Transient hypophosphataemia associated with acute infectious disease in paediatric patients.

Increased monocyte chemoattractant protein-1 levels indicating early vascular damage in lean young PCOS patients

Although both serum albumin and C-reactive protein (CRP) levels are separately recognized as predictors of adverse outcomes in many illnesses, the predictive value of their combination for adverse outcomes has not been evaluated. We therefore sought to examine the prognostic value of serum albumin for in-hospital mortality in the presence or absence of severe inflammation, as indicated by high CRP levels. In this cohort study, we measured serum albumin and CRP levels in 1638 older patients (aged 65 years or older) hospitalized for medical problems, and examined their utility, both separately and in combination, for predicting in-hospital mortality. In separate analyses of CRP and albumin, both high CRP levels (> or =5 mg/dl) and hypoalbuminemia (<3.5 g/dl) were associated with risk of in-hospital death. After dividing participants into four groups based on CRP and albumin levels (<5 mg/dl CRP and <3.5 mg/dl albumin), subjects with severe inflammation (CRP > or =5 mg/dl) and hypoalbuminemia were associated with an adjusted relative risk (ARR) of 3.8 for in-hospital mortality when compared with the reference (high albumin and low CRP). Even in the absence of severe inflammation, the presence of severe hypoalbuminemia was associated with an ARR of 2.6 for in-hospital mortality, when compared with patients without hypoalbuminemia. Both serum CRP and albumin levels are predictors of in-hospital mortality. However, high serum albumin levels may have a protective effect in older patients, regardless of degree of inflammation. Serum albumin levels remain a useful predictor for in-hospital mortality in older hospitalized patients.

Aim of the studyThe basic uses of C-reactive protein (CRP) and procalcitonin (PCT) in clinical practice are in the diagnosis and follow-up of infectious disease. The fact that CRP already achieves high levels in cases with lung cancer, however, limits its diagnostic specificity. Procalcitonin may be an important marker in the differential diagnosis of lung cancer patients who have fever and high CRP levels. Our objective in this study was to determine the levels of CRP and PCT in patients with newly diagnosed non-infectious non-small cell lung cancer (NSCLC) and to relate these results to patient and disease characteristics.Material and methodsSerum CRP and PCT levels were measured in 79 histopathologically proven NSCLC patients and 20 healthy controls. Results were compared with demographic and clinical variables in patients with NSCLC.ResultsSerum CRP concentrations were significantly higher in NSCLC patients compared to the control group [38.30 (7.79–185) mg/dl vs. 7.79 (3.36–26.10) mg/dl; p < 0.001]. There was no significant difference between the two groups in PCT levels (p > 0.05). A mild, positive correlation was found between CRP level and tumor diameter. When comparing CRP levels in the lung cancer patients grouped according to age, sex, smoking status, clinical TNM staging and performance status (PS), the only significant difference found was that for PS score.ConclusionsHigh serum CRP levels in non-infectious NSCLC patients are mainly related to PS status and weakly to tumor size. Adding serum PCT measurement may contribute to exclusion of infections in patients with NSCLC.

