C-reactive protein for rapid diagnosis of infection in leukaemia.

Abstract

C-reactive protein, measured in serum from 38 patients with leukaemia, was elevated to at least 100 mg/l at the beginning of 32 of 34 episodes of infection, and subsequently rose above 100 mg/l in all 34. Uninfected patients, whether in leukaemic remission or relapse and whether pyrexial or not, always had levels below 100 mg/l, with four exceptions out of 290 measurements. Estimation of two other acute-phase proteins, alpha 1-antitrypsin and orosomucoid, was not of additional diagnostic value. Serial measurement of C-reactive protein may be important for the early detection of infection in the leukaemic patient with neutropenia.

Evaluation of Neutropenic Fever: Value of Serum and Plasma Parameters in Clinical Practice

“…In fact, increases of CRP levels during bacteremia were similar in immunocompetent children and in children with leukemia [7]. Early studies in patients with leukemia suggested that increases of CRP levels above the threshold of 100 mg/l would be strongly indicative of relevant nonviral infectious complications even in neutropenia [8,9].…”

Interleukin-6: a potential inflammatory marker after total joint replacement

“…In the present study the maximum CRP concentrations were seen 48-72 h postoperatively and returned to levels below 50 mg/l at an average time of 157 h postoperatively. This period is considered critical for the initiation of bacterial infection [6,10]. In contrast, the IL-6 concentration increased rapidly with a peak 6-12 h postoperatively and a descent thereafter returning to levels below 50 pg/ml within 48 h. Kragsbjerg et al [4] have suggested that IL-6 levels above 50 pg/ml should be considered as an indication of active infection.…”

Serial study of C-reactive protein during infection in leukaemia.

“…6 We now recommend that blood specimens be taken for assay, or for storage, whenever venepuncture is performed in the neutropenic patient; the stored sera may then be used to provide sequential results if pyrexia subsequently develops. The serial study of C-RP is of considerably greater value in diagnosis, and as a guide to therapy, than single estimations.…”