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CRP Test

The CRP test measures C-reactive protein levels in the blood to detect inflammation in the body. A positive CRP test indicates inflammation from conditions like infection, injury, or heart disease, while a negative test suggests no detectable inflammation. CRP levels are classified as normal, moderate, or high risk for cardiovascular disease. The test is important for assessing disease risk and treatment response, though it is non-specific. Factors like medications, obesity, and sample quality can impact results, so laboratories minimize errors by carefully controlling sample collection, storage, and testing procedures.

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226 views

CRP Test

The CRP test measures C-reactive protein levels in the blood to detect inflammation in the body. A positive CRP test indicates inflammation from conditions like infection, injury, or heart disease, while a negative test suggests no detectable inflammation. CRP levels are classified as normal, moderate, or high risk for cardiovascular disease. The test is important for assessing disease risk and treatment response, though it is non-specific. Factors like medications, obesity, and sample quality can impact results, so laboratories minimize errors by carefully controlling sample collection, storage, and testing procedures.

Uploaded by

ces8bautista
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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CRP TEST

1. Indication of CRP test. (Why do we test?)

C-reactive protein (CRP) is a substance produced by the liver in response to inflammation.


A high level of CRP in the blood is a marker of inflammation. It can be caused by a wide variety
of conditions, from infection to cancer. High CRP levels can also indicate that there’s
inflammation in the arteries of the heart, which can mean a higher risk of heart attack. However,
the CRP test is an extremely nonspecific test, and CRP levels can be elevated in any
inflammatory condition. Other names for CRP are high-sensitivity C-reactive protein (hs-CRP)
and ultra-sensitive C-reactive protein (us-CRP).

2. Implication and significance of a negative/non-reactive and positive/reactive result.

Implication
Positive: Agglutination is observed if there is presence of detectable levels of CRP in the test
specimen (Qualitative method). Semi quantitative is performed when the qualitative method is
positive. Using isotonic saline, prepare serial dilution of the test specimen positive in the
qualitative method.

Negative: No Agglutination. Absence of detectible levels of CRP in the test specimen.

Significance
In general, the result is reported in either mg/dL or mg/L. When used for cardiac risk
stratification, hs-CRP levels less than 1 mg/dL are considered low risk. Levels between 1 mg/dL
and 3 mg/dL are considered a moderate risk and a level greater than 3 mg/dL is considered
high risk for the development of cardiovascular disease.

Interpretation of CRP levels:

Less than 0.3 mg/dL: Normal (level seen in most healthy adults).
0.3 to 1.0 mg/dL: Normal or minor elevation (can be seen in obesity, pregnancy, depression,
diabetes, common cold, gingivitis, periodontitis, sedentary lifestyle, cigarette smoking, and
genetic polymorphisms).
1.0 to 10.0 mg/dL: Moderate elevation (Systemic inflammation such as RA, SLE or other
autoimmune diseases, malignancies, myocardial infarction, pancreatitis, bronchitis).
More than 10.0 mg/dL: Marked elevation (Acute bacterial infections, viral infections, systemic
vasculitis, major trauma).
More than 50.0 mg/dL: Severe elevation (Acute bacterial infections).

3. Is the test still considered important? Why/ Why not?

Yes, although it is a non-specific test, is still considered important because it complements other
tests to assess the person’s risk in developing disease. For example, in assessing the risk of
cardiovascular disease, cholesterol is routinely requested. Elevated cholesterol levels are
associated with ‘plaque buildup’ and increased risk of heart attack. Measuring active
inflammation by CRP tests may show how prone a ‘plaque’ is to rupture.

CRP is a direct and quantitative measure of the acute-phase reaction and provides adequate
information about the actual clinical situation. In rheumatoid arthritis (RA), the CRP level reflects
short-term and long-term disease activity. In disorders such as RA, CRP can be used to assess
the effect of anti-inflammatory drugs
and the nature of their action. Levels of CRP rise after tissue injury or surgery. If the CRP level
is persistently elevated or returns to an increased level, it may indicate underlying sepsis.

Because CRP is non-specific, it is an unreliable indicator. CRP values may be normal when
other acute-phase proteins are altered in disorders such as SLE, dermatomyositis, and
ulcerative colitis. For example, SLE shows no CRP response, despite apparently active
inflammation.

4. What are factors that could affect our results? In the clinical laboratory setting, how do
we minimize introducing errors in our testing? Be specific.

False Decrease
 Use of non-steroidal anti-inflammatory drugs (NSAIDS)
 Statins
 Recent injury or illness particularly when using CRP test for cardiac risk stratification
 Magnesium supplementation

Mild elevation in CRP can be seen without any systemic or inflammatory disease. Females and
elderly patients usually have higher CRP levels. Obesity, insomnia, depression, smoking, and
diabetes can all contribute to mild elevations in CRP.

Sample Preparation
 Sample should be freshly collected. If testing is delayed, store samples at 2-8C for 48
hours. Bacterial contamination may cause protein denaturation and false positive result.
 Strongly lipemic or contaminated serum can cause false positive reactions.
 The presence of RF in serum sample (usually >20 IU/ml) may lead to false positive results.
 A prozone phenomena (antigen excess) may cause false negatives. It is advisable to check
all negative serum by retesting at a 1:10 dilution. Reaction times longer than specified may
produce apparent false reactions due to a drying effect.

Storage & Stability


 When not in use, store reagents and controls at 2 – 8C. Do not freeze.
 Prior to use, allow reagents and controls to warm up to room temperature.

References:
Bansal, P. et al. (2020). C Reactive Protein (CRP). Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK441843/
MacCleod, C.M., & O.T.Avery: J. Exper.Med. 73, 191, 1950.
Marcin, J. (2019). C-Reactive Protein Test. Retrieved from https://www.healthline.com/health/c-
reactive-protein
Nehring SM, Goyal A, Bansal P, et al. C Reactive Protein (CRP) [Updated 2020 Jun 5]. In:
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK441843/
Saxtad, J., L.A. Nilsson & L.A. Hanson: Acta Paediat. Scand. 59, 25, 1970.
Sproston, N. R., & Ashworth, J. J. (2018). Role of C-Reactive Protein at Sites of Inflammation
and Infection. Frontiers in immunology, 9, 754. https://doi.org/10.3389/fimmu.2018.00754
Turgeon, M.L. (2014). Immunology & Serology in Laboratory Medicine. Elsevier Inc.

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