Elevated CRP (C-Reactive Protein) Levels Can Predict Ileal... : Official journal of the American College of Gastroenterology | ACG (2024)

Abstracts: INFLAMMATORY BOWEL DISEASE

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Swaroop, Prabhakar P. MD; Raghuwanshi, Naishadh MD

Author Information

Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, TX and Gastroenterology and Hepatology, Saint Louis University Hospital, Saint Louis, MO.

American Journal of Gastroenterology 102():p S478-S479, September 2007.

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Purpose: The advent of high-sensitivity CRP (hs-CRP) has enabled us to detect disease activity in patient with IBD. We sought to examine the relationship between hs-CRP (CRP) and location of disease in IBD based upon endoscopic, histologic, and radiographic activity.

Methods: All IBD patients at our institution between July 2000 and June 2006 who had a CRP, and colonoscopy with biopsy and/or small bowel follow through (SBFT) performed with 90 days were identified, retrospectively. The diagnosis of Crohn's disease (CD) or Ulcerative Colitis (UC) must have been made or confirmed at our institution. Those patients who underwent proctocolectomy with IPAA were excluded from the study. The patients with CD and UC were separately identified and the odds ratio (OR) for an elevated CRP was determined based upon location of disease.

Results: A total of 218 patients with a confirmed diagnosis of IBD were identified of which 93 patients fulfilled the inclusion criteria. Of the 53 patients with CD, the mean CRP was 2.80 mg/dL, regardless of disease location. Using a cutoff CRP level of 2.0 mg/dL, the odds ratio (OR) for terminal ileum involvement was 3.38, suggesting that those CD patients with a CRP greater than 2.0 mg/dL are more prone to have ileal involvement. Of the 40 patients with UC, the mean CRP was 3.18 mg/dL, independent of location of disease. Again, using a cutoff CRP level of 2.0 mg/dL, the odds ratio (OR) for ileal involvement was 3.29. The data suggests that a CRP level greater than 2.0 mg/dL predicts backwash ileitis in those patients with UC. Interestingly, those patients who had CRP levels greater than 7.0 mg/dL were found to have Cytomegalovirus infection in the colon, Clostridium difficile infection, or another underlying systemic infectious process.

Conclusion: CRP elevation in Inflammatory Bowel Disease is associated with active disease determined endoscopically, histologically, or radiographically. In both CD and UC, a CRP > 2.0 mg/dL predicts findings of active ileal disease at ileocolonoscopy. Ileitis may play a crucial role in the inflammatory cascade of IBD.

© The American College of Gastroenterology 2007. All Rights Reserved.
Elevated CRP (C-Reactive Protein) Levels Can Predict Ileal... : Official journal of the American College of Gastroenterology | ACG (2024)

FAQs

Elevated CRP (C-Reactive Protein) Levels Can Predict Ileal... : Official journal of the American College of Gastroenterology | ACG? ›

Conclusion: CRP elevation in Inflammatory Bowel Disease is associated with active disease determined endoscopically, histologically, or radiographically. In both CD and UC, a CRP > 2.0 mg/dL predicts findings of active ileal disease at ileocolonoscopy. Ileitis may play a crucial role in the inflammatory cascade of IBD.

What does an elevated level of C-reactive protein CRP suggest? ›

High levels of CRP may mean you have a serious health condition that causes inflammation. Inflammation is your body's way of protecting your tissues and helping them heal from an injury, infection, or other disease. Inflammation can be acute (sudden) and temporary.

What autoimmune disease causes high CRP levels? ›

A wide variety of inflammatory conditions can cause elevated CRP levels, including : autoimmune conditions, including rheumatoid arthritis (RA), lupus, and certain types of inflammatory bowel disease (IBD), such as Crohn's disease and ulcerative colitis.

Is CRP always elevated in inflammatory bowel disease? ›

Introduction C-reactive protein (CRP) is an established marker of disease activity in inflammatory bowel disease (IBD). However not all flares in IBD are associated with an elevated CRP.

