Editorials

The renaissance of C reactive protein

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7277.4 (Published 06 January 2001) Cite this as: BMJ 2001;322:4

It may be a marker not only of acute illness but also of future cardiovascular disease

  1. Mark B Pepys, professor of medicine (m.pepys@rfc.ucl.ac.uk),
  2. Abi Berger, science editor
  1. Department of Medicine, Royal Free and University College Medical School, London NW3 2PF
  2. BMJ

    C reactive protein (CRP) has traditionally been used as an acute phase marker of tissue injury, infection, and inflammation, but the use of high sensitivity assays has recently shown that increased C reactive protein values predict future cardiovascular disease.

    The C reactive protein response has no diagnostic specificity, but serial measurements can be helpful in clinical management. It is a powerful screening test for organic disease and is useful in monitoring known infectious or inflammatory diseases and their response to treatment.1 Although a high value is unequivocal evidence of tissue damaging disease, C reactive protein values (unlike most other clinical laboratory tests) can really only be interpreted when all other clinical and laboratory information is available. Nevertheless, serial measurements of C reactive protein, added to the full clinical picture, contribute usefully to diagnosis, prognosis, and management.1

    C reactive protein is a trace protein in healthy subjects, with a median concentration of around 1 mg/l, but values can exceed 400 mg/l in the acute phase response. Routine applications in adult medicine require measurement above 5-10 mg/l, but the development of high sensitivity assays …

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