C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) or both? A systematic evaluation in pediatric ulcerative colitis

Dan Turner*, David R. Mack, Jeffrey Hyams, Neal LeLeiko, Anthony Otley, James Markowitz, Yair Kasirer, Aleixo Muise, Cynthia H. Seow, Mark S. Silverberg, Wallace Crandall, Anne M. Griffiths

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

65 Scopus citations

Abstract

Background: There has not been an extensive comparison of CRP and ESR in ulcerative colitis (UC), and thus, we aimed to explore their utility in UC. Methods: Four previously enrolled cohorts of 451 children with UC were utilized, all including laboratory, clinical and endoscopic data. A longitudinal analysis was performed on prospectively collected data of 75 children. Disease activity was captured by both global assessment and pediatric UC activity index (PUCAI). Results: The best thresholds to differentiate quiescent, mild, moderate and severe disease activity, were < 23, 23-29, 30-37, > 37. mm/h for ESR, and < 2.5, 2.5-5, 5.01-9, > 9. mg/L for CRP (area under the ROC curves 0.70-0.81). Correlation of endoscopic appearance with CRP and ESR were 0.55 and 0.41, respectively (P < 0.001). Both CRP and ESR may be completely normal in 34% and 5-10% of those with mild and moderate-severe disease activity, respectively. Elevated CRP in the presence of normal ESR or vice versa was noted in 32%, 38%, 30% and 17% of those with quiescent, mild, moderate and severe disease activity. Over time, the utility of CRP and ESR in reflecting disease activity remained stable in 70-80% of cases. Conclusion: In ~. 2/3 of children, both CRP and ESR values reflect disease activity to a similar degree and in the remaining, either CRP or ESR may be sufficient, with slight superiority of CRP. CRP is more closely correlated with endoscopic appearance. When either CRP or ESR performs well for a given patient, this is likely to remain so over time. Therefore, it may not be justified to routinely test both ESR and CRP in monitoring disease activity.

Original languageAmerican English
Pages (from-to)423-429
Number of pages7
JournalJournal of Crohn's and Colitis
Volume5
Issue number5
DOIs
StatePublished - Oct 2011

Keywords

  • C-reactive protein
  • Disease activity
  • Erythrocyte sedimentation rate
  • Pediatrics
  • Ulcerative colitis

Fingerprint

Dive into the research topics of 'C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) or both? A systematic evaluation in pediatric ulcerative colitis'. Together they form a unique fingerprint.

Cite this