Saturday, July 14, 2012

C-Reactive protein test is interesting but not clinically useful

Inflammatory processes play a significant role in the early development of artherosclerosis and in the final rupture of a mature plaque resulting in an acute vascular event, Myocardial infarction.

There are a number of markers of inflammation that can be measured and followed by physicians. Today we will focus on one of the common test measured by physicians ,C-Reactive protein (hs CRP ).

 C-Reactive Protein is produced in the liver and contains pro - inflammatory and pro-athrogenic
   properties.

 Autopsie studies have found higher levels in the people with acute plague rupture than those with stable atherosclerotic lesions.  Higher than normal levels have been found in people with obesity, smokers have a 2 fold higher concentration , metabolic syndrome , Type 2 diabetes, post menopausal women  taking hormone replacement therapy and kidney disease.
Cigarette smoking is the strongest environmental stimulus for CRP production.


Clinical Testing


Daily fluctuations in the test are significant and can be effected by minor things such as viral infection, skin lacerations ,  and some noninflammatory states ( chronic fatigue, high protein diets, alcohol consumption and depression) . Chronic inflammatory state such as rheumatoid arthrites and lupus may cause false positives. Levels can remain elevated for months following following major infections or other trauma.


Clinically I found this test to be interesting for help in understanding the disease process but of no real clinical benefit in my treatment decisions. I stopped ordering the test .

Tomorrow- More on why I stopped ordering CRP test.

Have fun , Be Smart and learn more about your lab test
David Calder,MD














3 comments:

  1. As a diabetic myself, I have learned to be conscious about my diet and protein intake. I prefer Wyeth's line of non-sweetened best pre workout supplements that tastes mild but the results are the same.

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  2. I wouldn't say it's completely useless. The fact that it lets you know something's wrong would be enough reason to keep the test around as an option as far as the local redmond urgent care is concerned.

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  3. Thank you for your comment. I should have been more specific in my title. I was referring to hsCRP . Dr. calder

    ReplyDelete

Your comments and questions are appreciated. David Calder,MD