Reactive Protein Levels In Patients Research Articles

Role of C-reactive protein in predicting the outcome of acute pancreatitis

Background: Acute pancreatitis is one of the most commonly encountered clinical entities in surgical practice and controversy still exists regarding the clinical features of acute pancreatitis. An early diagnosis, however, is regarded as mandatory for successful treatment. Over the years many Authors have proposed different scoring systems for the early assessment of the clinical evolution of acute pancreatitis. The most widely used scoring systems are often cumbersome and difficult to use in clinical practice because of their multi factorial nature. Thus, a number of unifactorial prognostic indices have been employed in routine hospital practice, such as C-reactive protein (CRP), serum amylase and serum lipase. These serum enzymes are easy to obtain in normal clinical practice and many authors consider them as reliable as multi factorial scoring systems.Methods: A hospital based observational prospective study was done with 30 patients to measure C reactive protein levels in patients of acute pancreatitis and evaluate if CRP levels predict the severity of pancreatitis.Results: In cases where CRP was raised >100 mg/dl on day 7 and beyond showed either a complication or increased duration of stay and delayed recovery. This correspondence of CRP with the clinical outcome co related well with other parameters like blood counts, serum lipase and amylase levels too.Conclusions: Hence, CRP can be a very useful uni factorial tool in assessing and thereby predicting the outcome in a case of pancreatitis.

Serum high sensitivity C reactive protein levels in patients with diabetic retinopathy: a cross sectional study

Background: Diabetic retinopathy (DR) is one of the major visual morbidities associated with diabetes. This study determined the levels of serum high-sensitivity C-reactive protein (hs-CRP) in patients with DR and to correlate the estimated levels of serum hs-CRP with the severity of DR and other coexisting factors.Methods: This was a cross-sectional study conducted between March 2009 and August 2010 and included patients with type 2 diabetes mellitus (T2DM) with or without DR. A detailed fundus evaluation was performed using direct and indirect ophthalmoscopy. The retinopathies were observed and documented in accordance with the Kanski's system of classification as background DR (BDR), pre-proliferative DR (PPDR), and proliferative DR (PDR). Laboratory investigations determined the levels of fasting blood glucose (FBG), postprandial blood glucose (PPBG), glycosylated hemoglobin, urine albumin excretion, and serum hs-CRP levels.Results: In total, 80 patients with T2DM were included (DR group, n=40 [BDR, n=22; PDR, n=11; PPDR, n=7]; control group, n=40). Highest serum hs-CRP levels were found in PDR group (6.68 mg/L), followed by PPDR and BDR group (3.2 mg/L and 1.56 mg/L, respectively). The PDR group showed the longest duration of diabetes (16 years), highest FBG (221.8 mg/dL) and HbA1c (6.68 mg/L). The incidence of albuminuria and maculopathy was higher in PDR group (72.7% and 54.54%, respectively). A significant association of hs-CRP levels with DR in patients with T2DM was observed. A significantly (<0.005) positive correlation of hs-CRP was also observed with age, duration of disease, FBG, PPBG, and HbA1c.Conclusions: Patients with severe grades of retinopathy had significantly higher hs-CRP levels than patients with the milder grades.

C – Reactive Protein Levels in Patients Diagnosed with Dengue Fever at a Tertiary Care Hospital, Mahabubnagar

C – Reactive Protein Levels in Patients Diagnosed with Dengue Fever at a Tertiary Care Hospital, Mahabubnagar

A study of C reactive proteins in patients with stable chronic obstructive pulmonary disease

Background: Whenever there is damage to the tissue or inflammatory process, the hepatocytes synthesize a protein which is an acute phase reactant, and this is the C reactive protein. Studies have shown that serum C reactive protein levels are usually elevated during acute exacerbations of COPD. The objective of this study was studying the baseline serum C reactive protein levels in patients with stable chronic obstructive pulmonary disease.Methods: During the study period, 90 subjects were studied. Out of them, 47 had stable COPD and 43 were without COPD. The subjects were either admitted in indoor wards or were attending OPD of department of tuberculosis and respiratory diseases, Dr. Murari Lal Chest Hospital, G.S.V.M Medical College, Kanpur, Uttar Pradesh, and were recruited if they fulfilled the criteria for inclusion. Informed consent was taken from all study subjects and the study protocol was approved by the board of faculty of medicine.Results: Of the 47 patients in the stable COPD group, 23 were found to be active smokers. Pearson’s correlation coefficient showed that lower limit of serum CRP levels were significantly negatively correlating with 6 MWD (r= -0.707; p=0.0001), FEV1% (r=-0.635; p=0.0001), PaO2 (r=-0.592; p=0.0001), and BMI (r= -0.534; p=0.0001). Pearson’s correlation coefficient showed that upper limit of serum CRP levels were significantly negatively correlating with 6 MWD (r= -0.707; p=0.0001), FEV1% (r= -0.633; p=0.0001), PaO2 (r= -0.61; p=0.001) and BMI (r= -0.520; p=0.0001).Conclusions: The circulating levels of inflammatory marker, baseline serum CRP are significantly elevated in patients with stable chronic obstructive pulmonary disease.

Sputum bacteriology, antibiotic sensitivity pattern and C reactive protein levels in patients of COPD with acute exacerbations

Sputum bacteriology, antibiotic sensitivity pattern and C reactive protein levels in patients of COPD with acute exacerbations

Impact of mandibular advancement devices on C-reactive protein levels in patients with obstructive sleep apnea.

