C-reactive protein - Revision history

Aidan at 17:24, 19 September 2024

2024-09-19T17:24:39Z

← Older revision		Revision as of 17:24, 19 September 2024
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	=== Hemodialysis ===		=== Hemodialysis ===

			* Theoretically removed with hemodialysis[[CiteRef::honore2019th]], but CRP is often elevated in stable patients on hemodialysis and peritoneal dialysis[[CiteRef::borazan2004th]]
	* Theoretically removed with hemodialysis<ref>Honore, P.M., De Bels, D., Attou, R. ''et al.'' The challenge of removal of sepsis markers by continuous hemofiltration. ''Crit Care'' 23, 173 (2019). https://doi.org/10.1186/s13054-019-2464-z</ref>, but CRP is often elevated in stable patients on hemodialysis and peritoneal dialysis<ref>Borazan A, Aydemir S, Sert M, Yilmaz A. The effects of hemodialysis and peritoneal dialysis on serum homocysteine and C-reactive protein levels. Mediators Inflamm. 2004 Dec;13(5-6):361-4. doi: [https://doi.org/10.1080/09629350400008786 10.1080/09629350400008786]. PMID: 15770053; PMCID: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781575/ PMC1781575].</ref>

	==Further Reading==		==Further Reading==

Aidan: added note about dialysis

2023-03-07T19:43:59Z

added note about dialysis

← Older revision		Revision as of 19:43, 7 March 2023
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	*CRP less effected by older age than ESR		*CRP less effected by older age than ESR

			=== Hemodialysis ===

			* Theoretically removed with hemodialysis<ref>Honore, P.M., De Bels, D., Attou, R. ''et al.'' The challenge of removal of sepsis markers by continuous hemofiltration. ''Crit Care'' 23, 173 (2019). https://doi.org/10.1186/s13054-019-2464-z</ref>, but CRP is often elevated in stable patients on hemodialysis and peritoneal dialysis<ref>Borazan A, Aydemir S, Sert M, Yilmaz A. The effects of hemodialysis and peritoneal dialysis on serum homocysteine and C-reactive protein levels. Mediators Inflamm. 2004 Dec;13(5-6):361-4. doi: [https://doi.org/10.1080/09629350400008786 10.1080/09629350400008786]. PMID: 15770053; PMCID: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781575/ PMC1781575].</ref>

	==Further Reading==		==Further Reading==

Aidan: /* Interpretation */

2021-01-17T20:05:55Z

Interpretation

← Older revision		Revision as of 20:05, 17 January 2021
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	**Non-infectious chronic inflammation, such as from smoking, uremia, or cardiac ischemia: 2 to 10 mg/L		**Non-infectious chronic inflammation, such as from smoking, uremia, or cardiac ischemia: 2 to 10 mg/L
	**Mild to moderate infection such as SSTI, cystitis or bronchitis: increases to 50 to 100 mg/L within 6 hours		**Mild to moderate infection such as SSTI, cystitis or bronchitis: increases to 50 to 100 mg/L within 6 hours
	*Typically ~~beings~~ to rise after 12 to 24 hours and has a half-life of about 19 hours		*Typically begins to rise after 12 to 24 hours and has a half-life of about 19 hours

	{\| class="wikitable"		{\| class="wikitable"

Aidan: /* Further Reading */

2021-01-13T01:15:02Z

Aidan at 01:13, 13 January 2021

2021-01-13T01:13:11Z

@@ Line 1: / Line 1: @@
 ==Normal Values==
-*Post-spinal surgery, it peaks at 15 ± 25 a few days after OR
+*Post-spinal surgery, it peaks at 15 ± 25 mg/L a few days after OR
-*Post-stroke, it can go up to 25 ± 10
+*Post-stroke, it can go up to 25 ± 10 mg/L
 *Post-TKA, it can go up to 155 mg/L
@@ Line 8: / Line 8: @@
 *The higher the value, the more likely to be a bacterial infection
 {| class="wikitable"
 !ESR
@@ Line 17: / Line 66: @@
 |high
 |low
-|rheumatoid arthritis, infection, low albumin elevated creatinine
+|[[rheumatoid arthritis]], infection, low albumin, elevated creatinine
 |-
 |low
@@ Line 24: / Line 73: @@
 |}
-* CRP less effected by older age than ESR
+*CRP less effected by older age than ESR
 ==Further Reading==

