Role of C-reactive Protein in Acute Respiratory Tract Infections in Children

• Main Authors: Sujata A Jadhav, Chitra C Khnawelkar, Satish V Kakade
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2018-07-01
• Series: National Journal of Laboratory Medicine
• Subjects: breathlessness; cough; infection; rhinitis
• Online Access: http://www.njlm.net/articles/PDF/2304/36105_CE(VSU)_F(SS)_PF1(VSU_SS)_PFA(NC)_PF2(VSU_SS)_PN(SHU).pdf
• ISSN: 2277-8551; 2455-6882

Introduction: C-reactive Protein (CRP) is an acute phase protein synthesised in liver. Its production is mainly by Interleukin-6, Interleukin-1β and tumor necrosis factor in response to infection or tissue inflammation. Raised CRP levels are considered as a marker of inflammation. Therefore, they can be used for screening of inflammatory conditions or other disease activity. Rapid increase in the synthesis of CRP within hours, after tissue injury or infection suggests that it contributes in host defense and that it is a part of the innate immune response. CRP plays an important role in host’s defense against infections. Aim: To measure CRP levels qualitatively and semi-quantatively in paediatric patients with Acute Respiratory Tract Infection (ARTI) and to study its association with day of illness on presentation and leucocyte count and severity of infection. Materials and Methods: This is the cross-sectional study conducted on paediatric patients of ARTIs coming to Krishna Hospital and Research Centre, Karad. Patients of either sex between the age group of one to five years were selected. Immediately after the diagnosis of ARTI, blood sample was taken to investigate CRP levels and total leucocyte count. Age and weight of the patients, day of illness, symptoms and signs were also noted. Results: Total 298 patients were included in the study. Fever, cough, rhinitis, throat pain, earache and breathlessness were the presenting symptoms. Out of these cough, fever and rhinitis were the most common symptoms of presentation. The percentage of positive CRP values was 14.4% i.e., in 43 patients this test was positive. In seven CRP positive patients leucocytosis was seen. Association of breathlessness with CRP positivity was observed. Conclusion: Breathlessness which is one of the sign of severe respiratory tract infection and respiratory distress was present in most of the CRP positive patients. Leucocytosis was not associated with raised CRP levels. Thus, raised CRP values can be associated with severity of respiratory tract infection but cannot be taken as the sign of bacterial infection and may not be considered as an indicator for antimicrobial prescription.