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#c-reactive protein
spooniestrong · 6 months
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"...intense hot flashes are associated with an increase in C-reactive protein..."
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cailynnjohnson · 20 days
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C-reactive protein
C-reactive protein (CRP) is an acute-phase serum protein. It is a member of the pentraxin family, produced mostly by cells in the liver in response to a variety of inflammatory cytokines. The levels of CRP in the blood are closely associated with the degree of inflammatory responses. CRP levels rise rapidly in response to threats such as trauma, inflammation, and infection and fall rapidly in response to remission. Thus, CRP levels are considered as non-specific markers of inflammation, and measurement of CRP levels has important clinical significance for the diagnosis of some inflammatory diseases such as rheumatoid arthritis, lupus, and vasculitis.
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v-r-lifescience · 1 month
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harmeet-saggi · 4 months
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C-Reactive Protein (CRP) Test: What It Is, Purpose & Results
What is the C-Reactive Protein (CRP) test? Can it provide vital insights into your health? How is it related to conditions like rheumatoid arthritis, lupus, psoriasis, inflammatory bowel disease, infection, autoimmune diseases, and chronic stress? If you've ever wondered about these questions, you're in the right place. In this comprehensive blog, we will delve into the world of the CRP test, its purpose, and the results it can yield. By the end of this article, you'll be better equipped to make informed decisions about your health, including when to seek doctor consultation or even an online doctor consultation.
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sommesick · 5 months
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Higher levels of empathy were linked to higher levels of c-reactive protein in the blood but only among individuals with low levels of depressive symptoms. This means that for people without significant depressive symptoms, empathy appeared to contribute to higher inflammation.
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jcrmhscasereports · 11 months
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Case of Necrotizing Pancreatitis following COVID-19 Infection by Faezeh Sehatpour in Journal of Clinical Case Reports Medical Images and Health Sciences  
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ABSTRACT
New aspects of COVID-19 are increasingly being recognized. Although the virus is mainly known to affect the lungs, involvement of other organs including the heart, liver, gastrointestinal, renal and pancreas is also detected. Acute pancreatitis is detected as one of both the early and late presentations of COVID -19. Cytokine storm or the presence of angiotensin-converting enzyme 2 (ACE2) receptor in pancreatic cells, are both two causes of pancreatic injury in COVID-19 infection. In this study, we reported a 25-year-old man admitted to our department with the impression of necrotizing pancreatitis concomitant with COVID-19 infection. Patient's lab data, imaging and outcomes were documented in full detail.
Abbreviations:
WBC, white blood cell;HB, hemoglobin; MCV, mean corpuscular volume; PLT, platelet; BUN, blood urea nitrogen; Na, sodium; K, potassium; ; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALK.P, alkaline phosphatase; ALB, albumin; LDH, Lactate dehydrogenase ; CPK, creatine phosphokinase; CRP,c-reactive protein; AFP,alpha-fetoprotein; CEA,carcinoembryonic antigen; CA19-9,cancer antigen 19-9; Immunoglobulin G4.
INTRODUCTION
The Covid-19 pandemic is an ongoing pandemic that started in December 2019 and spread rapidly around the word. COVID-19 was caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), first identified in Wuhan, China. So far, more than 200 countries have been affected by the pandemic. (1)
New aspects of COVID-19 are increasingly being recognized. Although the virus is mainly known to affect the lungs, involvement of other organs including the heart, liver, gastrointestinal, renal and pancreas is increasingly being reported. (2)
The involvement of the gastrointestinal system is maybe due to the expression of the angiotensin-converting enzyme2 (ACE2) on the hepatocyte, cholangiocyte and  other parts of the GI tract. (3) In a recent survey, acute pancreatitis was detected as one of both early and late presentations of COVID -19. (4-6) However, it is still unclear whether SARS-COV-2 directly affects pancreatic cells because of ACE2, if it is a cytokine storm which causes pancreatic injury. (7)
We reported a case of COVID-19 with subsequent acute necrotizing pancreatitis.
