C-reactive protein: Difference between revisions

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|bgcolor="Beige"|[[Abciximab]],[[Adalimumab]],[[Anakinra]],[[Aspirin]],[[Boldenone]],[[Clarithromycin]],[[Clindamycin]],[[Corticosteroid]],[[Demeclocycline]],[[Doxycycline]],[[Drospirenone]],[[Erythromycin]],[[Estrogen]],[,[[Fluoxetine]],[[Fluvoxamine]],[[Ibuprofen]],[[Imatinib]],[[Ketamine]],[[Ketorolac]],[[Tacrolimus]],[[Heparin Induced Thrombocytopenia]]
|bgcolor="Beige"|[[Abciximab]],[[Adalimumab]],[[Anakinra]],[[Aspirin]],[[Boldenone]],[[Clarithromycin]],[[Clindamycin]],[[Corticosteroid]],[[Demeclocycline]],[[Doxycycline]],[[Drospirenone]],[[Erythromycin]],[[Estrogen]],,[[Fluoxetine]],[[Fluvoxamine]],[[Ibuprofen]],[[Imatinib]],[[Ketamine]],[[Ketorolac]],[[Tacrolimus]],[[Heparin Induced Thrombocytopenia]]
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Revision as of 14:33, 14 June 2012

C-reactive protein, pentraxin-related
Identifiers
Symbols CRP ; MGC149895; MGC88244; PTX1
External IDs Template:OMIM5 Template:MGI HomoloGene: 476
RNA expression pattern
More reference expression data
Orthologs
Template:GNF Ortholog box
Species Human Mouse
Entrez n/a n/a
Ensembl n/a n/a
UniProt n/a n/a
RefSeq (mRNA) n/a n/a
RefSeq (protein) n/a n/a
Location (UCSC) n/a n/a
PubMed search n/a n/a

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]

Overview

C-reactive protein (CRP) is a plasma protein, an acute phase protein produced by the liver. It is a member of the pentraxin family of proteins. It should not be confused with C-peptide or Protein C.

C-reactive protein (CRP) is an inflammatory marker with a very large body of evidence demonstrating its prognostic utility in apparently healthy patients, as well as patients with acute coronary syndromes. Pre-angioplasty levels of CRP predict outcome, CRP levels rise after angioplasty, and it appears that the rise can be blunted by GP IIb/IIIa inhibitors.

History and nomenclature

C-reactive protein was originally discovered by Tillett and Francis in 1930 as a substance in the serum of patients with acute inflammation that reacted with the C polysaccharide of pneumococcus.[1] Initially it was thought that CRP might be a pathogenic secretion, as it was elevated in people with a variety of illnesses, including carcinomas. Discovery of hepatic synthesis and secretion of CRP closed that debate

Genetics and biochemistry

The CRP gene is located on the first chromosome (1q21-q23). CRP is a 224 residue protein[2] with a monomer molar mass of 25106 Da. The protein is an annular pentameric disc in shape. Proteins with this type of configuration are known as pentraxins. Native CRP is a bit different as it has 10-subunits making two pentameric discs, with an overall molecular mass of 251060 Da.

Pathophysiology

In the field of atherosclerosis, it is unclear if CRP plays a putative role in disease or is a marker of ongoing disease.

  • C-reactive protein (CRP) is an acute phase protein formed in the liver. The stimulus for CRP production is IL-6.
  • CRP rises more than 6 hours after triggering stimulus
  • Upon resolution of condition, CRP rapidly declines
  • CRP is considered to be a better indicator for an inflammatory response because of its shorter half-life and rapid increase

Function

CRP is a member of the class of acute phase reactants as its levels rise dramatically during inflammatory processes occurring in the body. This increment is due to a rise in the plasma concentration of IL-6, which is produced by macrophages, endothelial cells and T-cells as well as adipocytes. CRP binds to phosphorylcholine on microbes. It is thought to assist in complement binding to foreign and damaged cells and enhances phagocytosis by macrophages, which express a receptor for CRP. It is also believed to play an important role in innate immunity, as an early defense system against infections.

Diagnostic use

CRP is used mainly as a marker of inflammation. Measuring and charting C-reactive protein values can prove useful in determining disease progress or the effectiveness of treatments. Blood, usually collected in a serum-separating tube, is analysed in a medical laboratory or at the point of testing.

