Concordant message of different inflammatory markers in patients with rheumatoid arthritis. (1998 Dec)
concordant message of different inflammatory markers in patients with rheumatoid arthritis . The acute phase reaction is an unspecific response to inflammatory stimuli characterized by alterations in the concentration of several plasma proteins . It is of great clinical value to monitor the inflammatory state in patients with rheumatoid arthritis . The erythrocyte sedimentation rate ( ESR ) and C reactive protein ( CRP ) are the assays most widely used to measure the acute phase response , but there are also several other inflammatory markers ( e . g . , fibrinogen , haptoglobin , alpha 1 acid glycoprotein , alpha 1 antitrypsin , interleukins ( IL ) , serum amyloid component A ( SAA ) ) . We have studied the interrelationships between several of these markers ( ESR , haptoglobin , fibrinogen , CRP , SAA and IL 6 ) in rheumatoid arthritis patients . there was a good correlation between all acute phase markers in serum ( p . 01 ) . We found especially strong correlations between S CRP and SAA ( p . 000001 ) and between ESR and P fibrinogen ( p . 000004 ) . The strong correlation indicates that P fibrinogen could be used instead of ESR in monitoring rheumatoid arthritis patients . This would increase the specificity of the examination as ESR may be influenced by several factors other than the inflammatory response . there were no significant correlations between acute phase markers in serum or plasma and clinical index …

Levels of antioxidant proteins and soluble intercellular adhesion molecule 1 in serum of patients with rheumatoid arthritis. (2002 Aug)
levels of antioxidant proteins and soluble intercellular adhesion molecule 1 in serum of patients with rheumatoid arthritis . serum levels of soluble intercellular adhesion molecule 1 ( sicam 1 ) , ceruloplasmin ( Cp ) , and transferrin ( Tf ) were measured in patients with rheumatoid arthritis ( RA ) and the correlations of these parameters with disease activity were investigated . serum sicam 1 levels were determined by a sandwich enzyme linked immunosorbant assay ( elisa ) in serums from 42 patients with RA and 30 healthy controls . erythrocyte sedimentation rate ( ESR ) was determined by the westergren method and C reactive protein ( CRP ) , Cp , and Tf by nephelometric methods . disease activity was assessed by standard criteria . serum Tf levels were significantly diminished and serum levels of sicam 1 and Cp were significantly increased in patients with RA , compared to healthy controls . serum sicam 1 levels showed negative correlation with serum Tf levels ( r 0 . 47 , p 0 . 01 ) , and positive correlation with serum Cp levels ( r 0 . 49 , p 0 . 001 ) . there was weak positive correlation between sicam 1 levels and the ritche articular index ( RAI ) scores ( r 0 . 32 , p 0 . 05 ) and serum CRP levels ( r 0 . 44 , p 0 . 01 ) , but no significant correlations of sicam 1 levels with …

Relative sensitivity to change of the erythrocyte sedimentation rate and serum C reactive protein concentration in rheumatoid arthritis. (2004 May)
relative sensitivity to change of the erythrocyte sedimentation rate and serum C reactive protein concentration in rheumatoid arthritis . objective : To compare the sensitivity to change of the erythrocyte sedimentation rate ( ESR ) and serum C reactive protein ( CRP ) concentration used as measures of rheumatoid arthritis ( RA ) activity . methods : A literature search was conducted to identify all clinical trials and observational studies of disease modifying medications and corticosteroids in RA that reported results for both ESR and CRP before treatment and 4 weeks to 24 weeks after treatment in the same patients . For each test , effect sizes were computed as the change in the test with treatment divided by the pretreatment standard deviation . A pooled analysis was performed on the paired differences in effect sizes for ESR and CRP within each study . results : One hundred twenty three studies with 184 active treatment arms were identified that included measurements of both ESR and CRP . sixty three studies with 90 active treatment arms provided sufficient data to permit calculation of effect sizes , and were included in the analysis . In the 36 treatment arms that reported results at 12 weeks , the ESR was more sensitive to change than the CRP , with a paired difference in effect sizes of 0 . 09 units ( 95 confidence interval 0 . 03 , 0 . 15 ; p 0 . 005 ) . In the 76 treatment arms …