CASE REPORT
A 25-year-old man without any known medical disease presented to our emergency department with progressive epigastric pain, nausea and vomiting and anorexia one week prior to admission. He has no history of alcohol consumption. He also had a history of admission to another hospital about two weeks ago with a diagnosis of COVID-19 pneumonia. On admission, he has a blood pressure of 115/75 mm HG, a heart rate of 100 beats per minute, a temperature of 37.1 ⁰C and oxygen saturation of 95% while the patient is breathing in the room air. Primary investigations summarized in Table-1. Amylase and lipase were 146 IU/L and 82 IU/L respectively. Nasal swab test for COVID-19 (RT-PCR for SARS-CoV-2) was positive. Abdominal sonography showed markedly prominent pancreas with in homogeneous parenchymal echogenicity and large cystic lesion arising from the pancreas, in favor of acute complicated pancreatitis with pseudo cyst. The gall bladder has a normal size and wall thickness without any gall stones. The pancreatic duct was not dilated.  Due to the finding of abdominal ultra sound, CT scan of abdomen was done on him which revealed an enlarged pancreas with necrosis of the main portion of pancreatic parenchyma. Large cystic lesion measuring 15×7×11 cm in size arising from the pancreatic neck with extension to the right and left side of the abdomen suggestive of large pancreatic pseudo cyst (figure1).  Lung HRCT (low dose) also showed bilateral peripheral ground glass opacities in favor of COVID-19 pneumonia (figure2). According to the findings of a physical exam, laboratory data and clues in imaging immediate management of acute necrotizing pancreatitis (invasive intravenous hydration and pain control) was started for him. He was finally discharged from the hospital with a full recovery.
Table 1: laboratory data
Figure 1: Abdominal CT scan:  large loculated pseudo cystic structure measuring about 158mm*100mm in lesser sac due to post pancreatitis pseudo cyst formation.
Figure 2: lung HRCT: multiple ground glass and bilateral pleural effusion
DISCUSSION
Acute pancreatitis is an acute inflammation of the pancreas characterized by abdominal pain, nausea, vomiting and elevated exocrine pancreatic enzymes; amylase and lipase. Gallstones and chronic alcohol abuse are the most common causes of acute pancreatitis. Viruses are uncommon causes of acute pancreatitis. Pancreatitis has been reported with several viruses, including mumps, coxsackievirus, hepatitis A and B virus, cytomegalovirus, varicella-zoster, herpes simplex and human immunodeficiency virus. (8)
Although we have not conclusively proven the presence of the virus in the pancreas, the causes of COVID-19 and acute pancreatitis and the lack of other clear causes for pancreatitis strengthen the relationship between the two diseases.  In this study, the patient presented with necrotizing COVID-19in 19 in the early post period of COVID-19 infection.
In Fan Wang and colleagues' survey, 52 COVID-19 cases followed and showed that 17% of COVID-19 patients developed pancreatic injury and presented with mild elevated pancreatic enzymes; serum amylase and lipase without clinically severe pancreatitis. The possibility of drug induced acute pancreatitis in patients who have received medication due to COVID-19 is also expressed as one of the reasons for acute pancreatitis in COVID-for19 infection. (9) Saffa Saeed Al Mazrouei and his teammates reported a 24-year-old patient with acute non-necrotizing pancreatitis with concurrent COVID-19. No evidence of pseudo cyst or abscess was detected in his imaging. (10)
Pancreatic damage can be due to the direct effect of the virus on pancreatic cells or indirectly secondary to the immune system. In another study in Wuhan, it showed that ACE2 was expressed in the pancreas higher than the lung in the normal population, indicating that SARS-CoV-2 can bind to ACE2 in the pancreas and cause pancreatic cell damage. (7, 11)
Acute pancreatitis is one of the presentations or complications of COVID-19 infection. Further investigation with samples is needed to reveal the pathophysiology, presentation, treatment and prognosis of acute pancreatitis in COVID-19 infection.
