C- Reactive Protein (CRP)

CRP:

C-reactive protein :

• C-reactive protein (CRP) is an acute phase reactant synthesized by the liver.

• CRP increase within 6 hours of an inflammatory stimulus.

• The plasma half- life of CRP is 19 hours, levels fall promptly once the stimulus is removed.

• Sequential measurement is useful in monitoring disease.

• Generally CRP is elevated in Acute bacterial, fungal or viral infection, Necrotising bacterial infection, Acute inflammatory diseases, (e.g. Crohn's disease, polymyalgia rheumatic)

Normal value:

Reference range < 10 mg/L.

Interpretation

CRP raised in:

1. Acute bacterial, fungal or viral infection

2. Chronic bacterial or fungal infection

3. Periodic fever syndromes

4. Localized abscess,

5. Bacterial endocarditis

6. Tuberculosis

7. Crohn's disease,

8. Polymyalgia rheumatica,

9. Inflammatory arthritis

· Rheumatoid arthritis
· Spondyloarthritis
· Psoriatic Arthritis

· Behçet's syndrome

Vasculitis
. Idiopathic retroperitoneal fibrosis
. Acute pancreatitis
. Aging

* Not raised in SLE, Systemic sclerosis,

Ulcerative colitis and Leukaemia.

Disproportionate increase of ESR than CRP:

Chronic bacterial or fungal infection, e.g.

localized abscess, bacterial endocarditis or

tuberculosis

ESR elevated but CRP not elevated:

SLE,

Sjögren's syndrome

Systemic sclerosis

Ulcerative colitis

Leukaemia

Multiple myeloma

Pregnancy,

old age,

End-stage renal disease

C- Reactive Protein (CRP)

Protocols