Age adjustment corrects for apparent differences in erythrocyte sedimentation rate and C reactive protein values at the onset of seropositive … (2005 Jun)
Age adjustment corrects for apparent differences in erythrocyte sedimentation rate and C reactive protein values at the onset of seropositive rheumatoid arthritis in younger and older patients . objective : To evaluate the effect of age adjustment on baseline erythrocyte sedimentation rate ( ESR ) and C reactive protein ( CRP ) in patients with late onset rheumatoid arthritis ( LORA , age or 55 yrs ) and younger onset RA ( YORA , age 55 yrs ) in a cohort with early , rheumatoid factor ( RF ) positive RA that has not received disease modifying antirheumatic drugs ( dmard ) . methods : In an ongoing prospective cohort study of 263 patients with seropositive RA who were enrolled within 14 months of symptom onset , baseline assessments included ESR , CRP , tender and swollen joint counts , and functional status . westergren ESR determinations were performed in the rheumatologist s office or in a local laboratory using appropriate methods . CRP were performed at the specialty laboratories in santa monica , CA , using behring nephelometry . percentages of patients with greater than the upper limit of normal ( ULN ) laboratory values using both age unadjusted and age adjusted ESR and CRP values were determined . The late onset and younger onset RA patients were compared using wilcoxon rank sum and chi square tests . results : At study entry , both the YORA and LORA patients had comparable symptom duration , disease activity scores , …

Rapidly progressed secondary amyloidosis in a patient with still s disease with gamma allele in his SAA 1 gene A … (2000 Oct)
rapidly progressed secondary amyloidosis in a patient with still s disease with gamma allele in his SAA 1 gene A fifteen year old boy was admitted to our hospital because of lower abdominal pain , watery diarrhea and mucobloody stool . Two years before admission , he was diagnosed to have still s disease presenting with polyarthritis , sore throat , remittent fever and typical skin rash . He had been treated with non steroidal anti inflammatory agents , oral prednisolone and low dose methotrexate . although he was almost free of symptoms during the next two years , serum C reactive protein ( CRP ) levels continued to be elevated moderately . He began to complain of lower abdominal pain and loose stool in May 1997 and came down with mucous bloody diarrhea in June . laboratory data on admission showed an elevated level of serum CRP ( 13 . 9 mg / dl ) . The biopsy of the stomach , ileum , sigmoid colon and rectum revealed the deposition of amyloid protein of AA type , which confirmed the diagnosis of secondary amyloidosis . The dose of prednisolone was increased and dimethyl sulfoxide per os or rectum was instituted , which improved his gastro intestinal symptoms to some extent . however , fever , arthritis and diarrhea recurred along with tapered prednisolone dosage . In addition to gastro intestinal symptoms , arrhythmia and proteinuria appeared . these symptoms were considered to reflect general deposition of amyloid in …

Immunocytomorphopathological studies on the pathogenesis of rheumatoid arthritis. (1997 Apr)
immunocytomorphopathological studies on the pathogenesis of rheumatoid arthritis . thirty cases of rheumatoid arthritis were submitted to cytomorphological , histopathological ( HE , VG , PAS alcian , gömöri , safranine O ) , histoenzymological ( Acid phosphatase , chondroitin sulphatase , peroxidase ) and immunological ( rheumatoid factor ( RF ) ) studies ; circulating immune complexes , anti collagen antibodies II , reactive C protein ( CRP ) , complementary C3 fraction were also assessed . The synoviocytogram of the rheumatoid synovial fluid ( SF ) indicated a cytosis with polynucleosis and ragocytosis compared to the hydroarthrosic SF defined by lymphocytosis ( 47 . 8 ) . enzymologically , especially for high titres of rheumatoid factor , a phosphatase and peroxidase activity was observed in polymorphonuclear cells of a ragocytary type and in phagocytic mononuclear cells . The severe forms of rheumatoid arthritis ( RA ) were correlated histopathologically with chronic villous synovitis associated with some processes of obliterant vascularitis , fibrosis and sclerosis . At the level of synovio cartilage junction , fissures and a homogenization of the cartilaginous fundamental substance in the vicinity of disintegrated synovial structures were noticed . histoenzymologically , a lysosomal and oxidative activity was found in chondrocytes and in synovial macrophages . immunological assessments ( 73 serum and 60 synovial fluid samples ) showed pathological values of circulating immune complexes , anti collagen antibodies and C reactive protein . The complementary synovial depletion of the C3 fraction underlines the immune character of …