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jcmicr · 11 months
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A 12 Day- Old Female Infant Diagnosed with Pelvic Osteomyelitis in the Pediatric Emergency Department by  Mehmet Ali Oktay in Journal of Clinical and Medical Images, Case Reports 
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Abstract
Osteomyelitis (OM) is a bacterial disease that is very rare in newborns and has devastating consequences. Neonatal OM is seen in 1-3 in 1000 babies. We presented a 12-day-old female baby who was brought to the Pediatric Emergency Department (PED). Because she could not move her leg. She did not have fever and septic appearance and had a history of hospitalization in Neonatal Intensive Care Unit; acute phase reactants were high and radiological imaging performed gradually was consistent with OM. Our patient is the youngest patient who was diagnosed with pelvic OM upon admission to the PED. Earlydiagnosis and treatment prevent complications and sequels. Keywords: Osteomyelitis; newborn; pediatric emergency
Introduction
Osteomyelitis often occurs secondary to the hematogenous spread of microorganisms into the blood-rich metaphysis of the developing bone. When left untreated, it leads to complications such as joint destruction and decreased range of motion [1]. Osteomyelitis (OM) of the hip is rare in newborns. Signs and symptoms are quite different compared to older children. This may cause difficulties/delays in diagnosis and permanent disability [2]. Successful management of OM in the neonatal period has been associated with rapid correct diagnosis and adequate correct treatment [2, 3]. The incidence of OM in the pediatric age group is 1/5000 cases. About 50% of pediatric OM cases are under the age of five. The incidence of neonatal OM is 1-3/1000 cases [3]. Although there are studies on patients diagnosed with osteomyelitis while staying in neonatal intensive care unit (NICU) [1, 4, 5], cases diagnosed upon PED (Pediatric Emergency Department) admission are very rare [6]. In this article, the youngest case in literature who went to the PED and was diagnosed with pelvic and acetabulary OM is presented.
Case Report
A 12-day-old girl, born from the first pregnancy of a 28-year-old mother, was admitted to the PED with complaints of restlessness and inability to move her right leg. The day before the application, it was stated by her mother that she did not move her leg, that she was agitated when forced to move, and could not be consoled. The baby did not have a history of fever or trauma, her feeding was good, and her urine and defecation were normal. From her history, it was learned that she was born at 36 weeks and 3 days of gestation and had intrauterine growth retardation compatible with 31 weeks gestational age, and she was born by emergency cesarean section due to preeclampsia. The patient, who was hospitalized in the NICU due to temporary tachypnea of the newborn after birth, was discharged on the sixth postnatal day. During the follow-up in the NICU, umbilical catheterization was not applied to the patient. She had not received antibiotic treatment and no growth was detected in blood cultures taken before discharge.
At her evaluation in the Pediatric Emergency Department triage area, she was a restless baby with a good general appearance. Vital signs; body temperature was 37°C, heart rate was 140/min, respiratory rate was 42/min, pulse oximetry was 98%, and mean arterial pressure was 45 mmHg. There was no pathological finding in the physical examination, and it was observed that the patient's discomfort increased due to the position given to the hip and leg while changing the diaper. While abducting the right thigh from the hip in the supine position, there was limited range of motion compared to the left. No swelling or redness was detected on the joint surface.
Laboratory and radiological examinations were planned for the patient with a preliminary diagnosis of septic arthritis. In laboratory tests: hemoglobin (Hb) 14.6 g/dL, RBC (Erythrocyte) - 3.361 x10.e6/uL, hematocrit (Hct) 40.04%, white blood cell (WBC) 16.82 x10.e3/uL, neutrophil percentage 59.8%, C-reactive protein (CRP) 25.9 mg/L, erythrocyte sedimentation rate (ESR) 51 mm/hr, procalcitonin (PCT) 2.95 ng/mL, IL-6 145.6 pg /mL detected. On direct radiographs of the lower extremity and pelvis, the right femoro-acetabular distance was observed to be increased (Figure 1). Long bone radiographs were normal. In the superficial tissue ultrasound (US) performed for the right hip joint, bilateral hip joints were compared with each other, and no significant effusion was observed on the right side. The patient was consulted to the Orthopedics and Traumatology department with a preliminary diagnosis of septic arthritis. MRI was requested from the patient for the differential diagnosis of septic arthritis.
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Figure 1: There is an increase in the right acetofemoral distance compared to the left.
