Hight rde highc reative protein3/16/2023 Although acute-phase-proteins are relatively unspecific markers of different types of inflammation in human as well as in veterinary medicine, extremely high CRP concentrations > 100 mg/L in association with specific symptom complexes (e.g. Thus, it can be hypothesized that similar might be true for CRP.Īnother critical point in a patient with a severe inflammation of unknown origin is the question as to whether antibiotic treatment is required, especially in times of increasing antibiotic resistances of bacteria. However, it is well known for leukemoid reaction that such extreme leukocytosis is linked to only a small group of disease categories. To the authors’ knowledge, comparable information is scarce in dogs. įor humans, some inflammatory disease etiologies have proven to present with extremely increased CRP values more often than others. In humans, prevalence of CRP values > 100 m/l is ranging between 3 and 30% depending on the patient population. Scarce knowledge is available about the prevalence of CRP values above 100 mg/l in dogs. While current research provides at least some information on extreme leukocytosis in small animals, studies addressing extremely high CRP values in dogs are rare. While there is no general definition, which medical decision limits should be utilized to classify an inflammation as low grade or moderate, there is a consent that CRP values above 100 mg/l indicate a high grade inflammation. Different cut-off values have been discussed as medical decision limits for human and canine CRP. Canine CRP value increases of up to > 900 mg/l are reported in extremely rare cases. According to state-of-the-art scientific research, the CRP range of healthy dogs is below ~ 10–20 mg/l CRP. CRP measurement is meanwhile widely available in veterinary medicine. This wide range permits a more detailed evaluation of an inflammatory process than leukocyte counts. C-reactive protein (CRP) is an important major APP in dogs, which increases within the first 8-24 h after an inflammatory stimulus and reaches up to 100-fold of the baseline levels. APPs react more rapidly and with a shorter half-life period than classic markers of inflammation. Extremely high CRP concentrations do not allow a conclusion of the underlying etiology or an identification of bacterial inflammation.Īcute phase proteins (APP) are sensitive markers that change their concentration as a reaction to a systemic inflammatory process and are known to increase in response to infectious diseases, immune mediated diseases, neoplasia and surgery. They indicate a severe systemic disease of various etiologies with guarded prognosis. ConclusionsĬRP concentrations > 100 mg/l are occasionally seen in a clinic population. The 3-months survival rate was 46/73 (63%) while the majority 66/73 (90%) of patients was hospitalized. The prognostic significance was investigated by determining the 3-months survival and hospitalization rate in a subgroup with known outcome. Based on CRP, a detection of bacterial infection was not possible. The disease group ( p = 0.081) or organ system ( p = 0.17) did not have an impact on CRP. 147 dogs with CRP 101–368 mg/l were included and classified into disease categories: 86/147 (59%) with inflammatory etiology (among these, 23/86 non-infectious, 44/86 infectious (33/44 bacterial), 19/86 inflammation non-classifiable), 31/147 (21%) tissue damage, 17/147 (12%) neoplastic (all malignant) and 13/147 (9%) diverse diseases. If an organ classification was not possible, dogs were classified as “multiple”. Diseases were assigned to the affected organ system. inflammatory, neoplastic, tissue damage or “diverse”. Dogs were classified into 4 main disease categories, i.e. Prevalence of CRP > 100 mg/l was investigated in dogs presented between 20 and was 12%.įor evaluation of etiology and organ systems, dogs with CRP > 100 mg/l presented between 20 were enrolled. The aim of the retrospective study was to investigate the prevalence and evaluate dogs with CRP concentrations > 100 mg/l regarding the underlying etiology, the affected organ system and the prognostic significance. Similar decision limits for septic pneumonia are recommended for dogs but have not yet been evaluated for other organ systems. In human medicine, extremely high CRP (C-reactive protein) concentrations > 100 mg/l are indicators of bacterial infection and the need of antibiotic treatment.
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