Various analytical methods are available for CRP determination, such as ELISA, immunoturbidimetry, rapid immunodiffusion and visual agglutination.

Viral infections tend to give a lower CRP level than bacterial infection.

Cardiology diagnostic test

Arterial damage is thought to result from inflammation due to chemical insults. CRP is a general marker for inflammation and infection, so it can be used as a very rough proxy for heart disease risk. Since many things can cause elevated CRP, this is not a very specific prognostic indicator. Also, these values refer only to prolonged elevation, so a single measurement would be meaningless.

C-reactive protein blood test[3]

Low risk: <1mg/L
High risk: >3mg/L

Differential Diagnosis

Most common

Complete Differential Diagnosis

(By organ system)

Cardiovascular Amyloidosis,Catecholaminergic polymorphic ventricular tachycardia,Myocarditis,Ventricular Tachycardia,Abdominal Aortic Aneurysm,Acute Coronary Syndromes,Arrhythmogenic right ventricular dysplasia,Atherosclerosis,Brugada syndrome,Cardiomyopathy,Congestive Heart Failure,Myocardial infarction,Peripheral Arterial Disease,Romano-Ward syndrome,Shock (medical),Stress cardiomyopathy,Subclavian Artery Disease,Down syndrome,Noonan syndrome,Andersen-Tawil syndrome,Pseudoxanthoma elasticum,Rheumatic fever,Homocystinuria,Ehlers-Danlos syndrome,Friedreich's ataxia,Williams syndrome
Chemical / poisoning No underlying causes
Dermatologic Acrodermatitis enteropathica,Porphyria cutanea tarda,Squamous cell carcinoma,Acne vulgaris,Contact dermatitis,Eczema,Pachyonychia congenita,Pemphigus,Scleroderma,Neurofibromatosis
Drug Side Effect Abciximab,Adalimumab,Anakinra,Aspirin,Boldenone,Clarithromycin,Clindamycin,Corticosteroid,Demeclocycline,Doxycycline,Drospirenone,Erythromycin,Estrogen,,Fluoxetine,Fluvoxamine,Ibuprofen,Imatinib,Ketamine,Ketorolac,Tacrolimus,Heparin Induced Thrombocytopenia
Ear Nose Throat Collagenopathy, types II and XI,Wolfram syndrome,Ear infections,Down syndrome
Endocrine Diabetes mellitus,Diabetic ketoacidosis,Diabetic nephropathy,Glucagonoma,Graves' Disease,Growth hormone deficiency,Hypothyroidism,Lipoid congenital adrenal hyperplasia,McCune-Albright syndrome,Catecholaminergic polymorphic ventricular tachycardia,Wolfram syndrome,Werner syndrome,X-linked adrenal hypoplasia congenita,Peroxisomal disorder,Neuroendocrine tumors,Thyroid Carcinoma,Pendred syndrome,Down syndrome
Environmental Andrographis paniculata,Nylon worker's lung,Toxic and Nutritional Optic Neuropathy
Gastroenterologic Ascites,Autoimmune Hepatitis,Budd-Chiari syndrome,Celiac disease,Cholecystitis,Chronic pancreatitis,Cirrhosis,Colitis,Crohn's disease,Diarrhea,Eosinophilic gastroenteritis,Peutz-Jeghers syndrome,Shwachman-Diamond syndrome,Spontaneous bacterial peritonitis,Typhoid fever,Wilson's disease,Amyloidosis,Acrodermatitis enteropathica,Wilson's disease,Cystic Fibrosis,Dubin-Johnson syndrome,Primary biliary cirrhosis,Hemochromatosis,Zellweger syndrome,Gaucher's disease,Protein-Losing Enteropathy,Gastrointestinal stromal tumor,Hepatocellular carcinoma,Ulcerative colitis,Hepatitis B,Hepatitis C/co-infection with HIV,Hepatitis G,Hepatitis,Sarcoidosis,Rett syndrome,Sandhoff disease,Polycystic kidney disease,Salla disease,Down syndrome
Genetic Allan-Herndon-Dudley syndrome,Alport syndrome,Andersen-Tawil syndrome,ASPM (Genetics),Ataxia Telangiectasia,Atransferrinemia,Bloom syndrome,Cardiofaciocutaneous syndrome,Chronic granulomatous disease,Congenital Adrenal Hyperplasia,Congenital muscular dystrophy,Cystic Fibrosis,Down syndrome,Dubin-Johnson syndrome,Familial Mediterranean fever,Friedreich's ataxia,Myotonia congenita,Myotonic dystrophy,Neurofibromatosis,Niemann-Pick disease,Noonan syndrome,Osteogenesis imperfecta,Otospondylomegaepiphyseal dysplasia,Pachyonychia congenita,Pendred syndrome,Polycystic kidney disease,Primary biliary cirrhosis,Primary ciliary dyskinesia,Pseudoxanthoma elasticum,Rett syndrome,Rubinstein-Taybi syndrome,Salla disease,Sickle-cell disease,Stargardt's disease,Tay-Sachs Disease,Treacher Collins syndrome,Usher syndrome,Vitelliform macular dystrophy,Von Hippel-Lindau disease,,Von Willebrand disease,Waldenstrom macroglobulinemia,Walker-Warburg syndrome,Werner syndrome,Williams syndrome,Wiskott-Aldrich syndrome,Wolfram syndrome,X-linked adrenal hypoplasia congenita,X-linked alpha thalassemia mental retardation syndrome,X-linked congenital stationary night blindness,ZAP70 deficiency,Norrie disease,Shwachman-Diamond syndrome,SADDAN,Cystinuria,Sandhoff disease
Hematologic Abetalipoproteinemia,Activated protein C resistance,Acute myeloid leukemia,Anemia,Angiogenesis,Angiopathy,Antiphospholipid syndrome,Arteriogenesis,Blood transfusion,Cryoglobulinemia,Disseminated Intravascular Coagulation,Fanconi anemia,Fat Embolism Syndrome,Hemochromatosis,Hemoglobinuria,Heparin Induced Thrombocytopenia,Multiple myeloma,Protein S deficiency,Thrombocytopenia,Thrombocytosis,Thrombotic thrombocytopenic purpura,Porphyria cutanea tarda,Wiskott-Aldrich syndrome,Atransferrinemia,Sickle-cell disease,Von Hippel-Lindau disease,Von Willebrand disease,Waldenstrom macroglobulinemia,X-linked alpha thalassemia mental retardation syndrome,Cavernous Sinus Thrombosis,Gaucher's disease
Iatrogenic Antithrombin Therapy During Percutaneous Coronary Intervention (PCI) (patient information),Heparin Induced Thrombocytopenia
Infectious Disease