Objective To explore the diagnosis significance of serum procalcitonin (PCT) and C-reactive protein(CRP) in the fever of hematological maliganancies. Methods The levels of serum PCT and CRP in 186 fever patients with hematological maliganancies and 30 non-fever patients with hematological maliganancies were analyzed retrospectively. According to the clinical characteristics, the patients were divided into infectious fever patients (165 cases), non-infectious fever patients (21 cases) and non-fever patients (30 cases). The infectious fever patients were divided into the bacterial infection (102 cases), the fungal infection (27 cases), and the virus infection (36 cases). The patients confirmed with bacteria infection were divided into blood culture positive patients (24 cases, including 12 cases of gram-negative bacteria infection and 12 cases of gram-positive bacteria infection) and blood culture negative patients (78 cases) according to the result of blood culture. The levels of serum PCT and CRP were compared. Results The levels of serum PCT and CRP in infectious fever patients were higher than those in non-infectious fever patients and non-fever patients:1.40(0.02-54.81) μg/L vs. 0.45(0.04-12.80) μg/L and 0.30(0.01-0.98) μg/L, 78.9(3.6-199.6) mg/L vs. 17.1(2.4-78.9) mg/L and 6.7(1.0-24.2) mg/L,and there were significant differences (P 0.05). The level of serum PCT in bacterial infection was higher than that in fungal infection and virus infection:1.60 (0.28-54.81) μg/L vs. 0.55 (0.17-9.60) μg/L and 0.38 (0.02-12.45) μg/L, and there was significant difference (P 0.05). There was no significant difference in the level of serum CRP among bacterial infection, fungal infection and virus infection (P >0.05). The level of serum PCT and the positive rate of PCT in blood culture positive patients were higher than those in blood culture negative patients: 2.10 (0.35-54.81) μg/L vs. 0.78(0.28-22.41) μg/L, 87.5% (21/24) vs. 66.7% (52/78), there were significant differences (P 0.05). There were no significant differences in the level of serum CRP and the positive rate of CRP between blood culture positive patients and blood culture negative patients, or between gram-negative bacteria infection and gram-positive bacteria infection (P >0.05). Conclusions Serum PCT concentration can help to distinguish the infectious fever and non-infectious fever, especially to gram-negative bacteria infection. Serum CRP concentration is significant in distinguishing the infectious fever and non-infectious fever. Key words: Hematologic neoplasms; Fever; C-reactive protein; Procalcitonin

Background and AimsHyponatremia is associated with aggravation of inflammation in COVID-19 patients. However, to the best of our knowledge, no study has used longitudinal data and investigated the association between hyponatremia and COVID-19. Therefore, we analyzed COVID-19 patients’ changes in serum sodium (Na) levels from admission to discharge.MethodWe conducted a retrospective, single-center, observational cohort study, involving adult COVID-19 patients who were admitted to Japan Self-Defense Forces Central Hospital between April 1 and May 31, 2020. Serum Na level of < 135 mEq/L was defined as hyponatremia, 135–145 mEq/L as normonatremia, and > 145 mEq/L as hypernatremia. Inflammation was assessed by serum C-reactive protein (CRP) levels. Univariate logistic regression analyses were used to assess associations between hyponatremia at admission and need for oxygen or death during hospitalization. A comparison of serum Na levels at admission and discharge was tested using a paired t-test. Cross-sectional associations between serum Na and CRP levels at admission or days from onset to admission were analyzed using multivariate linear regression analyses. A restricted cubic spline (RCS) curve incorporated in one of these multivariate linear regression analyses was used to identify when serum Na levels were the lowest. In addition, we employed a mixed-effect model to examine the longitudinal association between changes in serum Na and CRP levels during hospitalization.ResultsNinety-eight patients were enrolled, of whom 53 (54%) were male and 39 (40%) had a smoking history. Mean (SD) or median (IQR) of age, eGFR, body mass index (BMI), serum Na, and CRP at admission were 50 (17) years, 82 (20) mL/min/1.73m2, 23.3 (5.5), 138 (3.7) mEq/L, and 1.8 (0.2–6.0) mg/dL, respectively. It took an mean of 8.9 (3.7) days from onset to admission due to social disruption. According to government policies, during observation period, patients diagnosed with COVID-19 have to be hospitalized, even if they have minor or improving clinical symptoms.At admission, hyponatremia was observed in 11 (11.2%) patients; the rest of the patients had normonatremia. Twenty-seven (27.6%) patients received oxygen, and 4 (4.1%) died during hospitalization. Hyponatremia at admission was significantly associated with the need for oxygen (odds ratio: 41.2; 95% CI: 4.9–344; P=0.001) and death (odds ratio: 32.3; 95% CI: 3.0-347; P=0.004). Irrespective of hyponatremia at admission, the serum Na levels at discharge were significantly higher than those at admission (Fig. 1).In both cross-sectional and longitudinal analyses, serum Na levels were negatively associated with serum CRP levels after adjustment for age, sex, eGFR, BMI, and smoking history (P<0.001), which suggests that serum Na levels may reflect the activity of COVID-19. Furthermore, the serum Na levels at admission were positively associated with days from onset to admission after adjustment for age, sex, eGFR, BMI, smoking history, and serum CRP levels (P=0.035), and the RCS curve showed that the serum Na levels tended to be the lowest around the 7th day after onset (Fig. 2).ConclusionHyponatremia in COVID-19 may occur secondarily, and a condition called “COVID-19-induced hyponatremia” might exist.

