Agreement between Erythrocyte Sedimentation Rate and C-Reactive Protein in Hospital

[Dr.Vad]

Among 5777 patients, 35% and 58% had an elevated CRP and ESR, respectively. ESR and CRP were in agreement in 67% of patients (both elevated in 30%, both normal in 37%). A disagreement was observed in 33% (elevated ESR/normal CRP in 28%, normal ESR/elevated CRP in 5%). Review of medical chart showed that 25 (5%) patients with elevated CRP and normal ESR had an active inflammatory disease (false-negative ESR) (наверное начало воспаления, когда ЦРП уже повысился, а фибриноген еще не стал синтезироваться/появляться в циркуляции). Conversely, 74 (28%) patients had elevated ESR and normal CRP: (из них) 32% (24 пациента) had resolving inflammatory disorders (фибриноген как острофаз. белок с длительным периодом полужизни), 28% (21 пациент) disclosed a variable interfering with the ESR measure (false-positive ESR), 32% had unexplained discrepancies, and 8% (6 пациентов) had an active inflammatory disease (false-negative CRP).

CONCLUSION: In hospital practice, joint measurement of ESR and CRP is unwarranted. Because of slow variation and frequent confounding, ESR is frequently misleading in unselected patients. When an inflammatory disorder is suspected, priority should be given to CRP.

Am J Med. 2010 Sep;123(9):863.e7-13.
Agreement between erythrocyte sedimentation rate and C-reactive protein in hospital practice.
Colombet I, Pouchot J, Kronz V, Hanras X, Capron L, Durieux P, Wyplosz B.
SourceHospital Informatics and Public Health, Hôpital Européen Georges Pompidou, France.

ПыСы. Fibrinogen, the most abundant acute phase reactant, has the greatest effect on the elevation of ESR when compared with other acute phase proteins.(3,4,11)