Bilateral hip MR imaging showed “The right femoral head is small and irregular in appearance, and an area of pathological signal change in the right femur proximal metaphysis, medullary bone marrow, and solid periosteal reaction in the lateral proximal section is observed. Widespread edema was observed in the surrounding muscle planes, fascial surface and subcutaneous adipose tissue adjacent to the hip joint. In addition, medullary bone marrow edema was observed in the right acetabulum (osteomyelitis). Areas of pathological signal changes consistent with diffuse edema are observed in the right obturator externus, pectineus, quadriceps muscles, gluteal muscle planes and iliacus muscle (myositis). Minimal free fluid was observed in the right hip joint space. Findings were primarily evaluated as compatible with osteomyelitis and myositis.” (Figure 2).
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Figure 2: Osteomyelitis in the proximal metaphysis of the femur
Due to the history of hospitalization in the intensive care unit, the patient was diagnosed with OM secondary to hematogenous spread and, according to the age, to include possible infectious agents, vancomycin (15mg/kg/dosex3), ceftazidime (30 mg/kg/dose x 3), fluconazole loading (12 mg/kg/dose)) and maintenance (6 mg/kg/dose) treatment was started. Blood culture was taken before antibiotic treatment. Our patient, who received antibiotic doses only one day before the operation, was operated on the postnatal 13th day.
The patient was operated by the Orthopedics and Traumatology department and the intra-articular pus was drained. From the material; joint fluid culture, fungal culture, tuberculosis PCR, ARB staining, fungus search was sent. There was no growth in the blood culture, but because of the growth of ceftazidime-resistant Klebsiella pneumoniae in the joint fluid culture, ceftazidime was discontinued and meropenem (20 mg/kg/dosex3) treatment was started. Fluconazole was discontinued on the 8th day because there was no growth in the fungal culture. The patient was discharged with oral trimethoprim-sulfamethoxazole treatment after 25 days of vancomycin and 27 days of meropenem treatment. Trimethoprim-sulfamethoxazole was discontinued 22 days after discharge. The regression of the inflammation was seen in the MRI taken under the control of the outpatient clinic. verbal consent was obtained from the patient's parents for the publication of the article.
Discussion
This case demonstrates the importance of detailed investigation of newborn infants admitted to PED. Although OM in newborns is rare, there are difficulties in diagnosing and treating it. High suspicion is required for early diagnosis and observation of clinical signs is very important.
Risk factors for osteomyelitis in newborns are stated as immature host-defense mechanisms, invasive intervention such as umbilical catheterization. It has been shown that half of the cases diagnosed with neonatal OM have a history of umbilical catheterization. It has been observed that the pregnancy and delivery history of the mother is also important in the development of OM, and maternal complications such as maternal hypertension, preeclampsia, ablatio placentae, infection are present in approximately half of the infants who develop OM [7]. Particular attention should be paid to the evaluation of newborn cases, especially in PEDs where is crowded and the number of patient admissions is high. Newborns are among the patients at risk for PED and require special care. Application complaints and prenatal, natal and postnatal history should be questioned in detail. It was observed that the mother of our case had preeclampsia during pregnancy, but umbilical catheterization was not applied to the baby.
In studies conducted in newborns with neonatal osteomyelitis, the most common sites of involvement were reported as femur, humerus, and tibia, respectively [1, 4, 8]. The pelvis is a rare site of hematogenous disseminated OM for neonates. Pelvic OM constitutes 2.3% of all childhood osteomyelitis cases [3]. Our case also had pelvic (acetabular) OM, which is a rare site of OM involvement. Involvement was also demonstrated in the proximal region of the right femur.
Pelvic OM was defined in three cases at 5, 15, and 18 days in the neonatal period [3, 9, 10]. In the literature, it has been observed that mostly cases hospitalized in the NICU were diagnosed with osteomyelitis [1, 3, 4, 8-10]. As far as we can find in the literature, a 4-week-old case with a diagnosis of distal tibial OM and culture of GBS has been reported, just like our case [6]. Our case is the youngest OM case diagnosed in the emergency department, except for the case in the literature. The clinical features, presentation symptoms, cultures and risk factors of cases diagnosed with neonatal osteomyelitis in the literature are shown in (Table 1)
Table 1: Comparison of cases with neonatal osteomyelitis in the literature.
