Serum C-reactive protein on the seventh day after pancreatitis could add value in predicting the course of disease progression

Elshal, Mohamed; Auf, Ahmed; El Fady, George A.; Raslan, Mohamed M.

doi:10.4103/ejs.ejs_202_22

Serum C-reactive protein on the seventh day after pancreatitis could add value in predicting the course of disease progression

Authors

Abstract

Background
The incidence of acute pancreatitis (AP) has increased recently. Although most cases follow a mild course, some cases follow a severe course that may lead to death. Different scoring systems are used for the assessment of the severity of the attack such as Acute Physiology and Chronic Health Examination, Ranson, and modified computed tomography severity index. The most popular method of grading is based on contrast-enhanced computed tomography imaging. The computed tomography severity index (CTSI), developed by Balthazar and Ranson, clarifies the degree of pancreatic and peripancreatic inflammation, extent of parenchyma necrosis, and fluid collection measured by the computed tomography. C-reactive protein (CRP) is an acute-phase reactant that is synthesized by hepatocytes. This synthesis is induced by the release of IL–1and IL–6. CRP is one of the most sensitive markers for inflammation used today.
Patients and methods
A prospective observational comparative study was done on 70 patients with AP; they were followed up by a correlation between CTSI and CRP levels on day 2 and day 7 after presentation.
Results
It was found that there is a statistically significant increase in CRP levels in correlation with CTSI. Results showed that CRP levels rise significantly in severe and in necrotizing pancreatitis.
Conclusion
CRP is a straightforward way to predict severity for patients with AP. Based on this study, CRP levels are useful in patients who have contraindications for computed tomography with intravenous contrast such as patients with renal failure and pregnant women.

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