C-Reactive Protein (CRP) is an acute-phase protein, produced exclusively in the liver. Interleukin-6 is the mediator for the synthesis by the hepatocytes- of CRP, a pentamer of approximately 120.000 Daltons. CRP is present in the serum of normal persons at concentrations ranging up to 5mg/l. The protein is produced by the fetus and the neonate and it does not pas the placental barrier, as such it can be used for the early detection of neonatal sepsis.
Because febrile phenoena, leukocyte count and erythrocyte sedimentation rate (ESR) are often misleading, investigators now prefer a quantitative CRP determination as a marker for acute inflammation and tissue necrosis. Within 6 hours of an acute inflammatory challenge the CRP level starts to rise.
Serum concentration of CRP increases significantly in cases of both infectious and non-infectious inflammation, of tissue damage and necrosis and in the presence of malignant tumours.-- CRP is present in the active stages of inflammatory disorders like rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, psoriatric arthropathy, systemic lupus erythematosus, polyarteritis, ulcerative colitis and Crohn's disease.
Widespread malignant disease with carcinoma of the lung, stomach, colon, breast, prostate and pancreas, Hodgkin's disease, non-Hodgkin's lymphoma and lymphosarcoma will give rise to high levels of CRP resulting from tissue damage by invading tumor cells. CRP, therefore may be used to monitor malignancy.
The CRP-level increases dramatically following microbial infections, and this may be particularly helpful for the diagnosis and monitoring of bacterial septicemia in neonates and other immunocompromised patients at risk. In children, CRP is useful for differential diagnosis of bacterial and viral meningitis.
Because the biological half-life of this protein is only 24 hours, CRP accurately parallels the activity of the inflammation process and the CRP concentration decreases much faster than ESR or any other acute phase parameter, which is particularly useful in monitoring appropriate treatment of bacterial diseases with antibiotics.
C-Reactive Protein measurements during the early and late post transplant period of bone marrow and organ transplantations is particularly useful in the management of interfering infections in these immunosuppressed patients.
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