Aidan at 17:52, 15 September 2020

2020-09-15T17:52:43Z

← Older revision		Revision as of 17:52, 15 September 2020
Line 1:		Line 1:
	== Normal Values ==		==Normal Values==

	* Post-spinal surgery, it peaks at 15 ± 25 a few days after OR		*Post-spinal surgery, it peaks at 15 ± 25 a few days after OR
	* Post-stroke, it can go up to 25 ± 10		*Post-stroke, it can go up to 25 ± 10
	* Post-TKA, it can go up to 155 mg/L		*Post-TKA, it can go up to 155 mg/L

	== Interpretation ==		==Interpretation==

	* The higher the value, the more likely to be a bacterial infection		*The higher the value, the more likely to be a bacterial infection

	== ~~Further~~ ~~Reading~~ ==		=== Comparison to ESR ===
			{\| class="wikitable"
			!ESR
			!CRP
			!Clinical Scenarios
			\|-
			\|high
			\|low
			\|rheumatoid arthritis, infection, low albumin elevated creatinine
			\|-
			\|low
			\|high
			\|low albumin
			\|}

			* CRP less effected by older age than ESR
⚫	=== ~~Spine~~ ===

			==Further Reading==
	* [https://doi.org/10.1016/j.spinee.2005.07.006 Serum C-reactive protein levels correlate with clinical response in patients treated with antibiotics for wound infections after spinal surgery]. ''Spine J''. 2006;6(3):311-315.
⚫	** CRP better than ESR

	=== ~~Joints~~ ===		===Spine===

	* [https://doi.org/10.~~1093~~/~~jac/dkr182 Serial measurement of~~ ~~the~~ C-reactive protein is a ~~poor~~ ~~predictor~~ of ~~treatment~~ ~~outcome~~ in ~~prosthetic~~ ~~joint~~ ~~infection~~]. ''J ~~Antimicrob Chemo~~''. ~~2011~~;66(7)~~;1590~~-~~1593~~.		*[https://doi.org/10.1016/j.spinee.2005.07.006 Serum C-reactive protein levels correlate with clinical response in patients treated with antibiotics for wound infections after spinal surgery]. ''Spine J''. 2006;6(3):311-315.
		⚫	**CRP better than ESR
⚫	** Although the population of patients with failure had higher CRP on average, CRP measurement was not useful for predicting failure in individual patients.
	* [https://doi.org/10.1371/journal.pone.0009358 C-Reactive Protein, Erythrocyte Sedimentation Rate and Orthopedic Implant Infection]. ''PLoS ONE''. 2010:5(2):e9358.
⚫	** ESR and CRP have poor Sn and Sp for diagnosing hardware infections
	* [https://doi.org/10.1007/s00264-017-3430-5 C-reactive protein may misdiagnose prosthetic joint infections, particularly chronic and low-grade infections]. ''International Orthopaedics''. 2017.
⚫	** 1/3 of culture-positive PJIs had normal CRP and 1/4 had normal ESR.
⚫	** Most common associated organisms were coagulase-negative staphylococci and ''C. acnes''
⚫	* [https://doi.org/10.1302/0301-620X.97B7.35500 Seronegative infections in hip and knee arthroplasty: periprosthetic infections with normal erythrocyte sedimentation rate and C-reactive protein level]
⚫	** 4% of PJI have normal CRP and ESR
⚫	** CoNS was more common, ''Staph. aureus'' less common

