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Medical Forum / General / Laboratory / September 2008How much inflammation does a CRP of 375 mg/dL indicate?
How much inflammation does a CRP of 375 mg/dL indicate? Moderate- severe, since it's 37.5x the reference range of <10 mg/dL? Autoimmune/ bacterial, since viral infections tend to elicit a lower rise in CRP? Thanks!!! http://www.webmd.com/a-to-z-guides/c-reactive-protein-crp?page=2 - quote from this page below: "Many conditions can change CRP levels. Your doctor will talk with you about any abnormal results that may be related to your symptoms and medical history. What Affects the Test You may not be able to have the test or the results may not be helpful if: a.. You have just exercised. b.. You take certain medicines, such as hormone replacement therapy (HRT), birth control pills, nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, corticosteroids, or medicine to lower your cholesterol (for example, pravastatin). c.. You have an intrauterine device (IUD) in place. d.. You are pregnant. e.. You are very overweight (obese)." http://www.labtestsonline.org/understanding/analytes/crp/faq.html http://en.wikipedia.org/wiki/C-reactive_protein http://www.nlm.nih.gov/medlineplus/ency/article/003356.htm http://www.crphealth.com/faq/gen/1/why.hs-crp.html - quote below: "What Do the hs-CRP Test Results Mean? back to top hs-CRP levels are expressed in terms of milligrams per liter (mg/L). Concerning your hs-CRP level and cardiovascular risk, a level of less than 1mg/L indicates lower risk, a level between 1 and 3mg/L indicates moderate risk, and a level higher than 3mg/L indicates a higher risk. As research has shown, this may hold true even if your LDL cholesterol levels are low. If your hs-CRP level is very high, above 10mg/L, you should have the test repeated after 2-3 weeks, as the high hs-CRP level may reflect an acute infection that you are experiencing at the time. You should therefore have your hs-CRP evaluated only when feeling well. If upon repeat testing your hs-CRP level remains high, then you are most probably in the higher cardiovascular risk group. In middle-aged Americans, the average hs-CRP level is between 1.0 and 2.0 mg/L. About one quarter of Americans have a hs-CRP level above 3mg/L, placing them in the higher risk group." Douglas - you seem to delight in taking some types of test results and/or situations to the extreme nth degree. A result of 375 with hs-CRP is probably not possible, although it MAY be possible with the regular CRP test. It's nice to have an inquiring mind, but sometimes I think you are seriously trying to set us up to make us all look like fools. Is this somehow gratifying to you? It makes it extremely difficult for us out here to answer your questions. If you'd make them more realistic, perhaps we could have serious discussions. If you're going to try to set up hypotheticals, at least specify which CRP test you're hypothesizing about before you try to set us up. There are two types of CRP testing in my cursory reading on the subject. The newer version hs-CRP, doesn't even have values that go this high, I don't think. Anybody else with more experience with this test want to chime in? I have not been involved with this type of testing in many years. Judy Dilworth, M.T. (ASCP) Microbiology > How much inflammation does a CRP of 375 mg/dL indicate? Moderate- > severe, since it's 37.5x the reference range of <10 mg/dL? Autoimmune/ > bacterial, since viral infections tend to elicit a lower rise in CRP? > > Thanks!!! "JEDilworth" <bactitech@nospamhortonsbay.com> wrote in message news:x6SdnRtBNsXMnSfVnZ2dnUVZ_gydnZ2d@buckeye- > Douglas - you seem to delight in taking some types of test results and/or > situations to the extreme nth degree. A result of 375 with hs-CRP is > probably not possible, although it MAY be possible with the regular CRP > test. It's nice to have an inquiring mind, but sometimes I think you are > seriously trying to set us up to make us all look like fools. Is this > somehow gratifying to you? Only last week he threw in an impossible MCHC to see if we were good enough to spot it. Didn't he admit to being a teenager not yet in college, or am I thinking of someone else? I think you have him tagged :-). Yes, I noticed the high MCHC also but it's been awhile since I was in Hematology so I didn't do the math to realize that it was impossible from the outset. I used to know that stuff pretty well. I haven't done Hematology since 1985. Yeah, I think he thinks he's being really cute. This cuteness won't impress his professors though. They'll have him fingered from the outset. Douglas, you need to ask questions that make sense, not outrageous ones. Your future instructors, especially in medical school (should you persevere and get that far) absolutely will NOT put up with it. They will shoot you down and do it in front of your peers on rounds. I worked at a med school for a long time. This DOES happen. My mom was just a patient in that same medical school. The docs DO defend their turf and will put you in your place. Don't get me wrong; an inquiring mind is a very good thing. If you read case histories and question along those lines, with REAL lab results and real patients, this will stand you in good stead. Picking outrageous lab value numbers out of the air will end up with people not taking you seriously. Judy Dilworth, M.T. (ASCP) Microbiology > Only last week he threw in an impossible MCHC to see if we were good > enough to spot it. Didn't he admit to being a teenager not yet in > college, or am I thinking of someone else? On Aug 31, 6:15 pm, "JEDilworth" <bactit...