Chronic Kidney disease (CKD) is a serious life threatening disease associated with morbidity and mortality in India. Hypothetical relationship between serum uric acid and C-Reactive protein (CRP) levels has been demonstrated in the pathophysiology of CKD. Fifty chronic kidney disease patients before dialysis and fifty controls were executed for measurement of serum uric acid and C-Reactive protein as well as other biochemical parameters analysis. Serum C-Reactive protein was measured by quantitative turbidimetric immunoassay. In this study, serum uric acid, creatinine, urea and C-Reactive protein levels were significant raised in CKD group to that of controls. Notably serum C-Reactive protein levels were significantly higher in the CKD patients associated with non-diabetic factors in comparison to diabetic associated CKD patients. A receiver operating characteristic curve (ROC) exhibited a strong association between uric acid and C-Reactive protein levels. A strong direct relationship between serum uric acid and C-Reactive protein in CKD patients are plausibly culprits in the progression of diseases.

Use of C-reactive protein in differentiation between acute bacterial and viral otitis media: Tejani N.R.; Chonmaitree T.; Rassin D.K.; Howie V.M.; Owen M.J.; Goldman A.S.Pediatrics (1995) 95/5 (664–669)

Diabetes mellitus (DM) is among the most common long-term conditions worldwide. He complex persistent disease associated with high blood glucose or hyperglycemia caused by insulin secretion, potency, or both. In this study, the concentration of C-reactive protein was precisely measured and the potential association that might exist between them was explored in T2DM patients. In type 2 diabetics, numerous recent investigations have shown a correlation between CRP and renal impairment. The purpose of this study was to determine whether C-reactive protein and diabetic kidney disease (DKD) are related in Ramadi City residents with type 2 diabetes mellitus. The study was Ninety samples, included 40 healthy samples and 50 patient samples, whose ages ranged from 11 to 50 years, were collected from Ramadi Teaching Hospital in Anbar - Ramadi from October 2024 to February 2025. Four ml of fresh blood was drawn by vein puncture with plastic syringe from each patient and healthy human. The blood specimen was shifted to a plain tube, after which the tube was centrifuged for 10 mins at (3000 xg). Serum was then aliquots into several Eppendorf tubes then kept frozen at -20 °C until used. The serum levels of C-reactive protein were determined by the Cobas Integra 400 plus device, and by the color reactions, the serum glucose levels،creatinine and urea were measured Spectrophotometer (Apple-303). The findings of this thesis, based on age comparison, indicated no significant difference between the patient group and the healthy control group. The mean ages of the patient group and the healthy group were 29.80 years and 32.79 years, respectively. The study's findings demonstrated that the concentrations of C-reactive protein (CRP) and fasting serum glucose (F.S. G) were considerably greater in those with type 2 diabetes mellitus (T2DM) than in the group of healthy people, with recorded values of 16.17 ± 2.823 mg/L for CRP and 252.7 ± 109.3 mg/dl for F.S.G. Pearson correlation analysis revealed no significant correlation between sex or age and the C-reactive protein levels in serum and glucose (P &gt; 0.05). Additionally, no significant correlation was found between serum C-reactive protein and glucose levels (P &gt; 0.05). Increased levels of C-reactive protein (CRP) are seen in people with type 2 diabetes mellitus (T2DM), and they may have a role in the development of diabetic kidney disease (DKD) by promoting inflammation.

