The relation of C-reactive protein to vasoocclusive crisis in children with sickle cell disease

Mohammed, Fatima Ali; Mahdi, Najat; Sater, Mai S.; Al-Ola, Khadija; Almawi, Wassim Y.

doi:10.1016/j.bcmd.2010.08.003

Cited by 33 publications

(23 citation statements)

References 27 publications

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“…Heightened proinflammatory cytokine production has been reported in individuals with SCA during the steady state and in VOC [32], [33], [36]. In this study, CRP levels in stable SCA patients were higher than that of the controls.…”

Section: Discussionsupporting

confidence: 54%

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Serum Copeptin and Cortisol Do Not Accurately Predict Sickle Cell Anaemia Vaso-Occlusive Crisis as C-Reactive Protein

et al. 2013

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ObjectiveThis study assessed the diagnostic performance and prognostic properties of C-reactive protein (CRP), copeptin and cortisol in individuals with sickle cell anaemia (SCA).DesignProspective case-control studyMethodsSixty consecutive SCA subjects (18–40 years) comprising 30 subjects in the steady state and 30 subjects in vaso-occlusive crisis (VOC) were recruited into this study. Thirty (30) apparently healthy individuals with HbAA genotype served as controls. ELISA was used for the determination of serum levels of copeptin, CRP and cortisol. Data obtained were statistically analyzed using the Student’s t-test and Mann Whitney U as appropriate and P<0.05 was considered significant.ResultsSCA subjects in VOC had significantly lower copeptin level and significantly higher CRP level compared with controls. However, serum levels of copeptin, cortisol and CRP were significantly higher in SCA subjects in VOC compared with SCA subjects in steady state. Furthermore, CRP had the widest Area under the ROC curve (AUROC) than copeptin and cortisol. No significant difference was observed in the levels of copeptin, CRP and cortisol when SCA subjects in VOC who were hospitalized for less ≤5 days were compared with subjects who had longer stays.ConclusionIt could be concluded that C-reactive protein has a superior diagnostic performance for vaso-occlusive crisis in individuals with sickle cell anaemia and that C-reactive protein, cortisol and copeptin are not good prognostic markers in SCA subjects in vaso-occlusive crisis.

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Section: Discussionsupporting

confidence: 54%

“…Mohammed et al [33] also reported a strong association between increased CRP levels with vaso-occlusive crisis (VOC). However, its diagnostic and prognostic performance in individuals with SCA still needs further research.…”

Section: Introductionmentioning

confidence: 99%

Serum Copeptin and Cortisol Do Not Accurately Predict Sickle Cell Anaemia Vaso-Occlusive Crisis as C-Reactive Protein

et al. 2013

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“…Microvascular (primarily postcapillary venular) occlusion is accepted to be a major component of the pathophysiology in SCD [2; 3]. Although publications on the use of skin LDF assessment in SCD are relatively sparse (14 publications total), evidence suggests that microvaso-occlusion in SCD is present in the cutaneous circulation [4; 5; 6].…”

Section: Introductionmentioning

confidence: 99%

Serial assessment of laser Doppler flow during acute pain crises in sickle cell disease

Shi¹,

Manwani²,

Olowokure³

et al. 2014

Blood Cells, Molecules, and Diseases

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Changes in basal laser Doppler flowmetry (LDF) of skin blood flow in sickle cell disease are reported to have pathophysiologic relevance in pain crisis. This is the first study to strictly control for LDF variability in determining the value of serial, basal (unprovoked) skin LDF as a practical method to assess resolution of acute pain crisis in sickle cell patients. Daily LDF measurements were repeated on the exact same skin areas of the calf and forehead throughout each of 12 hospital admissions for uncomplicated acute pain crisis. A progressive increase in perfusion was observed in the calf throughout hospitalization as pain crisis resolved, but measurement reproducibility in the calf was poor. Reproducibility in the forehead was better, but no significant trend over time in perfusion was seen. There was no significant correlation between perfusion and pain scores over time. There was also no significant pattern of LDF oscillations over time. In conclusion, only perfusion units and not oscillatory pattern of LDF has probable pathophysiological significance in sickle cell disease vaso-occlusion. The reproducibility of basal skin LDF specifically in sickle cell disease needs to be confirmed.

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“…In the pediatric population, CRP has been utilized in diseases such as Kawasaki disease [13], asthma [14], appendicitis [15], and neonatal sepsis [16]. Recently, an elevation of the CRP has been noted in children with SCD during episodes of vasoocclusive crisis [17].…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the C-Reactive Protein in Predicting the Need for Antibiotics Among Febrile Inpatients with Sickle Cell Disease

Gershel¹,

Kreiner²,

Spitzer³

et al. 2015

TOIDJ

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Abstract:Objective: To determine whether the C-reactive protein (CRP) can help identify which febrile patients with sickle cell disease (SCD) require antibiotic therapy. Patients and Methods:We performed a chart review of patients with SCD (including S-S, S-C, and S-Thal) admitted to the hospital with fever [temperature >38.3 o C <2 years of age; >38.9 o C ≥2 years of age] over a thirty-month period (July 2009 -December 2011). Data extracted included temperature, age, high sensitivity CRP value, chest x-ray and culture results, and the underlying cause of fever, categorized as bacterial (antibiotics necessary) or non-bacterial (antibiotics not necessary). The Mann-Whitney U-test was then used to compare the median CRP levels of patients requiring antibiotics versus those whose illnesses did not require antibiotic treatment.Results: Fifty-four febrile patients with SCD were admitted to the hospital. Nineteen had final diagnoses that required antibiotic treatment and their median CRPs were significantly higher than the thirty-five who had diagnoses that did not meet the requirements for antibiotic treatment (100.9 mg/L vs 17.3 mg/L, p <.001). All patients who needed antibiotics had a CRP >39 mg/L. Conclusion:The current data indicate that among febrile patients with SCD, the CRP may help differentiate bacterial infections which require antibiotic treatment from other diseases for which antibiotics are not necessary. Our data suggests that there may be a level of CRP below which a bacterial etiology is unlikely.

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The relation of C-reactive protein to vasoocclusive crisis in children with sickle cell disease

Cited by 33 publications

References 27 publications

Serum Copeptin and Cortisol Do Not Accurately Predict Sickle Cell Anaemia Vaso-Occlusive Crisis as C-Reactive Protein

Serum Copeptin and Cortisol Do Not Accurately Predict Sickle Cell Anaemia Vaso-Occlusive Crisis as C-Reactive Protein

Serial assessment of laser Doppler flow during acute pain crises in sickle cell disease

Usefulness of the C-Reactive Protein in Predicting the Need for Antibiotics Among Febrile Inpatients with Sickle Cell Disease

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