Bacterial: Leptospira,Pseudomonas aeruginosa,Relapsing fever,Rheumatic fever,Sepsis,Streptococcus pneumoniae,Syphillis,Tetanus,Tick-borne meningoencephalitis,Tuberculosis,Chlamydia,Cholera,Group A streptococcal infection,Tuberculosis,Lung abscess,Meningitis,Brain Abscess,Saccharopolyspora rectivirgula,Bacteremia

Fungal: Aspergillus clavatus,Thermoactinomyces sacchari,Thermoactinomyces vulgaris,Coccidioidal Meningitis

Helminthic: Hookworm infection,Schistosomiasis

Protozoal: Cladosporium,Malaria

Viral: Lentivirus,Non-Polio enterovirus infections,Poliomyelitis,Rabies,Yellow fever,Anthrax,Foot-and-mouth disease,Hantavirus pulmonary syndrome,Hepatitis B,Hepatitis C/co-infection with HIV,Hepatitis G,,Herpes simplex,HIV,Influenza,Lassa Fever,Severe acute respiratory syndrome,Smallpox,Vaccinia,Encephalitis,Myocarditis

Musculoskeletal / Ortho Achondrogenesis,Collagenopathy, types II and XI,Duchenne's Muscular Dystrophy,Dysarthria,Ehlers-Danlos syndrome,Emery-Dreifuss Muscular Dystrophy,Fibrodysplasia ossificans progressiva,Osteoarthritis,Osteomalacia,Osteoporosis,SADDAN,Still's disease,McCune-Albright syndrome,Rubinstein-Taybi syndrome,Allan-Herndon-Dudley syndrome,Congenital muscular dystrophy,Myotonia congenita,Myotonic dystrophy,Osteogenesis imperfecta,Otospondylomegaepiphyseal dysplasia,Treacher Collins syndrome,Gout,Rheumatoid arthritis,Polymyositis,Noonan syndrome,Rheumatic fever,Poliomyelitis,Salla disease,Vitelliform macular dystrophy,Walker-Warburg syndrome
Neurologic Acute Disseminated Encephalomyelitis,Adrenoleukodystrophy,Amyotrophic Lateral Sclerosis,Asceptic Meningitis,Astrocytoma,Benign familial neonatal convulsions,Bovine spongiform encephalopathy,Brain Abscess,Cavernous angioma,Cavernous Sinus Thrombosis,Cerebral edema,Cerebral hemorrhage,Coccidioidal Meningitis,Creutzfeldt-Jakob Disease,Ddx:Meningitis,Devic's disease,Encephalitis,Encephalopathy,Epilepsy,Experimental autoimmune encephalomyelitis,Glioblastoma multiforme,Juvenile myoclonic epilepsy,Meningioma,Multiple sclerosis,Zellweger syndrome,Walker-Warburg syndrome,Friedreich's ataxia,Williams syndrome,Neurofibromatosis,Pendred syndrome,Rett syndrome,Ataxia Telangiectasia,Poliomyelitis,Rabies,Tick-borne meningoencephalitis,Sandhoff disease,Down syndrome,Wilson's disease,Rubinstein-Taybi syndrome,Niemann-Pick disease,Polycystic kidney disease (Berry anuerysms),Gaucher's disease,Amyloidosis,Ehlers-Danlos syndrome
