomy with the degree of inflammation in the excised plaque tissue. Luminex immunoassays were used to determine the levels of IL-6, IL-10, monocyte chemoattractant protein-1 and tumour necrosis factor-α (TNF-α) in plasma and in homogenized plaque tissue from 160 endarterectomy specimens. Plaque sections were stained with antibodies against CD68 to determine the plaque macrophage content. Plasma high-sensitivity (hs)CRP levels were significantly correlated with plasma IL-6 and TNF-α. However, there were no significant associations between plasma hsCRP concentration and plaque cytokine levels or macrophage contents. The present findings strongly argue against hsCRP as a marker of plaque inflammation. Hence, it is more likely that elevated hsCRP is a sign of a subclinical systemic inflammation and this in turn may contribute to progression of cardiovascular disease.