Clinical Pathology: General Principles, Clinical Chemistry

• C-reactive protein (CRP) is an acute-phase response protein. In response to acute inflammation, such as occurs during infection, trauma, or surgery, a significant increase in CRP, by as much as 100 to 1000 times over baseline levels, can occur.

• CRP begins to increase at approximately 6 to 12 hours after the onset of a bacterial infection and usually peaks at 48 hours. CRP concentrations are usually higher in bacterial than in viral infections. CRP is used in the assessment of inflammatory disease, such as rheumatoid arthritis, neonatal sepsis and meningitis, malignancy, and trauma.

• The magnitude of the increase in CRP levels is related to the severity of the inflammation and is the result of increased cytokine production, especially interleukin (IL)-6, which increases CRP synthesis.

• CRP levels in serum are used to monitor a patient’s response to antibiotic treatment for bacterial infection.

• Measurement of CRP levels is also used as an indicator of risk for cardiovascular disease.

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