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C-Reactive Protein (CRP)

15 Azn
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C-Reactive Protein (CRP)

C-reactive protein (CRP) is the most sensitive and rapidly responding acute-phase protein, used as a marker of inflammation, necrosis, and tissue injury. It plays a key role in stimulating the immune response, interacting with T- and B-lymphocytes, and activating the complement system. CRP is primarily synthesized in the liver (hepatocytes) and is absent in the blood of healthy individuals.

Clinical Importance of CRP

  • CRP levels correlate with disease activity and progression.
  • It increases significantly in inflammatory processes, parasitic infections, trauma, and malignancies.
  • CRP is often compared with ESR (erythrocyte sedimentation rate): both rise sharply at the onset of illness.
  • CRP decreases within days after successful treatment, returning to normal within 6–10 days, while ESR takes 2–4 weeks to normalize.
  • Unlike ESR, CRP levels are not affected by hormones or pregnancy.
  • In viral infections and spirochetal infections, CRP increases only slightly, whereas high CRP levels strongly indicate a bacterial infection.

 

Sample: Venous blood
Pre-test recommendations:

  • Fasting for 8–14 hours before the test is recommended.
  • The test can also be taken 4 hours after a light meal.
  • Collagen diseases (autoimmune disorders)
  • Acute infectious diseases
  • Cancer screening
  • Monitoring the effectiveness of antibacterial therapy
  • Assessing the treatment response in chronic diseases (e.g., amyloidosis)
  • Evaluating cardiovascular risk in patients with atherosclerosis, diabetes, and chronic dialysis

Interpretation of CRP Levels

Causes of Increased CRP Levels

  1. Infections:

    • Acute viral and bacterial infections
    • Tonsillitis
    • Infectious endocarditis
    • Tuberculosis
    • Neonatal sepsis
    • Meningitis
    • Sepsis
    • Peritonitis

  2. Autoimmune and inflammatory diseases:

    • Rheumatoid arthritis
    • Systemic vasculitis
    • Rheumatic polyarthritis
    • Ankylosing spondylitis (Bechterew’s disease)
    • Exacerbation of chronic inflammatory diseases (infectious and autoimmune)

  3. Tissue damage and trauma-related conditions:

    • Myocardial infarction
    • Stroke
    • Acute pancreatitis, pancreatic necrosis
    • Burns
    • Postoperative complications
    • Neutropenia

  4. Oncological conditions:

    • Malignant tumors and metastases
    • Multiple myeloma

  5. Cardiovascular and metabolic disorders:

    • Hypertension
    • Atherosclerosis
    • Diabetes mellitus
    • Obesity

  6. Hormonal and other conditions:

    • Elevated estrogen and progesterone levels
    • Gastrointestinal diseases
    • Graft rejection
    • Secondary amyloidosis
    • Pregnancy
    • Intense physical activity

  7. Medication-induced CRP elevation:

    • Use of oral contraceptives and estrogen therapy

Causes of Decreased CRP Levels

  • Use of nonsteroidal anti-inflammatory drugs (NSAIDs): aspirin, ibuprofen
  • Use of corticosteroids, statins, beta-blockers

Clinical Significance of CRP Measurement

  • CRP is an essential marker for monitoring inflammation and infection severity.
  • High CRP levels suggest bacterial infections, severe inflammation, or cardiovascular risk.
  • CRP normalization indicates effective treatment and reduced inflammation.