2. Overview Inflammatory Markers
Inflammatory Markers are class of
proteins whose plasma concentrations
increase or decrease in response to
inflammation.
This response is called the acute-phase
reaction.
Inflammatory Markers include C
reactive protein (CRP), Erythrocyte
Sedimentation Rate, Plasma
Viscosity, Fibrinogen, Ferritin, and
several other acute phase proteins,
though only the first three are
commonly referred to as inflammatory
markers.
3. Normal levels of Inflammatory Markers are valuable
in ruling out a few specific conditions, notably
Polymyalgia Rheumatica, Giant Cell Arteritis,
Myeloma, and Infection of Hip Revisions
Raised levels of inflammatory markers may be found
in many other conditions, particularly Infections,
Autoimmune Conditions, Cardiac conditions,
Chronic Conditions and certain Cancers. In these
cases, they increase the probability of the condition
being present, but additional information would be
needed to be confident the disease is present or
absent.
Inflammatory markers are too non-specific to be a
useful tool for diagnosing serious underlying disease
and should rarely be used in this situation.
4. There are multiple Inflammatory Markers
but most used Inflammatory markers are
CRP, ESR and IL-6, FERRITIN etc.
Measurement of inflammatory markers has
two main functions: to detect acute
inflammation that might indicate specific
diseases, or to give a marker of treatment
response (we will not consider this second
indication here).
5. CRP is used to identify the presence of inflammation, to
determine its severity, and to monitor response to
treatment.
CRP is a protein made by your liver. It's sent into your
bloodstream in response to inflammation.
Inflammation is your body's way of protecting your
tissues if you've been injured or have an infection. It can
cause pain, redness, and swelling in the injured or
affected area. Some autoimmune disorders and chronic
diseases can also cause inflammation.
This is sometimes called an acute phase protein. This
means that the level of CRP increases when you have
certain diseases which cause inflammation. CRP can be
measured in a blood sample. The CRP test measures the
level of one specific protein, whereas the ESR takes
account of many proteins.
CRP: most people without any underlying health
problem have a CRP level less than 3 mg/L and nearly
always less than 10 mg/L.
C-Reactive Protein-
6. Help predict your risk of
developing heart disease
The inflammation from
atherosclerosis is a low level of long-
term inflammation that produces
only small amounts of CRP.
Therefore, the test requires higher
sensitivity than previous tests in
order to detect the small increases of
CRP. Thus, this test is known as CRP
high sensitivity or HSCRP.
7. The ESR measures the rate at which the
red blood cells separate from the plasma
and fall to the bottom of a test tube.
If certain proteins cover red cells, these
will stick to each other and cause the red
cells to fall more quickly. So, a high ESR
indicates that you have some
inflammation, somewhere in the body.
Levels of ESR are generally higher in
females. Also the level increases with
increasing age.
ESR: the normal range is 0-22 mm/hr for
men and 0-29 mm/hr for women.
ESR-
8. CRP - appears in short time hence
useful in acute Conditions
ESR - takes some time hence
advised in chronic conditions
Comparison-
9. Indications of CRP-
• When it is suspected that you might be
suffering from an inflammatory disorder (as
with certain types of arthritis and autoimmune
disorders or inflammatory bowel disease) or to
check for the possibility of infection (especially
after surgery).
• Other trauma
• Monitor treatment of chronic inflammatory
conditions, such as rheumatoid arthritis and
lupus.
•
10. Indications of ESR
A physician usually requests an ESR test
(along with other tests) to evaluate a
patient who has symptoms that
suggest polymyalgia
rheumatica or temporal arteritis, such as
headaches, neck or shoulder pain, pelvic
pain, anaemia, unexplained weight loss
and joint stiffness. There are many other
conditions that can result in a temporary
or sustained elevation in the ESR and
some that will cause a decrease.
Suspected Cancer or known cancer Case.
Chronic conditions.
