Pattern of change of C-reactive protein levels and its clinical implication in patients with acute poisoning

Yong Oh Kim, Hyung Il Kim, Bo Kyeung Jung, Yong Oh Kim, Hyung Il Kim, Bo Kyeung Jung

Abstract

Objectives: C-reactive protein is well known as an inflammatory indicator in injury, infection, and cancer. However, little is known about its role in poisoning. C-reactive protein levels first increase and then decrease within several days during poisoning management. This study aimed to verify the C-reactive protein change pattern and its clinical co-infection possibility in patients with poisoning.

Methods: Daily C-reactive protein levels of the patients with poisoning, who were admitted for more than 5 days, were measured. Microbial cultures were conducted, and fever (⩾38°C) and infection-related symptoms were investigated.

Results: In the enrolled 56 patients, the initial median C-reactive protein levels at hospital day 1, 2, 3, 4, and 5 were 0.28, 4.85, 10.91, 10.57, and 6.68 mg/dL, respectively. C-reactive protein level was the highest at hospital day 3 and decreased thereafter. No statistical difference was observed in the daily and maximal C-reactive protein levels between the culture-positive and culture-negative groups. The levels at hospital days 3-5 and the maximal level were 8.4, 9.2, 5.49, and 11.02 mg/dL, respectively, in non-fever group. The levels at hospital days 3-5 and the maximal level were 7.4, 9.2, 4.74, and 10.81 mg/dL, respectively, in non-symptoms group. Levels at hospital days 3-5 and the maximal level were 5.21, 4.93, 3.7, and 5.28 mg/dL, respectively, in all-negative (culture-negative without fever or infection symptoms) group.

Conclusions: Acute rise and fall of C-reactive protein levels can be observed in the infection-unlikely patients with poisoning. The levels were similar to bacterial infection levels, possibly due to the drug reaction itself, rather than for superimposed infections.

Keywords: Acute-phase proteins; inflammation; metabolism.

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

© The Author(s) 2022.

Figures

Figure 1.
Figure 1.
The median CRP values of patients with intoxication. CRP: C-reactive protein; HD: hospital day.
Figure 2.
Figure 2.
The median CRP values compared across groups. (a) Comparison of non-culture vs any-culture group. (b) Comparison of non-fever vs any-fever group. (c) Comparison of non-infection symptoms vs any-infection symptoms group. (d) Comparison of all-negative vs any-positive group. CRP: C-reactive protein; HD: hospital day. The interquartile range bars are deleted.

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Source: PubMed

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