Nutritional / Metabolic Biotinidase deficiency,Carbamoyl phosphate synthetase I deficiency,Carnitine palmitoyltransferase II deficiency,Citrullinemia,Cystinuria,Gaucher's disease,Glutaric acidemia type 2,Glutaric aciduria type 1,Glycogen storage disease type I,GM2-gangliosidosis, AB variant,Gout,High protein diet,Homocystinuria,Hurler's Syndrome,Hyperlipidemia,Hypermethioninemia,Hyperprolinemia,Isovaleric acidemia,Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes,Paraproteinemia,Pellagra,Peroxisomal disorder,Phenylketonuria,Propionic acidemia,Protein-energy malnutrition,Protein-Losing Enteropathy,Sandhoff disease,Tyrosinemia,Urea cycle disorder,Uremia,Toxic and Nutritional Optic Neuropathy,Salla disease,Niemann-Pick disease,Tay-Sachs Disease,Osteomalacia,Nephrotic syndrome,Soy allergy,Acrodermatitis enteropathica,Porphyria cutanea tarda
Obstetric/Gynecologic Endometriosis,Hydatidiform mole
Oncologic Adenoid cystic carcinoma,Breast cancer,Cervical cancer,Gastrointestinal stromal tumor,Hepatocellular carcinoma,Melanoma,Mesothelioma,Neuroendocrine tumors,Paraneoplastic syndrome,Thyroid Carcinoma,Squamous cell carcinoma,Glucagonoma,Peutz-Jeghers syndrome,Astrocytoma,Cavernous angioma,Glioblastoma multiforme,Meningioma,Bladder cancer,Prostate cancer
Opthalmologic Arteritic anterior ischemic optic neuropathy,Corneal ulcer,Drusen,Keratoconjunctivitis sicca,Vitelliform macular dystrophy,Stargardt's disease,X-linked congenital stationary night blindness,Norrie disease,Collagenopathy, types II and XI,Wolfram syndrome,Walker-Warburg syndrome,Toxic and Nutritional Optic Neuropathy,Wilson's disease,Ehlers-Danlos syndrome,Down syndrome
Overdose / Toxicity No underlying causes
Psychiatric Bipolar disorder
Pulmonary Lung abscess,Hypersensitivity Pneumonitis,Atypical pneumonia,Bird breeder's lung,Bronchitis,Byssinosis,Cheese worker's lung,Chemical worker's lung,Emphysema,Grain handler's lung,Hot tub lung,Humidifier lung,Infant respiratory distress syndrome,Loeffler's syndrome,Malt worker's lung,Nylon worker's lung,Primary ciliary dyskinesia,Pleural Effusion,Pneumonia,Pseudomonas aeruginosa,Tuberculosis,Severe acute respiratory syndrome,Saccharopolyspora rectivirgula,Amyloidosis,Cystic Fibrosis,Sarcoidosis
Renal / Electrolyte Nephrotic syndrome,Acidosis,Androgen insensitivity syndrome,Chronic Renal Failure,Hypercalcemia,Focal segmental glomerulosclerosis,Gitelman syndrome,Glomerulonephritis,Hyperammonemia,Hyperkalemic periodic paralysis,Hypernatremia,Nephronophthisis,Diabetic nephropathy,Polycystic kidney disease,Alport syndrome,Congenital Adrenal Hyperplasia,Adrenoleukodystrophy,ZAP70 deficiency,Thrombotic thrombocytopenic purpura,Zellweger syndrome,Cystinuria
Rheum / Immune / Allergy

