A number of serum proteins may show a nonspecific increase in their blood concentration in response to inflammation. These can contribute to a number of findings including an elevation in the erythrocyte sedimentation rate (ESR). The increase in these proteins is often mediated by cytokines.


Sources of inflammation may include:

(1) infection

(2) autoimmune disorder

(3) tumor necrosis

(4) burn injury

(5) trauma or surgery


Proteins which may increase in response to inflammation:

(1) alpha-1 antichymotrypsin

(2) a1pha-1 antitrypsin

(3) alpha-1 acid glycoprotein

(4) C-reactive protein (CRP)

(5) ceruloplasmin

(6) complement

(7) factor VIII

(8) ferritin

(9) fibrinogen

(10) haptoglobin

(11) lipoproteins

(12) plasminogen

(13) plasminogen activator inhibitor 1 (PAI-1)

(14) polyclonal immunoglobulins (as gamma globulins)

(15) serum amyloid A protein

(16) von Willebrand factor (vWF)


An acute phase reactant such as CRP can be used:

(1) to identify the presence of inflammation

(2) to monitor disease severity


Acute phase reactants that may be problematic for diagnosis, when a mild deficiency is increased into the normal range:

(1) ferritin (for iron deficiency anemia)

(2) ceruloplasmin (for Wilson's disease)

(3) von Willebrand factor (for mild von Willebrand's disease)

(4) fibrinogen (for DIC)

(5) alpha-1 antitrypsin (for A1AT deficiency)


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