	=== ~~Other~~ ===		===Joints===

	* [https://doi.org/10.~~1001~~/~~archinternmed.2007.73~~ ~~Prognostic~~ ~~Value~~ of ~~Serial~~ C-~~Reactive~~ ~~Protein~~ ~~Measurements~~ in ~~Left-Sided~~ ~~Native~~ ~~Valve~~ ~~Endocarditis~~]. ''~~Arch~~ ~~Intern~~ ~~Med~~''. ~~2008~~;~~168~~(3)~~:302~~-~~307~~.		*[https://doi.org/10.1093/jac/dkr182 Serial measurement of the C-reactive protein is a poor predictor of treatment outcome in prosthetic joint infection]. ''J Antimicrob Chemo''. 2011;66(7);1590-1593.
		⚫	**Although the population of patients with failure had higher CRP on average, CRP measurement was not useful for predicting failure in individual patients.
⚫	** After 1 week following starting therapy, a CRP over 122 predicts failure (OR 10)
	* [https://doi.org/10.~~1016~~/~~0003-4975(94)90206-2 Utility of~~ C-~~reactive~~ ~~protein~~ ~~measurements~~ ~~for~~ ~~empyema~~ ~~diagnosis~~ ~~after~~ ~~pneumonectomy~~]. ''~~Annals~~ ~~Thoracic Surg~~''. ~~1994;57~~(4):~~933-936~~.		*[https://doi.org/10.1371/journal.pone.0009358 C-Reactive Protein, Erythrocyte Sedimentation Rate and Orthopedic Implant Infection]. ''PLoS ONE''. 2010:5(2):e9358.
		⚫	**ESR and CRP have poor Sn and Sp for diagnosing hardware infections
⚫	** Post-operative rise or high-plateau of CRP predicted postoperative infection (empyema)
	* [https://doi.org/10.1007/~~s11605~~-~~009~~-~~0928~~-~~1 Diagnostic Accuracy of~~ C-reactive ~~Protein~~ ~~for~~ ~~Intraabdominal~~ ~~Infections~~ ~~After~~ ~~Colorectal~~ ~~Resections~~]. ''J ~~Gastrointest Surg~~''. ~~2009;13(9):1599-1606~~.		*[https://doi.org/10.1007/s00264-017-3430-5 C-reactive protein may misdiagnose prosthetic joint infections, particularly chronic and low-grade infections]. ''International Orthopaedics''. 2017.
		⚫	**1/3 of culture-positive PJIs had normal CRP and 1/4 had normal ESR.
⚫	** Post-resection day 3 (or 5 or 7) CRP predicts intraabdominal infection, with Sn 82% and Sp 73% using a cutoff of 190 mg/L (normal <10)
		⚫	**Most common associated organisms were coagulase-negative staphylococci and ''C. acnes''
		⚫	*[https://doi.org/10.1302/0301-620X.97B7.35500 Seronegative infections in hip and knee arthroplasty: periprosthetic infections with normal erythrocyte sedimentation rate and C-reactive protein level]
		⚫	**4% of PJI have normal CRP and ESR
		⚫	**CoNS was more common, ''Staph. aureus'' less common

		⚫	===Other===

			*[https://doi.org/10.1001/archinternmed.2007.73 Prognostic Value of Serial C-Reactive Protein Measurements in Left-Sided Native Valve Endocarditis]. ''Arch Intern Med''. 2008;168(3):302-307.
		⚫	**After 1 week following starting therapy, a CRP over 122 predicts failure (OR 10)
			*[https://doi.org/10.1016/0003-4975(94)90206-2 Utility of C-reactive protein measurements for empyema diagnosis after pneumonectomy]. ''Annals Thoracic Surg''. 1994;57(4):933-936.
		⚫	**Post-operative rise or high-plateau of CRP predicted postoperative infection (empyema)
			*[https://doi.org/10.1007/s11605-009-0928-1 Diagnostic Accuracy of C-reactive Protein for Intraabdominal Infections After Colorectal Resections]. ''J Gastrointest Surg''. 2009;13(9):1599-1606.
		⚫	**Post-resection day 3 (or 5 or 7) CRP predicts intraabdominal infection, with Sn 82% and Sp 73% using a cutoff of 190 mg/L (normal <10)

	[[Category:Diagnostics]]		[[Category:Diagnostics]]

Aidan at 11:16, 16 August 2019

2019-08-16T11:16:11Z

← Older revision		Revision as of 11:16, 16 August 2019
Line 1:		Line 1:
	= C-reactive protein (CRP) =

	== Normal Values ==		== Normal Values ==

Line 39:		Line 37:
	* [https://doi.org/10.1007/s11605-009-0928-1 Diagnostic Accuracy of C-reactive Protein for Intraabdominal Infections After Colorectal Resections]. ''J Gastrointest Surg''. 2009;13(9):1599-1606.		* [https://doi.org/10.1007/s11605-009-0928-1 Diagnostic Accuracy of C-reactive Protein for Intraabdominal Infections After Colorectal Resections]. ''J Gastrointest Surg''. 2009;13(9):1599-1606.
	** Post-resection day 3 (or 5 or 7) CRP predicts intraabdominal infection, with Sn 82% and Sp 73% using a cutoff of 190 mg/L (normal <10)		** Post-resection day 3 (or 5 or 7) CRP predicts intraabdominal infection, with Sn 82% and Sp 73% using a cutoff of 190 mg/L (normal <10)