Rheumatology: Ulcerative colitis,Rheumatoid arthritis,Scleroderma,Sarcoidosis,Polymyositis,Ankylosing Spondylitis,Reactive Polyarticular Arthritis

Immunology: Soy allergy,Pemphigus,Hepatitis,Angioedema,Autoimmune polyendocrine syndrome,Food allergy,Graft-versus-host disease,Hyperimmunoglobulinemia D with recurrent fever,Mollusk shell hypersensitivity,Systemic lupus erythematosus,Vitiligo,Chronic granulomatous disease,Hypersensitivity Pneumonitis

Sexual No underlying causes
Trauma No underlying causes
Urologic Bladder cancer,Prostate cancer
Dental Amelogenesis Imperfecta,Ehlers-Danlos syndrome
Miscellaneous Atrophy,Bone healing,Botulinum toxin,Brachioradial pruritis,Erythropoietin,Excitotoxicity,Snakebites,Total Parenteral Nutrition

Complete Differential Diagnosis

(In alphabetical order)

  1. Abciximab (patient information)
  2. Abdominal Aortic Aneurysm
  3. Abetalipoproteinemia
  4. Achondrogenesis
  5. Acidosis
  6. Acne vulgaris
  7. Acrodermatitis enteropathica
  8. Activated protein C resistance
  9. Acute Coronary Syndromes
  10. Acute Disseminated Encephalomyelitis
  11. Acute myeloid leukemia
  12. Adalimumab
  13. Adenoid cystic carcinoma
  14. Adrenoleukodystrophy
  15. Allan-Herndon-Dudley syndrome
  16. Alport syndrome
  17. Amelogenesis Imperfecta
  18. Amyloidosis
  19. Amyotrophic Lateral Sclerosis
  20. Anakinra (patient information)
  21. Andersen-Tawil syndrome
  22. Androgen insensitivity syndrome
  23. Andrographis paniculata
  24. Anemia
  25. Angioedema
  26. Angiogenesis
  27. Angiopathy
  28. Ankylosing Spondylitis
  29. Anthrax
  30. Antiphospholipid syndrome
  31. Antithrombin Therapy During Percutaneous Coronary Intervention (PCI) (patient information)
  32. Aortic aneurysm
  33. Arrhythmogenic right ventricular dysplasia
  34. Arteriogenesis
  35. Arteritic anterior ischemic optic neuropathy
  36. Asceptic Meningitis
  37. Ascites
  38. Aspergillus clavatus
  39. Aspirin
  40. ASPM (Genetics)
  41. Astrocytoma
  42. Ataxia Telangiectasia
  43. Atherosclerosis
  44. Atransferrinemia
  45. Atrophy
  46. Atypical pneumonia
  47. Autoimmune Hepatitis
  48. Autoimmune polyendocrine syndrome
  49. Benign familial neonatal convulsions
  50. Biotinidase deficiency
  51. Bipolar disorder
  52. Bird breeder's lung
  53. Bladder cancer
  54. Blood transfusion
  55. Bloom syndrome
  56. Boldenone
  57. Bone healing
  58. Botulinum toxin
  59. Bovine spongiform encephalopathy
  60. Brachioradial pruritis
  61. Brain Abscess
  62. Breast cancer
  63. Bronchitis
  64. Brugada syndrome
  65. Budd-Chiari syndrome
  66. Byssinosis
  67. Carbamoyl phosphate synthetase I deficiency
  68. Cardiofaciocutaneous syndrome
  69. Cardiomyopathy
  70. Cardiovascular Effects of Cocaine
  71. Carnitine palmitoyltransferase II deficiency
  72. Catecholaminergic polymorphic ventricular tachycardia
  73. Cavernous angioma
  74. Cavernous Sinus Thrombosis
  75. Celiac disease
  76. Cerebral edema
  77. Cerebral hemorrhage
  78. Cervical cancer
  79. Cheese worker's lung
  80. Chemical worker's lung
  81. Cholecystitis
  82. Cholera
  83. Chronic granulomatous disease
  84. Chronic pancreatitis
  85. Chronic Renal Failure
  86. Cirrhosis
  87. Citrullinemia
  88. Cladosporium
  89. Clarithromycin
  90. Clindamycin
  91. Coccidioidal Meningitis
  92. Colitis
  93. Collagenopathy, types II and XI
  94. Congenital Adrenal Hyperplasia
