Characteristics of apparently healthy individuals with a very low C-reactive protein

Ziv‐Baran, Tomer; Wasserman, Asaf; Goldiner, Ilana; Stark, Moshe; Shenhar‐Tsarfaty, Shani; Shapira, Itzhak; Zeltser, David; Mailis, Inna; Berliner, Shlomo; Rogowski, Ori

doi:10.1016/j.cca.2019.04.073

Cited by 7 publications

(6 citation statements)

References 19 publications

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“…This low-grade occult inflammatory response increases with age and is associated with increased morbidity and mortality. [21][22][23][24][25][26] However, individuals who present very low concentrations of this biomarker are generally very healthy. 27 Therefore, it is highly unusual to detect very low concentrations of this protein in individuals who are hospitalized with serious medical conditions.…”

Section: Discussionmentioning

confidence: 99%

Patients who are admitted to the Department of Internal Medicine with a very low C-reactive protein concentration

et al. 2021

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Introduction C-reactive protein (CRP) is a marker commonly used in clinical practice as a reference for the inflammatory activity in vivo. Low levels are often associated with good health and lower risk for adverse outcomes. Patients and methods We examined medical records of the last 6 years, of all patients admitted for hospitalization in internal medicine wards who had the first CRP measurement below ≤ 0.03 mg/L (detection limit). Diagnosis criteria and 7 days’ survival were reviewed. Results Out of 61,590 total admissions to internal medicine wards, three hundred and thirteen patients had CRP equal to or lower than 0.03 mg/L (0.5%). Second CRP measurement revealed gradual increment up to 10.8 ± 35.4 mg/L. Four patients died within 7 days from admission. Discussion Presentation to the internal medicine department with a very low concentration of CRP is highly unusual, but it does not exclude the existence of significant acute morbidities. Clinicians should take additional CRP tests before any conclusion is considered regarding the presence or absence of an inflammatory response.

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Section: Discussionmentioning

confidence: 99%

Patients who are admitted to the Department of Internal Medicine with a very low C-reactive protein concentration

et al. 2021

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“…No difference was found in these repeated tests. [ 9 ] Therefore, it seems unlikely that the changes of repeated CRP values are caused by variation of measurement unrelated to an infectious etiology.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, such an impression might have clinical consequences expressly, in cases where clinicians decide upon discharging the patient rather than admitting the former, in the presence of relatively low CRP concentrations. [ 8 , 9 ]…”

Section: Introductionmentioning

confidence: 99%

A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP

Goldberg¹,

Shalmon²,

Shteinvil³

et al. 2020

Medicine

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A first C-reactive protein (CRP) test, as often performed by clinicians during the presentation of patients with an acute bacterial infection, might be misleading. The aim of our study was to explore the dynamic between a second CRP test taken within 12 hours from admission CRP test in a cohort of patients diagnosed with acute bacterial infection in comparison to CRP in a control group of apparently healthy individuals. This was a historical cohort study comprised of all patients admitted to the Sourasky Tel-Aviv Medical Center, Israel, between July 2007 and March 2016. The study cohort included adult patients who were diagnosed as having an infection, assumed to be of bacterial etiology (cellulitis and erysipelas, pneumonia, cholecystitis, pyelonephritis, or septicemia), who had a CRP test during the first 6 hours of hospital admission (baseline CRP), and a successive CRP test up to 12 hours from the first one (recurrent CRP). The control group was of healthy subjects who attended our medical center for a routine annual check-up. The study included 950 patients. Baseline CRP ranged from 0.04 to 454 mg/L. The median CRP velocity was 0.53 mg/L/h. Patients were grouped by baseline CRP into 4 groups (CRP < 10, 10–74.9, 75–199.9, ≥200). There was an increase in median CRP velocity between the first (0.48 mg/L/h) and the second (0.93 mg/L/h) groups, which then was decreased in the next 2 groups (0.46 and −2.58 mg/L/h, respectively). In 45 of 103 (44%) patients of the group of baseline CRP concentration less than 10 mg/dL with bacterial diagnosis, there was a complete overlap with CRP values of apparently healthy individuals during their routine annual checkup. A first single low CRP result cannot exclude the presence of a significant bacterial infection. Patients with acute bacterial infection might present with a relatively low CRP value that at times correspond to normal limit CRP concentrations. A second test, obtained within 12 hours of admission, might serve as an important tool to identify patient with an evolving inflammatory burst commonly seen during acute bacterial infection.

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“…The ADVIA chemistry Wide-Range C-Reactive Protein (wrCRP) method measures CRP in serum and plasma by latex-enhanced immunoturbidimetric assay. The wrCRP laboratory methods were described previously [ 13 ]. Blood cells count was performed by using the Beckman Coulter UniCel.…”

Section: Methodsmentioning

confidence: 99%

“…This database includes individuals who have attended the Tel Aviv Medical Center for a routine annual health check-up and agreed to participate in the inflammation survey. wrCRP was evaluated on a regular basis for all participants [ [13] , [14] , [15] ]. Since the mean age of the participants in the routine annual examination was lower, we divided the participants into age groups (<50, 50–59, 60–69, 70–79 and 80+ years) and randomly selected 10 participants in the same age group for each patient who received TCZ.…”

Section: Methodsmentioning

confidence: 99%

Reduced C-reactive protein level at hospital admission in patients treated with Tocilizumab – An attention may be required

Berman

Berliner

Bashouti

et al. 2023

Heliyon

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Characteristics of apparently healthy individuals with a very low C-reactive protein

Cited by 7 publications

References 19 publications

Patients who are admitted to the Department of Internal Medicine with a very low C-reactive protein concentration

Patients who are admitted to the Department of Internal Medicine with a very low C-reactive protein concentration

A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP

Reduced C-reactive protein level at hospital admission in patients treated with Tocilizumab – An attention may be required

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