Wilson et al monitored serum C-reactive protein (CRP) in patients admitted for acute pancreatitis. The pattern of change in CRP can help identify a patient at risk for complicated disease. The authors are from the Royal Infirmary in Glasgow.
Criteria for complicated acute pancreatitis:
(2) local pancreatic complication (abscess, pseudocyst, pancreatic necrosis, peripancreatic necrosis)
Specimen collection: Daily from the day of admission (day 1) to either day 8 or discharge, whichever is sooner.
Measurement of CRP was done using fluorescence polarization immunoassay on the Abbott TDX. The normal range was not given, but in Figure 3 the upper limit of normal approximates 10 mg/L, which is the value given in Tietz (Clinical Guide to Laboratory Tests, Third Edition).
Values indicating complicated pancreatitis:
(1) maximum (peak) CRP on second, third or fourth hospital day >= 210 mg/L
(2) CRP on day 7 >= 120 mg/L
• CRP peak >= 210 mg/L: sensitivity 83%, specificity 85%, correctly classified 85%
• CRP day 7 >=120 mg/L: sensitivity 90%, specificity 85%, correctly classified 87%
• Performance comparable to Glasgow or Ranson scores.
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