  95. Congenital muscular dystrophy
  96. Congestive Heart Failure
  97. Contact dermatitis
  98. Corneal ulcer
  99. Corticosteroid
  100. Creutzfeldt-Jakob Disease
  101. Crohn's disease
  102. Cryoglobulinemia
  103. Cystic Fibrosis
  104. Cystinuria
  105. Ddx:Hypercalcemia
  106. Ddx:Meningitis
  107. Demeclocycline
  108. Devic's disease
  109. Dexamethasone
  110. Diabetes mellitus
  111. Diabetic ketoacidosis
  112. Diabetic nephropathy
  113. Diarrhea
  114. Disseminated Intravascular Coagulation
  115. Down syndrome
  116. Doxycycline
  117. Drospirenone
  118. Drusen
  119. Dubin-Johnson syndrome
  120. Duchenne's Muscular Dystrophy
  121. Dysarthria
  122. Eczema
  123. Ehlers-Danlos syndrome
  124. Emery-Dreifuss Muscular Dystrophy
  125. Emphysema
  126. Encephalitis
  127. Encephalopathy
  128. Endometriosis
  129. Eosinophilic gastroenteritis
  130. Epilepsy
  131. Erythromycin
  132. Erythropoietin
  133. Estrogen
  134. Excitotoxicity
  135. Experimental autoimmune encephalomyelitis
  136. Familial Mediterranean fever
  137. Fanconi anemia
  138. Fat Embolism Syndrome
  139. Fibrodysplasia ossificans progressiva
  140. Flunisolide Oral Inhalation (patient information)
  141. Fluoxetine
  142. Fluticasone and Salmeterol Oral Inhalation (patient information)
  143. Fluvoxamine
  144. Focal segmental glomerulosclerosis
  145. Food allergy
  146. Foot-and-mouth disease
  147. Friedreich's ataxia
  148. Gastrointestinal stromal tumor
  149. Gaucher's disease
  150. Gitelman syndrome
  151. Glioblastoma multiforme
  152. Glomerulonephritis
  153. Glucagonoma
  154. Glutaric acidemia type 2
  155. Glutaric aciduria type 1
  156. Glycogen storage disease type I
  157. GM2-gangliosidosis, AB variant
  158. Gout
  159. Graft-versus-host disease
  160. Grain handler's lung
  161. Graves' Disease
  162. Group A streptococcal infection
  163. Growth hormone deficiency
  164. Hantavirus pulmonary syndrome
  165. Hemochromatosis
  166. Hemoglobinuria
  167. Heparin Induced Thrombocytopenia
  168. Hepatitis
  169. Hepatitis B
  170. Hepatitis C/co-infection with HIV
  171. Hepatitis G
  172. Hepatocellular carcinoma
  173. Herpes simplex
  174. High protein diet
  175. HIV
  176. Homocystinuria
  177. Hookworm infection
  178. Hot tub lung
  179. Humidifier lung
  180. Hurler's Syndrome
  181. Hydatidiform mole
  182. Hydrocortisone Oral (patient information)
  183. Hyperammonemia
  184. Hypercalcemia
  185. Hyperimmunoglobulinemia D with recurrent fever
  186. Hyperkalemic periodic paralysis
  187. Hyperlipidemia
  188. Hypermethioninemia
  189. Hypernatremia
  190. Hyperprolinemia
  191. Hypersensitivity Pneumonitis
  192. Hypertrophic Cardiomyopathy
  193. Hypothyroidism
  194. Ibuprofen
  195. Imatinib (patient information)
  196. Infant respiratory distress syndrome
  197. Influenza
  198. Isovaleric acidemia
  199. Juvenile myoclonic epilepsy
  200. Keratoconjunctivitis sicca
  201. Ketamine
  202. Ketorolac
  203. Lactobacillus
  204. Lactobacillus reuteri
  205. LÃffler's syndrome
  206. Lassa Fever
  207. Latent tuberculosis
  208. Lentivirus
  209. Leptospira
  210. Lipoid congenital adrenal hyperplasia
  211. Lung abscess
  212. Malaria
  213. Malt worker's lung
  214. McCune-Albright syndrome
  215. Melanoma
  216. Meningioma
  217. Mesothelioma
  218. Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes
  219. Mollusk shell hypersensitivity
  220. Multiple myeloma
  221. Multiple sclerosis
  222. Myocardial infarction
  223. Myocarditis
  224. Myotonia congenita
  225. Myotonic dystrophy
  226. Nephronophthisis
  227. Nephrotic syndrome
  228. Neuroendocrine tumors
  229. Neurofibromatosis
  230. Niemann-Pick disease
  231. Non-Polio enterovirus infections
  232. Noonan syndrome
  233. Norrie disease
  234. Nylon worker's lung
  235. Osteoarthritis
  236. Osteogenesis imperfecta
  237. Osteomalacia
  238. Osteoporosis
  239. Otospondylomegaepiphyseal dysplasia
  240. Pachyonychia congenita
  241. Paraneoplastic syndrome
  242. Paraproteinemia
  243. Pellagra
  244. Pemphigus
  245. Pendred syndrome
  246. Peripheral Arterial Disease
  247. Peroxisomal disorder
  248. Peutz-Jeghers syndrome
  249. Phenylketonuria
  250. Pleural Effusion
  251. Pneumonia
  252. Poliomyelitis
  253. Polycystic kidney disease
  254. Polymyositis
  255. Porphyria cutanea tarda
  256. Primary biliary cirrhosis
  257. Primary ciliary dyskinesia
  258. Propionic acidemia
  259. Prostate cancer
  260. Protein S deficiency
  261. Protein-energy malnutrition
  262. Protein-Losing Enteropathy
  263. Pseudomonas aeruginosa
  264. Pseudoxanthoma elasticum
  265. Rabies
  266. Reactive Polyarticular Arthritis
  267. Relapsing fever
  268. Rett syndrome
  269. Rheumatic fever
  270. Rheumatoid arthritis
  271. Romano-Ward syndrome
  272. Rubinstein-Taybi syndrome
  273. Saccharopolyspora rectivirgula
  274. SADDAN
  275. Salla disease
  276. Sandhoff disease
  277. Sarcoidosis
  278. Schistosomiasis
  279. Scleroderma
  280. Sepsis
  281. Severe acute respiratory syndrome
  282. Shock (medical)
  283. Shwachman-Diamond syndrome
  284. Sickle-cell disease
  285. Sitophilus granarius
  286. Smallpox
  287. Snakebites
  288. Soy allergy
  289. Spontaneous bacterial peritonitis
  290. Squamous cell carcinoma
  291. Stargardt's disease
  292. Still's disease
  293. Streptococcus pneumoniae
  294. Stress cardiomyopathy
  295. Subclavian Artery Disease
  296. Syphillis
  297. Systemic lupus erythematosus
  298. Tacrolimus
  299. Tay-Sachs Disease
  300. Tetanus
  301. Thermoactinomyces sacchari
  302. Thermoactinomyces vulgaris
  303. Thrombocytopenia
  304. Thrombocytosis
  305. Thrombotic thrombocytopenic purpura
  306. Thyroid Carcinoma
  307. Tick paralysis
  308. Tick-borne meningoencephalitis
  309. Total Parenteral Nutrition (patient information)
  310. Toxic and Nutritional Optic Neuropathy
  311. Treacher Collins syndrome
  312. Triamcinolone Oral Inhalation (patient information)
  313. Tuberculosis
  314. Typhoid fever
  315. Tyrosinemia
  316. Ulcerative colitis
  317. Urea cycle disorder
  318. Uremia
  319. Usher syndrome
  320. Vaccinia
  321. Ventricular Tachycardia Including Torsades De Pointes and Polymorphic Ventricular Tachycardia
  322. Vitelliform macular dystrophy
  323. Vitiligo
  324. Von Hippel-Lindau disease
  325. Von Willebrand disease
  326. Waldenström macroglobulinemia
  327. Walker-Warburg syndrome
  328. Werner syndrome
  329. Williams syndrome
  330. Wilson's disease
  331. Wiskott-Aldrich syndrome
  332. Wolfram syndrome
  333. X-linked adrenal hypoplasia congenita
  334. X-linked alpha thalassemia mental retardation syndrome
  335. X-linked congenital stationary night blindness
  336. Yellow fever
  337. ZAP70 deficiency
  338. Zellweger syndrome