Comparison of serum and synovial fluid concentrations of beta 2 microglobulin and C reactive protein in relation to clinical disease … (1990 Jan)
comparison of serum and synovial fluid concentrations of beta 2 microglobulin and C reactive protein in relation to clinical disease activity and synovial inflammation in rheumatoid arthritis . beta 2 microglobulin and C reactive protein ( CPR ) were measured in 33 and 57 matched pairs of serum and synovial fluid ( SF ) respectively , from patients with active rheumatoid arthritis ( RA ) . serum beta 2 microglobulin concentrations were higher than in normal controls and the SF concentration was higher than the serum concentration on 25 of 33 occasions ( 76 ) , suggesting a local production of beta 2 microglobulin within the synovial membrane . there was a correlation between serum and SF concentrations of beta 2 microglobulin ( r 0 . 50 ) . patients serum CRP concentrations in 57 samples were higher than in normal controls and were greater than in the matched SFs on 49 of the 57 paired samples ( 86 ) . In 18 samples CRP was absent in the SF , suggesting a local consumption or binding within the synovial membrane . twenty four patients with RA given either sodium aurothiomalate or D penicillamine for six months showed highly significant clinical improvements accompanied by reductions in serum and SF immunoglobulin concentrations and knee joint suprapatellar pouch synovial membrane T lymphocyte infiltrates . In this group of patients serum CRP , but not beta 2 microglobulin , fell significantly , but there were no significant changes in SF beta 2 microglobulin …

Measurement of plasma calprotectin as an indicator of arthritis and disease activity in patients with inflammatory rheumatic diseases. (1994 Aug)
measurement of plasma calprotectin as an indicator of arthritis and disease activity in patients with inflammatory rheumatic diseases . objective : To investigate if the plasma level of the granulocyte protein calprotectin is a useful indicator of severity of arthritis in patients with inflammatory rheumatic diseases , and to analyze which factors contribute to the raised plasma calprotectin levels . methods : plasma calprotectin levels were measured by elisa : In a cross sectional study of 154 patients with various inflammatory rheumatic diseases , calprotectin levels were correlated with laboratory and clinical variables . results : The plasma levels of calprotectin and C reactive protein ( CRP ) correlated significantly with the clinical evaluation of swollen joints ( r 0 . 51 , p or 0 . 01 and r 0 . 29 , p or 0 . 01 , respectively ) . calprotectin levels , but not CRP levels or erythrocyte sedimentation rate , were significantly lower in patients with no swollen joints than in patients with one or more swollen joints ( 2613 . 6 micrograms / l vs 6287 . 0 micrograms / l , p 0 . 001 ) . A significant correlation between calprotectin and number of neutrophils was demonstrated ( r 0 . 43 , p or 0 . 01 ) , indicating that circulating neutrophils contribute to plasma calprotectin levels . conclusion : The plasma calprotectin level may be a useful indicator of arthritis in inflammatory rheumatic diseases .

Rise in serum C reactive protein after hip and knee arthroplasties in patients with rheumatoid arthritis. (2001 Feb)
Rise in serum C reactive protein after hip and knee arthroplasties in patients with rheumatoid arthritis . objective : serum C reactive protein ( CRP ) concentration was evaluated in patients with rheumatoid arthritis ( RA ) undergoing total hip arthroplasty ( THA ) or total knee arthroplasty ( TKA ) to ascertain the postoperative CRP response . methods : thirty seven consecutive patients with RA who had undergone THA or TKA were included in the study . The CRP concentration was measured in every patient once preoperatively and every other day for one week postoperatively . results : The peak median CRP concentration ( 94 mg / l ) was achieved on the first and second day postoperatively and was seven times higher than the median preoperative concentration ( 13 mg / l ) . CRP declined to the preoperative concentration in about one week . The rise of the CRP concentration was significant ( p 0 . 001 ) . No infection was encountered in this series . conclusion : A rapid rise in the postoperative CRP concentration is normal in patients with RA treated by THA or TKA . The CRP concentration decreases to the preoperative value in about one week . serial CRP measurements , including at least one preoperative measurement , are needed when the clinical significance of the postoperative CRP values is evaluated . When the postoperative CRP concentration remains raised for several days compared with the preoperative value , or even rises , …