To determine the effect of treatment of obstructive sleep apnea (OSA) with custom-made mandibular advancement devices (MADs) on C-reactive protein (CRP) levels in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Case series with chart review. Charts of consecutive patients fitted with custom-made mandibular advancement devices for treatment of OSAHS between December 2011 and November 2012 were reviewed. Demographics such as age, sex, and body mass index (BMI) were collected. Prefitting and postfitting polysomnograms were reviewed. Pre- and posttreatment apnea-hypopnea index (AHI) and average O2 saturation were compared. Only patients with documented CRP levels determined prior to mandibular advancement device fitting and again after improvement of OSAHS symptoms were included. Forty-nine patients (77.6% male, age 47.4 ± 11.7 years, BMI 29.6 ± 5.0 kg/m(2)) were included in this study. Patients initially had elevated CRP levels (2.5 ± 1.8 mg/dl), which decreased significantly following use of their custom-made mandibular advancement device (1.9 ± 1.3 mg/dl, P = 0.006) by approximately 24%. AHI decreased significantly from 33.3 ± 21.7 pretreatment to 12.1 ± 22.3 posttreatment (P < 0.001). Treatment with MADs reduced AHI by approximately 69.3%. Minimum oxygen saturation significantly improved from 85.1% ± 5.9 pretreatment to 90.7% ± 3.6 posttreatment (P < 0.001). Treatment with custom-made mandibular advancement devices significantly reduced elevated CRP levels in patients with mild to severe OSAHS. Therapy achieves reasonable response and cure rates in the observed patients with a significant reduction in AHI.

Prognostic role of pre‐transplantation serum C‐reactive protein levels in patients with acute leukemia undergoing myeloablative allogeneic stem cell transplantation

The aim of this study was to identify indicators of outcome prior to transplantation in allogeneic hematopoietic stem cell transplantation (HCT). Clinical data of 106 patients with acute leukemia were retrospectively analyzed. We examined the role of pre-conditioning serum C-reactive protein (CRP) and ferritin levels, HCT-CI and European Group for Blood and Marrow Transplantation (EBMT) scores on transplant toxicities, transplant-related mortality (TRM), progression-free survival (PFS), and overall survival (OS). High pre-conditioning serum CRP levels showed a positive correlation with higher EBMT scores (p < 0.001), HCT-CI (p = 0.004), and ferritin levels (p < 0.001). In univariate Cox regression analysis, serum CRP ≥10 mg/L, serum ferritin ≥1500 ng/mL, and HCT-CI ≥3 had a significant adverse effect on OS. Serum CRP ≥10 mg/L and HCT-CI ≥3 predicted increased risk of TRM in univariate analysis. Multivariate Cox regression analysis showed that HCT-CI score ≥3 independently predicted increased risk of TRM and CRP ≥10 mg/L predicted increased risk of disease progression. Although CRP lost its significance on TRM in multivariate analysis, as an inexpensive and readily available serum biomarker of inflammation, the prognostic role of pre-transplant CRP levels should be analyzed in selected diseases and increased number of patient groups.

Impact of the metabolic syndrome on high-sensitivity C reactive protein levels in patients with acute coronary syndrome

Objective Underlying predisposition for a heightened inflammatory response is postulated as one of the mechanisms for elevated high-sensitivity C reactive protein (hs-CRP) levels in patients with acute coronary syndrome (ACS). It is unclear whether metabolic syndrome (MetS) may cause a predisposition for heightened hs-CRP response in patients with ACS. The aim of this study is to investigate the interaction between hs-CRP levels and presence of MetS in patients with and without ACS. Methods Two hundred and seventy-three consecutive patients presenting with a first ACS event and 261 MetS patients without any ACS event were included to the study. The study participants were divided into three groups as MetS (+) ACS (−) [ n = 261], MetS (−) ACS (+) [ n = 110], and MetS (+) ACS (+) [ n = 163]. Median levels of hs-CRP were compared between and within the three groups. Results Hs-CRP levels were lowest in MetS (+) ACS (−) subjects and highest in MetS (+) ACS (+) patients. Factors associated with hs-CRP levels were troponin elevation, presence of ACS, body mass index (BMI), and presence of MetS ( R 2 = 0.26, p < 0.01). Predictors of elevated hs-CRP levels (>0.3 mg/dl) were the presence of ACS (OR = 3.6, 95% CI = 1.9–6.5, p < 0.01), presence of MetS (OR = 2.1, 95% CI = 1.0–4.0, p = 0.02), troponin elevation (OR = 5.7, 95% CI = 2.8–11.5, p < 0.01) and BMI (OR = 1.1, 95% CI = 1.0–1.1, p < 0.01). Conclusions The presence of MetS had an impact on the increase in hs-CRP levels observed with an ACS event in the study population. These findings suggested that a heightened baseline inflammatory status of MetS may predispose ACS patients to an augmented hs-CRP response.

Influence of Fluvastatin alone and in Combination Therapy on C Reactive Protein Levels in Patients with Coronary Artery Disease and Mixed Hyperlipidaemia (FACT Study)

Influence of Fluvastatin alone and in Combination Therapy on C Reactive Protein Levels in Patients with Coronary Artery Disease and Mixed Hyperlipidaemia (FACT Study) -