@nospamhortonsbay.com> wrote: > I think you have him tagged :-). Yes, I noticed the high MCHC also but > it's been awhile since I was in Hematology so I didn't do the math to [quoted text clipped - 27 lines] > > - Show quoted text - Actually, I never have a chance to ask ANY questions of my profs, since they have no time. Seriously, I don't think I'm being cute; just need to ask the right questions, I guess. Here's a better one; why hasn't CRP completely eliminated ESR testing, since ESR can be affected by hematopathies, along w/ inflammation? Here's a better one; why hasn't CRP completely eliminated ESR testing, since ESR can be affected by hematopathies, along w/ inflammation? ------------------------------------------------------------------------------------------------------- Do you know how the two tests are performed? One is incredibly scientifically involved, requiring science, analysers, reagents and money. The other merely involves mixing a sample of blood and shoving off for an hour. Both give (effectively) the same result, i.e. ther higher it is, the more ill the patient. One is a fraction of the cost (in money and effort) of the other. That's it in a nutshell. There has been lots of talk on the lab boards about the usefulness of ESR's (sed rates). The fact is that sed rates are pretty low tech, don't take a lot of time, and, if elevated, show that there is inflammation present. It doesn't tell you what KIND of inflammation, but it is an indicator. You put some blood in a marked tube, put the tube in a special rack so they stand upright, set a timer for an hour, and read where the red cells fall down to on the column in an hour. The faster they fall, the more inflammation there is. The results are measured in millimeters. Obviously this can be affected by hematocrit and red cell size, but it's a ball park test anyway. Not all labs are set up for the new CRP testing, I would guess. It's not my department though. Manky would know more about this. Judy Dilworth, M.T. (ASCP) Microbiology > Do you know how the two tests are performed? > One is incredibly scientifically involved, requiring science, [quoted text clipped - 4 lines] > more ill the patient. One is a fraction of the cost (in money and > effort) of the other. > That's it in a nutshell. There has been lots of talk on the lab boards > about the usefulness of ESR's (sed rates). The fact is that sed rates are [quoted text clipped - 6 lines] > measured in millimeters. Obviously this can be affected by hematocrit and > red cell size, but it's a ball park test anyway. As I tell my trainees, it's a one-stop test to weed out the malingerers. If it's normal, all is well, if it's high, something's wrong. Dunno what, but something.... > Not all labs are set up for the new CRP testing, I would guess. It's not > my department though. Manky would know more about this. Here in the UK CRP testing is common, but an ESR is cheap and easy. > Judy Dilworth, M.T. (ASCP) > Microbiology [quoted text clipped - 7 lines] >> ill the patient. One is a fraction of the cost (in money and effort) of >> the other. > > That's it in a nutshell. There has been lots of talk on the lab boards > > about the usefulness of ESR's (sed rates). The fact is that sed rates are [quoted text clipped - 29 lines] > > - Show quoted text - I would dispute the statement that ESR is cheap and easy. In an integrated and automated lab it's much easier to do CRP than ESR. CRP may have more expensive reagents but it's measured on the same instruments as the other biochemistry tests so need no more sample handling. ESR either needs an extra citrate tube or further handling of an EDTA tube. When you are running 2 to 3 thousand patient requests per day extra sample handling needs to be reduced as much as possible. It's also quicker to do CRP than ESR even with automated ESRs. Douglas also has his figures wrong. The reference range of <10 is for mg/L. In mg/dL the reference range would be <1. A result of 375 mg/ dL is 375 times the reference range. In mg/L we see about 15 per day at this sort of level although we don't routinely dilute samples >320mg/L and some of these may be much higher. On Aug 30, 7:24 pm, "JEDilworth" <bactit...@nospamhortonsbay.com> wrote: > http://www.webmd.com/a-to-z-guides/c-reactive-protein-crp?page=2- quote > from this page below: [quoted text clipped - 71 lines] > > - Show quoted text - I wasn't talking about hs-CRP; I'm talking about the "regular" CRP test. Douglas You asked a lot of questions on February 26th regarding the use of CRP vs ESR I suggest you read the answers from then!! I suggest you follow the advise given then and dig into the links provided then for "crp in clinical use" - they are still useful and would have brought you most of the answers to your questions. And as Mike Collins says:- get your figures right - you just killed a patient. |
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