High-sensitivity C-reactive protein in paediatric inflammatory bowel disease

Abstract

The measurement of hs-CRP did not prove useful in the assessment of disease activity or glucocorticoid treatment in paediatric IBD patients that had undetectable standard CRP.

C-reactive protein in Crohn’s disease: how informative is it?

“…With an arbitrary cut-off value of 1 mg/dl, there was a 73% sensitivity and 91% specificity in the prediction of granulomatous CD (OR 28; 6-134.32; p < 0.00001). A Finish study [37] reached comparable conclusions, and it was speculated that higher local production of TNF-a in the granulomatous lesions of CD patients could explain higher CRP levels.…”

“…Earlier studies already demonstrated the importance of CRP measurement as a guide in the determination of extent and in the management of patients with attacks of UC [34,35]. Yet, most of studies concluded that CRP levels in UC were lower than that in CD [24][25][26]29,31,[36][37][38]. There was also a bigger percentage of patients with normal CRP in UC than in CD.…”

“…However, in Jones et al [49] there was no correlation between CDAI score and hs-CRP. Sidoroff et al [37] looked for the correlation between hs-CRP C-reactive protein in Crohn's disease Review informahealthcare.com and clinical activity in pediatric patients with IBD who had undetectable values of standard CRP (<5 mg/l). Clinical activity was categorized into active and quiescent disease according to Physicians Global Assessment.…”

“…hs-CRP assays detected high levels in those previously thought to be within normal range [33,36,37,49]. In a Hungarian study in which disease activity was defined by HBI, the median hs-CRP gradually increased according to disease severity (mild: 20.7 mg/l; IQR: 11.5-41 mg/l, moderate-to-severe: 25.1 mg/l; IQR: 6.3-67.8 mg/l) [33].…”

Role of Biomarkers in the Study and Management of Inflammatory Bowel Disease

“…30 It is noteworthy that a recent Finnish study found no incremental benefit from the use of high-sensitivity CRP over that of standard CRP in children. 31 It is important to note that the tightness and even the direction of these correlations may vary when a given marker is used to study patients with either UC or CD, when evaluating patients with mucosal inflammation in different anatomic locations and even when different types of treatment are used. For example, several studies have suggested a trend for closer correlation between clinical activity and CRP in patients with CD and with ESR in those with UC.…”