Preoperative C-reactive protein levels are associated with tumor size and lymphovascular invasion in resected non-small cell lung cancer

Background: Intensive care units (ICUs), despite advances in critical care nursing, have frequent issues with early diagnosis and adequate treatment. Recently discovered world-class procalcitonin (PCT), a revolutionary laboratory marker, has been shown to be useful in this regard. The objective is to Comparison of concentrations of serum procalcitonin (PCT) and c-reactive protein (CRP) with a comparable level of organ malfunction during sepsis and evaluation of the interaction between serum PCT and CRP concentrations with different organ malfunction occurrence in sepsis. Design: It is a Hospital-Based Prospective study. Participants and Setting: Fifty people were admitted to the intensive care unit of Gandhi Medical College. Subjects and Methods: The extent of sepsis-related organ impairment was evaluated with the sequential organ failure assessment (SOFA) on day 1. Patients were identified by category 1(0-6), category 2(7-12), group 3(13-18), and group 4(19-24) in 4 separate classes with varying organ impairment seriousness of sepsis. Serum PCT and CRP concentrations have been measured. Results: The majority of the patients belonged to the age groups of 60-69 years (30%) and 50-59 years (22%) Majority of the patients belonged to the Sofa group 1 around 42% followed by sofa group 2 with 38%, sofa group 3 with 16% and the least belonged to the sofa group 4 with 4%. The mean PCT and CRP concentration in those who survived was 14.73 ng/ml and 149.916mg/L respectively and in those who died were 45.76 ng/ml (p-value &lt;0.001) and 183.584 mg/L (p-value 0.172) respectively. The linear correlation between PCT plasma concentrations and the four groups was significantly stronger than with CRP. Conclusion: In SOFA and serum PCT, The level of organ dysfunction and complications in sepsis patients is closely related to serum CRP levels.

Severe acute pancreatitis (SAP) is a serious systemic disease with high mortality. Ulinastatin is a drug widely used for patients with SAP and multiple organ failure syndrome. The present study aimed to investigate the capacity of the serum C-reactive protein (CRP) levels to predict the therapeutic effects of ulinastatin combined with somatostatin as well as determine the severity of SAP. SAP patients were treated with ulinastatin combined with somatostatin and serum CRP levels were measured. The computed tomography severity index (CTSI), acute physiology and chronic health evaluation II (APACHE II) and gastrointestinal failure scores were used to determine the therapeutic effects. All patients were assigned to the effective group and the ineffective group. Receiver operating characteristic curve analysis was performed to determine the sensitivity and specificity of CRP levels in predicting the severity of SAP and patient prognosis. Logistic regression analysis was adopted to investigate the factors influencing the therapeutic effects. Prior to and after treatment, serum CRP levels in patients of the effective and ineffective groups were significantly different. After treatment, serum CRP levels in patients of the effective group exhibited a more obvious reduction. The sensitivity and specificity of serum CRP levels in predicting the therapeutic effects of ulinastatin combined with somatostatin in SAP patients upon hospital admission were 0.813 and 0.934, respectively. Serum CRP levels were positively correlated with APACHE II, CTSI and gastrointestinal failure scores of SAP patients. The logistic regression demonstrated that serum albumin, creatinine and CRP levels on admission were factors influencing the therapeutic effects of ulinastatin combined with somatostatin in SAP patients. These results indicate that serum CRP levels may have a predictive value regarding the therapeutic effects of ulinastatin combined with somatostatin and are an indicator of the severity of gastrointestinal failure in SAP.

BackgroundRecent studies report on increased serum levels of C-reactive protein (CRP) in systemic scleroderma (SSc) pts.ObjectivesThe current study was aimed at identifying potential correlations between CRP levels, immunologic SSc phenotypes...

