Comparison of erythrocyte sedimentation rate and C-reactive protein levels (literature review and own data)

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Comparison of erythrocyte sedimentation rate and C-reactive protein levels (literature review and own data)

Journal Title: Український терапевтичний журнал - Year 2019, Vol 0, Issue 2

Abstract

Erythrocyte sedimentation rate (ESR) and C-reactive protein (C-RP) are used for the diagnosis and control of the treatment in the course of inflammatory conditions, moreover they can provide an understanding of the disease pathophysiological basis. Objective — to assess the state of the problem of ESR and C-RP usage based in the literature data and own clinical observations. Materials and methods. The literature review of the data in PubMed database and Ukrainian sources has been performed. Besides, the analysis has been performed on the set of own results of the examination of 373 patients with hemorrhagic vasculitis, rheumatic fever, acute forms of coronary heart disease (CHD), divided into comparable groups depending on the condition of the gall bladder (GB). Data were processed using Statistica 6.0 software; results were considered significant if p < 0.05. Results and discussion. In the serological diagnosis of acute diseases, the preference was given to C-RP which is produced by liver for the recognition and elimination of foreign pathogens, endotoxins, necrotized or apoptotic cells. At acute inflammatory conditions C-RP may be increased up to 50—100 mg/l for 4—6 hours after affecting by pathogenic stimulus. The ESR begins to rise later, within 24—48 hours after the onset of inflammation. The frequency of discordant changes in ESR and C-RP among all hospitalized patients is 12 %. The minimal ESR values were reveled in patients with CHD, for whom coronary artery bypass grafting was planned, in subjects with intact GB (12.71 ± 1.75) mm/hr) and folded gallbladder (9.92 ± 1.10) mm/h), and maximal ESR was in case of hemorrhagic vasculitis (19.18 ± 2.95) mm/h). The mean C-RP level in patients with hemorrhagic vasculitis was 2.5 times higher than normal value (7.51 ± 1.22) mg/l). The C-RP levels were the highest in patients with rheumatic fever (19.57 ± 4.36) mg/l, p < 0.05). Conclusions. Changes in ESR and C-RP are not parallel, thus the analysis of both parameters is required. The discordant changes in ESR and C-RP may be stipulated by nosology, age, gender, presence of obesity, GB condition. The GB condition affects the severity of systemic inflammation, which is maximal in the case of post-inflammatory deformations of GB neck, signs of chronic cholecystitis, cholelithiasis, and history of cholecystectomy. Changes in ESR and C-RP can often be discordant, including case of rheumatic fever and hemorrhagic vasculitis.

Authors and Affiliations

L. M. Strilchuk

Keywords

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EP ID EP634395
DOI 10.30978/UTJ2019-2-96
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