What cancers are associated with high CRP levels? ›

Elevated CRP levels have been found to be associated with several cancers, including breast, lung, gastric, and colorectal cancer, hepatocellular carcinoma, and renal carcinoma (Roxburgh and McMillan, 2010; Wu et al., 2011).

Should I be worried about high CRP? ›

If your CRP test results reveal that you have high levels of CRP, it doesn't necessarily mean that you have a medical condition that needs treatment, especially if they're only slightly elevated. Several factors, such as smoking, recent injury and certain health conditions, can raise your CRP levels.

What should I avoid if my CRP is high? ›

Limiting or avoiding inflammatory foods like refined carbohydrates, fried foods, red meat and processed meat can help reduce CRP. Instead, focus on eating more anti-inflammatory foods like leafy greens, nuts, fatty fish and whole grains.

What happens if high CRP is left untreated? ›

When CRP remains high, it is an indication of chronic inflammation. Elevated CRP is a risk factor for many chronic inflammation-related disorders, including cardiovascular disease, cancer, diabetes, obesity, and more.

What autoimmune disease causes high inflammation? ›

Some examples of autoimmune diseases are: Rheumatoid arthritis (RA). Your immune system produces antibodies that attach to the linings of your joints. Your immune system cells then attack the joints, causing inflammation, swelling, and pain.

What is the treatment for high CRP levels? ›

If you're at high risk of cardiovascular disease and your test results show high CRP, your doctor may suggest a statin or other cholesterol-lowering medication. Vitamin C has also been explored as a way to lower CRP levels for people who have an elevated risk of cardiovascular disease.

What is ileal disease? ›

Terminal ileal disease is defined as disease limited to the lower third of the small bowel with or without cecal involvement. Patients with Crohn disease of the ileum commonly present with symptoms suggestive of inflammation or obstruction.

Does CRP show diverticulitis? ›

C-reactive protein (CRP) is a very well known acute phase reactant that shows the presence of inflammation, severity of diverticulitis, prediction of perforation, and response to antibiotic therapy in colonic diverticular disease [1, 2].

What are the 4 stages of ulcerative colitis? ›

The main stages of UC are mild, moderate, severe, and fulminant. Fulminant UC is a subset of the condition that causes sudden and severe symptoms. UC is not curable with medication, but treatments can reduce the frequency and severity of flares specific to the stage.

What is the most likely cause of high CRP? ›

A high test result is a sign of inflammation. It may be due to serious infection, injury or chronic disease. Your health care provider may recommend other tests to determine the cause.

Is CRP a tumour marker? ›

Elevated CRP levels (> 10 μg/ml) are associated with active, advanced cancer disease.

What infections are associated with high CRP? ›

Substantially raised CRP values are usually found in pneumonia,3-6 and a high CRP value has been shown to be a strong predictor for this disease in general practice. However, raised CRP values may also be found in uncomplicated viral respiratory infections, particularly those caused by influenza virus and adenovirus.

What is an alarming CRP? ›

Generally, a CRP level of less than 10 mg/L is considered normal. CRP levels between 10 and 100 mg/L indicate mild to moderate inflammation, while levels above 100 mg/L indicate severe inflammation.

What infections cause high CRP levels? ›

Substantially raised CRP values are usually found in pneumonia,3-6 and a high CRP value has been shown to be a strong predictor for this disease in general practice. However, raised CRP values may also be found in uncomplicated viral respiratory infections, particularly those caused by influenza virus and adenovirus.

What level of CRP indicates arthritis? ›

Normal C-reactive protein (CRP) levels
C-reactive protein level (in milligrams per liter of blood) in adultsWhat it means
10.0–100.0moderately elevated, which signifies infection or an inflammatory condition such as rheumatoid arthritis (RA), Crohn's disease, or lupus
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How do you treat high CRP levels? ›

If you're at high risk of cardiovascular disease and your test results show high CRP, your doctor may suggest a statin or other cholesterol-lowering medication. Vitamin C has also been explored as a way to lower CRP levels for people who have an elevated risk of cardiovascular disease.

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