Document Detail


C-reactive protein and erythrocyte sedimentation rate discordance: frequency and causes in adults.
MedLine Citation:
PMID:  22921838     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
C-reactive protein (CRP) levels and the erythrocyte sedimentation rate (ESR) are widely used tests of inflammation that sometimes show opposite results. We performed a retrospective cohort study to clarify the frequency and causes of CRP/ESR discordance in adults. Between January and December of 2011, the laboratories of Texas Health Presbyterian Hospital performed 2150 paired CRP/ESR measurements in 1753 patients, 1731 of whom were nonpregnant adults aged ≥ 18 years. Initial CRP and ESR results for each patient were divided into quartiles. CRP/ESR discordance, predefined as results differing by 2 or 3 quartiles, occurred in 212 patients (12%), 105 of whom had high CRP/low ESR discordance and 107 of whom had high ESR/low CRP discordance (6%). The 212 patients in the CRP/ESR-discordant group (128 women and 84 men) were subdivided into 1 of 6 diagnostic categories, and the causes of discordances were compared. The high CRP/low ESR-discordant group had more patients with infections than the high ESR/low CRP-discordant group (P = .001), particularly infections in the urinary tract (P = .03), gastrointestinal tract (P = .001), lungs (P = .005), and bloodstream (P = .03). However, they had fewer bone and joint infections than the high ESR/low CRP-discordant group (P = .001). Connective tissue diseases, such as systemic lupus erythematosus, were less common in the high CRP/low ESR-discordant group than in the high ESR/low CRP-discordant group (P = .001). Ischemic strokes or transient ischemic attacks almost invariably occurred in the high ESR/low CRP-discordant group (P = .001), whereas myocardial infarction or venous thromboembolism was limited to the high CRP/low ESR-discordant group (P = .001). Our findings provide information to physicians who order these 2 tests together and receive discordant results, which occurs in approximately 1 in 8 patients.
Authors:
Mark Feldman; Bilal Aziz; Gha Na Kang; Mildred A Opondo; Randall K Belz; Connie Sellers; Edward L Goodman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-22
Journal Detail:
Title:  Translational research : the journal of laboratory and clinical medicine     Volume:  -     ISSN:  1878-1810     ISO Abbreviation:  Transl Res     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101280339     Medline TA:  Transl Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
Affiliation:
Texas Health Presbyterian Hospital Dallas, Dallas, Texas.
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