Amyloidosis and rheumatoid arthritis. (1985 Sep)
amyloidosis and rheumatoid arthritis . In spite of an apparent decrease in its occurrence during the last 2 3 decades , amyloidosis associated with rheumatoid arthritis is a significant cause of increased morbidity and early death in both juvenile and adult onset rheumatoid arthritis ( RA ) . Like other forms of reactive amyloidosis , the amyloid fibrils associated with rheumatoid disorders are of the protein AA type , and the acute phase reactant SAA , which is complexed to high density lipoprotein in serum , is its putative precursor . raised SAA appears to be one of the prerequisites for the development of reactive , AA amyloid . effective treatment of the underlying disorder i . e . rheumatoid arthritis , which lowers the levels of SAA is , therefore , recommended both as a prophylactic and therapeutic measure against reactive amyloidosis . As renal disease is the most severe and life threatening consequence of reactive amyloidosis , both hemodialysis and renal transplantation are also to be considered in such patients .

Plasma interleukin 6 and renin substrate in reactive arthritis , rheumatoid arthritis , and systemic lupus erythematosus. (1992 Nov)
plasma interleukin 6 and renin substrate in reactive arthritis , rheumatoid arthritis , and systemic lupus erythematosus . In order to study the role of interleukin 6 ( IL 6 ) in inflammatory disease we monitored plasma levels of IL 6 and acute phase proteins such as C reactive protein ( CRP ) and renin substrate ( RS ) in patients with reactive arthritis ( ReA ) , rheumatoid arthritis ( RA ) , and systemic lupus erythematosus ( SLE ) . venous plasma samples were collected : ( 1 ) during the acute phase or exacerbation of the disease , and ( 2 ) several months latter during convalescence . increased mean 95 confidence intervals ( CI ) levels of plasma IL 6 were observed in patients with ReA both in the acute phase and later , 229 ( 177 to 280 ) ng / l and 197 ( 134 to 260 ) ng / l respectively ( P less than 0 . 001 as compared to controls ) . The corresponding plasma IL 6 levels in RA patients were 283 ( 223 to 340 ) ng / l and 183 ( 151 to 226 ) ng / l , respectively ( P less than 0 . 001 as compared to controls ) . plasma IL 6 levels in SLE patients were not increased . plasma RS levels were increased in all patient groups , but no significant correlation to IL 6 or CRP levels was observed , whereas …

Correlation of persistently high serum amyloid A protein and C reactive protein concentrations with rapid progression of secondary amyloidosis. (1983 Jun)
correlation of persistently high serum amyloid A protein and C reactive protein concentrations with rapid progression of secondary amyloidosis . The importance of serum amyloid A protein in the progression of renal failure was studied over three years in 28 patients with secondary ( amyloid A type ) amyloidosis predominantly due to rheumatoid arthritis . creatinine clearance , the amount of protein in the urine , and serum amyloid A and C reactive protein concentrations were determined regularly . linear regression analysis showed a close correlation between the change in creatinine clearance each year and both serum amyloid A concentrations ( 20 patients : r 0 . 83 , p less than 0 . 001 ) and C reactive protein concentrations ( 28 patients : r 0 . 80 , p less than 0 . 001 ) . The correlation between serum amyloid A and C reactive protein concentrations was also significant ( 317 parallel measurements : r 0 . 81 , p less than 0 . 001 ) . these findings suggest that monitoring serum amyloid A or C reactive protein concentrations is valuable in assessing the prognosis in secondary amyloidosis and that therapeutic measures that lower serum amyloid A concentrations may reduce the formation of amyloid .

It is said that elevated erythrocyte sedimentation rate and the elevation of C reactive protein ( CRP ) may be … (1990 May)
It is said that elevated erythrocyte sedimentation rate and the elevation of C reactive protein ( CRP ) may be indicators of continuing joint destruction in rheumatoid arthritis . What then is the explanation for joint destruction in some patients in whom there is no such apparent elevation of either the sedimentation rate of CRP ? It is said that elevated erythrocyte sedimentation rate and the elevation of C reactive protein ( CRP ) may be indicators of continuing joint destruction in rheumatoid arthritis . What then is the explanation for joint destruction in some patients in whom there is no such apparent elevation of either the sedimentation rate or CRP ?