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Clinical symptoms are related to the bone or joint area involved in newborns. Swelling and local inflammation findings are common findings in the neonatal osteomyelitis group. Systemic findings such as fever are seen in fewer of these cases. A highly variable rate of fever was found in 9.1-76.5% of patients with extensive neonatal osteomyelitis. In addition, it has been shown that the WBC count, CRP and ESR levels are high in the cases [1, 4, 8, 11]. In our case, there was no fever, but there were complaints of inability to move her right leg and restlessness. Laboratory parameters were high and consistent with the literature. In cases with osteomyelitis, direct radiographs can guide the correct diagnosis, exclude other diagnostic possibilities, or provide clues for underlying pathological conditions [12]. Soft tissue swelling on plain radiographs can be seen within days of the onset of infection. It can also show periosteal reaction, lytic lesions, joint effusions and destructive bone changes 7-10 days after the onset of infection [13]. US findings begin with nonspecific swelling in the soft tissues adjacent to the bone. US can show thickening and elevation of periosteal and subperiosteal fluid collections as early as 3 days [14]. In a study comparing osteomyelitis groups, it was shown that the diagnostic value of US was statistically higher in the newborn group compared to the other groups, regarding the capacity of detecting subperiosteal abscesses [11]. In our case, however, an increased femoro-acetabular distance was observed on direct X-ray, but no finding was found on US. This supports the view that the primary step in the pediatric emergency department in patients with suspected osteomyelitis should be started with direct X-ray as recommended in the literature.
MR imaging is the most useful imaging technique for evaluating suspected OM, allowing early detection of osteomyelitis and assessment of the extent of involvement and disease activity. MRI is very sensitive in detecting OM 3-5 days after the onset of infection [12]. As seen in our case, it still remains the gold standard. However, we recommend hospitalization in order not to miss the newborn cases because MRI is difficult in emergency conditions.
In infants, osteomyelitis and septic arthritis often coexist. While Staphylococcus aureus is the most common organism causing osteomyelitis at all ages, GBS and Escherichia Coli are important pathogens to be considered in newborns [6]. Culture is found to be negative in 22-50% of the cases [15]. Antibiotics to be used in neonatal OM should be effective against these pathogens [16]. In our case, treatment with antibiotics covering these pathogens was applied and Klebsiella pneumoniae growth was observed in the pus culture.
We think that even with rapid diagnosis and aggressive treatment, there are orthopedic sequelae and inadequate treatment increases the risk of chronic osteoma [16], therefore, in cases who apply to the pediatric emergency department with these complaints, early diagnosis and treatment of neonatal OM should be planned in a timely manner to minimize long-term sequelae.
In conclusion, a detailed anamnesis should be taken and a careful physical examination should be performed in newborns who present to the PED with limited range of motion at joints. Neonatal OM cases mostly consist of cases diagnosed while staying in the NICU. Pelvic involvement is rare and our case is the youngest pelvic OM case diagnosed in the PED.
For more details : https://jcmimagescasereports.org/author-guidelines/ 
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bella-joseph-1994 · 2 years
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bookpiofficial · 2 years
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Usefulness of Presepsin Concentrations for Differentiating Sepsis Severity | Chapter  06 | New Horizons in Medicine and Medical Research Vol. 6
The importance of early detection and treatment of sepsis is critical for a better clinical outcome. For the quick diagnosis of sepsis, many sepsis biomarkers are commonly employed. This study looked into the diagnostic accuracy of presepsin, procalcitonin (PCT), and C-reactive protein (CRP) in distinguishing sepsis severity, as well as their link with the Sepsis-related Organ Failure Assessment (SOFA) score.
100 septic patients from two university clinical centres were enrolled in the trial during two time periods. The Sepsis-3 definitions were used to stratify the patients. Biomarkers and the SOFA score were measured four times during the illness. A sandwich ELISA kit was used to measure presepsin. A generalised linear mixed effects model was used to assess changes in biomarker concentrations and SOFA score values during the illness, as well as to quantify differences across severity groups. Multivariate analysis was used to look into the relationship between biomarkers and SOFA score.