Role in cardiovascular disease

Recent research suggests that patients with elevated basal levels of CRP are at an increased risk for diabetes,[4][5] hypertension and cardiovascular disease. A study of over 700 nurses showed that those in the highest quartile of trans fat consumption had blood levels of C-reactive protein (CRP, a pro-inflammatory cytokine which is a cardiovascular disease risk factor) that were 73% higher than those in the lowest quartile.[6] Although one group of researchers indicated that CRP may only be a moderate risk factor for cardiovascular disease,[7] this study (known as the Reykjavik Study) was found to have some problems for this type of analysis related to the characteristics of the population studied, and there was an extremely long follow-up time which may have attenuated the association between CRP and future outcomes.[8] Others have shown that CRP can exacerbate ischemic necrosis in a complement-dependent fashion and that CRP inhibition can be a safe and effective therapy for myocardial and cerebral infarcts.[9]

To measure the CRP level, a "high-sensitivity" CRP or hs-CRP test needs to be performed and analyzed by a laboratory. This is an automated blood test designed for greater accuracy in measuring low levels of CRP, which allows the physician to assess cardiovascular risk. If a result in the low-risk range is found ( < 1 mg/L), it does not need repeating. Higher levels need repeating, and clinical evaluation as necessary.

Role in colon cancer

The role of inflammation in cancer is not well known. Some organs of the body show greater risk of cancer when they are chronically inflamed.

Blood samples of persons with colon cancer have an average CRP concentration of 2.69 milligrams per liter. Persons without colon cancer average 1.97 milligrams per liter. The difference was statistically significant.[10] These findings concur with previous studies that indicate that anti-inflammatory drugs could lower colon cancer risk.[11]

Related chapters

Additional images

  • C-reactive protein

    C-reactive protein

References

  1. ↑ Tillett WS, Francis Jr T (1930). "Serological reactions in pneumonia with a nonprotein somatic fraction of pneumococcus". J Exp Med. 52: 561–585.
  2. ↑ NCBI Entrez Protein #CAA39671 [1]
  3. ↑ Torelli, Julius (2005), Beyond Cholesterol, p.45. ISBN 0-312-34863-0
  4. ↑ Pradhan AD (2001). "C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus". JAMA. 286: 327&ndash, 334. PMID 11466099.
  5. ↑ Dehghan A (2007). "Genetic variation, C-reactive protein levels, and incidence of diabetes". Diabetes. 56: 872. PMID 17327459.
  6. ↑ Esther Lopez-Garcia (2005). "Consumption of Trans Fatty Acids Is Related to Plasma Biomarkers of Inflammation and Endothelial Dysfunction". The Journal of Nutrition. 135 (3): 562&ndash, 566. PMID 15735094.
  7. ↑ John Danesh (2004). "C-Reactive Protein and Other Circulating Markers of Inflammation in the Prediction of Coronary Heart Disease". New England Journal of Medicine. 350 (14): 1387&ndash, 1397. PMID 15070788.
  8. ↑ Koenig, Wolfgang (2006). C-Reactive Protein – A Critical Cardiovascular Risk Marker [2]
  9. ↑ Pepys MB, Hirschfield GM, Tennent GA, Gallimore JR, Kahan MC, Bellotti V, Hawkins PN, Myers RM, Smith MD, Polara A, Cobb AJ, Ley SV, Aquilina JA, Robinson CV, Sharif I, Gray GA, Sabin CA, Jenvey MC, Kolstoe SE, Thompson D, Wood SP (2006). "Targeting C-reactive protein for the treatment of cardiovascular disease". Nature. 440: 1217&ndash, 1221. PMID 16642000.
  10. ↑ Erlinger TP, Platz EA, Rifai N, Helzlsouer KJ (2004). "C-reactive protein and the risk of incident colorectal cancer". Journal of the American Medical Association. 291 (Feb. 4): 585–590. PMID 14762037.
  11. ↑ Baron JA; et al. (2003). "A randomized trial of aspirin to prevent colorectal adenomas". New England Journal of Medicine. 348: 891–899. PMID 12621133.

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