SummaryBackgroundSerum procalcitonin (PCT) and C-reactive protein (CRP) are markers of systemic inflammation and bacterial infection. We aimed to compare the usefulness of procalcitonin and CRP in patients with community-acquired pneumonia and exacerbations of chronic obstructive pulmonary disease (COPD).MethodsA total of 116 consecutive patients were included in the study: 76 with chronic obstructive pulmonary disease in group 1, and 40 with pneumonia in group 2.ResultsMedian serum CRP level was 44 mg/L in the COPD group and 132 mg/L in the pneumonia group. Median value of serum PCT was found to be 0.07 in the COPD group and 0.14 ng/mL in the pneumonia group. Serum PCT and CRP levels were significantly higher in the pneumonia group compared to the COPD group (p<0.001). The area under the ROC curve was 0.788 (CI: 0.704–0.872) for CRP and 0.699 (CI: 0.599–0.800) for procalcitonin to identify pneumonia.ConclusionsProcalcitonin and CRP levels were significantly higher in patients with community-acquired pneumonia presenting to the emergency department with indications for hospitalization than in patients with exacerbations of chronic obstructive pulmonary disease. Serum CRP and procalcitonin concentrations were strongly correlated. CRP might be a more valuable marker in these patients with lower respiratory tract infections.

Aim To investigate the association between serum C-reactive protein (CRP) levels and coronary collateral circulation (CCC) in Chinese patients with angiography-proven ≥95% coronary stenosis.Methods In this study, 1158 patients with angiography-proven ≥95% occlusion in ≥1 major epicardial coronary artery were enrolled, and then classified into two groups: poor CCC (Rentrop grades 0–1) and good CCC (Rentrop grades 2–3). CRP levels were grouped using the following two models: Model 1 discretized CRP group with 33.33% and 66.66% as the critical values and Model 2 with 1.0 and 3.0 mg/L as the cut off values.Results There were significant differences in serum CRP levels between the two groups (5.76 ± 3.45 vs. 3.49 ± 2.44 mg/L, respectively; p < 0.001), and compared with the first CRP tertile, the risks of poor CCC were higher in the second and third CRP tertiles (OR 2.31, 95%CI [1.67–3.19], OR 6.25, 95%CI [4.52–8.62], respectively). The receiver operating characteristic curve analysis indicated that the optimal cutoff value of CRP to predict poor CCC was 4.21 mg/L with 59.6% sensitivity and 74.33% specificity.Conclusions CRP levels are an independent predictor for poor CCC and might supply a useful biomarker in clinical applications.Key messagesC-reactive protein (CRP) is a non-specific inflammatory marker that is regarded as an independent risk and prognostic factor for individuals who suffer from coronary artery disease (CAD) and cardiovascular disorders.In a Chinese cohort of patients with coronary artery occlusion or stenosis of ≥95% TIMI grade 1 anterograde-flow, the relationship between CRP concentrations and angiographically visible coronary collateral (CC) was assessed.Our data indicated that elevated CRP associated with a significant impairment in CC development, and might supply a useful biomarker in clinical applications.

Percutaneous coronary intervention (PCI) is known to induce both local and systemic inflammatory states. In addition to lowering lipid levels, statins exert well-proven anti-inflammatory effects. We investigated the effects of pravastatin on serum C-reactive protein (CRP) and neopterin levels in the short term after elective PCI. In this randomized prospective study, 93 patients undergoing elective PCI were enrolled. Group 1 (n=30) received pravastatin at a dose of 10 mg/day, Group 2 (n=29) was given 40 mg/day, and Group 3 (n=34) served as the control group and received no lipid-lowering drugs. Blood samples were drawn before and after PCI to measure serum CRP and neopterin levels. Differences among the groups for continuous variables were evaluated by the ANOVA and the Kruskal-Wallis test as appropriate. The Chi-square test was used for comparison of categorical variables. Demographic features and the characteristics of the PCI, including the number of vessels and lesions and the duration and number of inflations, did not differ among groups (p>0.05). Serum CRP and neopterin levels were significantly increased after PCI (p<0.001). Mean serum neopterin levels before and after the PCI were as follows: Group 1: 13.3±5.9 vs 22.8±15.4 nmol/L, Group 2: 16.9±10.2 vs 22.0±14.9 nmol/L, controls: 15.2±11.9 and 18.8±11.5 nmol/L. Prior pravastatin therapy had no significant effect on these inflammatory markers (F=0.5, p=0.6). Percutaneous coronary intervention induces a pronounced inflammatory response. The pre-procedural administration of 2 different doses of pravastatin seems not enough to suppress this inflammation at the short-term follow-up. Further trials are needed to clarify this issue.