			[[Category:Diagnostics]]

Aidan: Aidan moved page C-reactive protein (CRP) to C-reactive protein without leaving a redirect

2019-08-16T11:16:00Z

Aidan moved page C-reactive protein (CRP) to C-reactive protein without leaving a redirect

← Older revision	Revision as of 11:16, 16 August 2019
(No difference)

Maintenance script: Imported from text file

2019-08-11T18:05:49Z

Imported from text file

New page

= C-reactive protein (CRP) =

== Normal Values ==

* Post-spinal surgery, it peaks at 15 ± 25 a few days after OR
* Post-stroke, it can go up to 25 ± 10
* Post-TKA, it can go up to 155 mg/L

== Interpretation ==

* The higher the value, the more likely to be a bacterial infection

== Further Reading ==

=== Spine ===

* [https://doi.org/10.1016/j.spinee.2005.07.006 Serum C-reactive protein levels correlate with clinical response in patients treated with antibiotics for wound infections after spinal surgery]. ''Spine J''. 2006;6(3):311-315.
** CRP better than ESR

=== Joints ===

* [https://doi.org/10.1093/jac/dkr182 Serial measurement of the C-reactive protein is a poor predictor of treatment outcome in prosthetic joint infection]. ''J Antimicrob Chemo''. 2011;66(7);1590-1593.
** Although the population of patients with failure had higher CRP on average, CRP measurement was not useful for predicting failure in individual patients.
* [https://doi.org/10.1371/journal.pone.0009358 C-Reactive Protein, Erythrocyte Sedimentation Rate and Orthopedic Implant Infection]. ''PLoS ONE''. 2010:5(2):e9358.
** ESR and CRP have poor Sn and Sp for diagnosing hardware infections
* [https://doi.org/10.1007/s00264-017-3430-5 C-reactive protein may misdiagnose prosthetic joint infections, particularly chronic and low-grade infections]. ''International Orthopaedics''. 2017.
** 1/3 of culture-positive PJIs had normal CRP and 1/4 had normal ESR.
** Most common associated organisms were coagulase-negative staphylococci and ''C. acnes''
* [https://doi.org/10.1302/0301-620X.97B7.35500 Seronegative infections in hip and knee arthroplasty: periprosthetic infections with normal erythrocyte sedimentation rate and C-reactive protein level]
** 4% of PJI have normal CRP and ESR
** CoNS was more common, ''Staph. aureus'' less common

=== Other ===

* [https://doi.org/10.1001/archinternmed.2007.73 Prognostic Value of Serial C-Reactive Protein Measurements in Left-Sided Native Valve Endocarditis]. ''Arch Intern Med''. 2008;168(3):302-307.
** After 1 week following starting therapy, a CRP over 122 predicts failure (OR 10)
* [https://doi.org/10.1016/0003-4975(94)90206-2 Utility of C-reactive protein measurements for empyema diagnosis after pneumonectomy]. ''Annals Thoracic Surg''. 1994;57(4):933-936.
** Post-operative rise or high-plateau of CRP predicted postoperative infection (empyema)
* [https://doi.org/10.1007/s11605-009-0928-1 Diagnostic Accuracy of C-reactive Protein for Intraabdominal Infections After Colorectal Resections]. ''J Gastrointest Surg''. 2009;13(9):1599-1606.
** Post-resection day 3 (or 5 or 7) CRP predicts intraabdominal infection, with Sn 82% and Sp 73% using a cutoff of 190 mg/L (normal <10)

← Older revision		Revision as of 01:15, 13 January 2021
Line 76:		Line 76:

	==Further Reading==		==Further Reading==

			* Acute Phase Reactants in Infections: Evidence- Based Review and a Guide for Clinicians. ''Open Forum Infect Dis''. 2015;2(3):ofv098. doi: [https://doi.org/10.1093/ofid/ofv098 10.1093/ofid/ofv098].

	===Spine===		===Spine===