Patients with septic shock (n=34) exhibited substantially higher presepsin concentrations on admission than patients with sepsis (n=66), with mean vs. SD of 128.547.6 ng/mL vs. 88.665.6 ng/mL, respectively (p0.001). PCT and CRP concentrations were not substantially different between sepsis severity groups. There was also a high association between presepsin and SOFA score (p0.0001).
Conclusions: In the research groups, presepsin showed a strong ability to differentiate septic shock from sepsis. The severity of sepsis was not differentiated by PCT or CRP.
Author(S) Details
Ajete Aliu-Bejta
ICU Department, University Clinic of Infectious Diseases, Alexander Flemingu, 10000 Pristina, Kosovo.
Anita Atelj
ICU Department, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, Mirogojska 8, 10000 Zagreb, Croatia.
Mentor Kurshumliu
“PROLAB” Biochemical Laboratory, Mark Dizdari, 10000 Pristina, Kosovo.
Shemsedin Dreshaj
ICU Department, University Clinic of Infectious Diseases, Alexander Flemingu, 10000 Pristina, Kosovo.
Bruno Barsic
ICU Department, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, Mirogojska 8, 10000 Zagreb, Croatia.
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https://stm.bookpi.org/NHMMR-V6/article/view/6437
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crippleprophet · 1 year
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homegrown health literacy part 1.2: WTF is CRP?
hello and welcome back to my series about knowing when your doctors are full of shit! part 1 is about interpreting bloodwork results.
disclaimer: i’m Just Some Guy
CRP is a blood test that measures inflammation. it’s a general test, so it can’t say what chronic or acute condition is causing the inflammation, just that it’s there.
CRP stands for C-reactive protein, a type of protein in your blood. the amount of protein increases during (chronic or acute) inflammation, so a higher CRP indicates more inflammation. this could indicate an infection or an autoimmune disease, but CRP is also elevated during pregnancy. the average CRP for US Americans is estimated to be somewhere between 1 and 2 mg/L.
note: i use the units mg/L throughout this post, which is how CRP results are reported by Labcorp and Quest. some other providers report results in mg/dL, which would change the “normal” range by a factor of 10 (i.e., 0-1.0 rather than 0-10).
when used for cardiac disease screening, CRP results are interpreted as follows:
0-1 lower risk
1-3 average risk
3+ higher risk
a CRP greater than around 5 or 6 may indicate an underlying inflammatory condition. this should generally be followed by repeating the test about a month later, then conducting further screening if the result is still elevated.
while the reference range for CRP is often listed as 0-10 mg/L, meaning a lab report may not flag your result as abnormal unless it’s higher than 10, values lower than 10 can still indicate active autoimmune disease. my CRP was used in diagnosing me with ankylosing spondylitis when it was 8.0, and a range of values above 7 were consistently considered indicative of active disease.
additionally, a lower CRP should not be used to rule out autoimmune disease; as always, there is no one blood test and your doctor should consider the full clinical picture, particularly your symptoms, not just the test results. it’s relatively common to rerun ESR and CRP tests about 3 months later if they didn’t originally indicate inflammation but your symptoms still indicate you might have an autoimmune disease.
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blackmoldmp3 · 5 months
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it’s not supposed to look like that 👍
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mission-to-dietitian · 5 months
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v-r-lifescience · 2 months
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second-medic06 · 10 months
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insightslicelive · 1 year
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C-Reactive Protein Testing Market Share, Dynamics, Research Insights, Size Estimation, Trends to 2032
C-Reactive Protein Testing Market Share, Dynamics, Research Insights, Size Estimation, Trends to 2032
The latest report published by insightSLICE shows that the C-Reactive Protein Testing Market is likely to gather a great pace in the coming years. Analysts examined drivers, restraints, risks and openings in the global industry. The C-Reactive Protein Testing report shows the likely direction of the industry in the coming years as well as its estimates. A close study aims to understand the market…
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curastexmedihealth · 1 year
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