TITLE:
C-reactive protein and erythrocyte sedimentation rate: Continuing role for erythrocyte sedimentation rate
AUTHORS:
Gurmukh Singh
KEYWORDS:
CRP; ESR; Osteomyelitis; Inflammation
JOURNAL NAME:
Advances in Biological Chemistry,
Vol.4 No.1,
February
10,
2014
ABSTRACT: Background:
Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) tests are
often done to detect or monitor patients with suspected inflammatory
disorders. The objective of the study was to ascertain if the manual ESR test
added value to the information available from automated CRP results alone. Methods:
In this retrospective, observational study at a safety-net hospital, the ESR
and CRP values were compared in 4527 instances when both tests were done. In
150 instances, involving 97 patients; when ESR was >60 mm/hr and CRP was
≤1.0 mg/dL, the medical records were reviewed to discern the cause of disparity
between the ESR and CRP results and to assess the utility of continued use of
the ESR test. Results: Review of medical records did not reveal an
explanation for elevated ESR in 20 patients with normal CRP results. In the
remaining 77 (79%) patients, an inflammatory disorder was noted despite a
normal CRP value; in 27 (28%) patients, the disorder was osteomyelitis.
Presence of skin necrosis was also a prominent factor in the discrepant
results. Conclusions: ESR has value in detecting inflammatory disorders that
may not be obvious by clinical examination or CRP results. ESR has a particularly
useful role in patients with suspected bone lesions and osteomyelitis.