The value of erythrocyte sedimentation rate and C reactive protein in evaluating disease activity in ankylosing spondylitis objective : To … (2005 Sep)
The value of erythrocyte sedimentation rate and C reactive protein in evaluating disease activity in ankylosing spondylitis objective : To determine whether erythrocyte sedimentation rate ( ESR ) or C reactive protein ( CRP ) is more appropriate in measuring the disease activity in ankylosing spondylitis ( AS ) . methods : We studied 126 consecutive patients with AS . The external criteria for disease activity were cowling clinical assessment of disease activity and the Bath AS disease activity index ( basdai ) . In each measure we defined 3 levels of disease activity i . e . no activity , ambiguous activity and definite activity . The patients with AS were divided into 2 groups : those with spinal involvement only and those with peripheral arthritis as well . For each criterion of disease activity , the patients without activity and with definite activity were included in receiver operating characteristic curve , which was used to determine cutoff values with the highest sensitivity and specificity . We also calculated spearman correlation . results : The median ESR and CRP were 25 . 3 mm / 1 h and 11 . 1 mg / L in the spinal group and 30 . 0 mm / 1 h and 15 . 0 mg / L in the peripheral group . In both groups the spearman correlation coefficients between ESR and CRP were around 0 . 30 . there was no correlation between ESR , CRP , and the 2 disease activity …

Membrane associated phospholipase A2 detected by a radioimmunoassay is a sensitive marker of inflammation in rheumatoid arthritis. (1992 Aug)
membrane associated phospholipase A2 detected by a radioimmunoassay is a sensitive marker of inflammation in rheumatoid arthritis . To investigate the clinical significance of membrane associated phospholipase A2 ( M PLA2 ) measured by a radioimmunoassay ( RIA ) in rheumatoid arthritis , we examined serum M PLA2 concentrations in 16 patients with rheumatoid arthritis . All showed elevated levels of serum M PLA2 . On the other hand , serum concentrations of C reactive protein ( CRP ) and IL 6 were increased in 13 ( 81 . 3 ) and 14 ( 87 . 5 ) of 16 patients , respectively . The serum concentrations of M PLA2 were significantly correlated with those of CRP . these results indicate that M PLA2 is an acute phase reactant and a sensitive and useful marker of inflammation in rheumatoid arthritis .

Comparative usefulness of C reactive protein and erythrocyte sedimentation rate in juvenile rheumatoid arthritis. (2007 Dec)
comparative usefulness of C reactive protein and erythrocyte sedimentation rate in juvenile rheumatoid arthritis . objective : To compare serial C reactive protein ( CRP ) and erythrocyte sedimentation rate ( ESR ) levels in juvenile rheumatoid arthritis ( JRA ) patients and investigate their application as diagnostic parameters and prognostic predictive factors . methods : We carried out retrospective chart review among JRA patients who were followed up at the national taiwan university hospital ( NTUH ) between 1994 and 2005 . results : thirty nine girls and 68 boys were included in this study . At the time of diagnosis , the prevalence of ESR was significantly greater than that of CRP ( 86 . 8 vs . 47 . 2 , p 0 . 05 ) . ESR revealed more responsiveness to treatment compared to CRP ( SRMs were 0 . 69 and 0 . 31 , respectively ) . At the time of diagnosis , high CRP levels ( or 5mg / dL ) correlated with poor therapeutic response , as do positive CRP ( 0 . 8 mg / dL ) and high ESR levels ( 40 mm / h ) after treatment for six months . overall , initial high CRP levels ( or 5mg / dL ) demonstrated the strongest predictive role of failure of the first remission . conclusion : For disease diagnosis , ESR can be a better parameter than CRP but a high initial CRP level can strongly predict treatment …

Alteration of interleukin 1 production and the acute phase response following medication of adjuvant arthritic rats with cyclosporin A or … (1989 Jan)
alteration of interleukin 1 production and the acute phase response following medication of adjuvant arthritic rats with cyclosporin A or methotrexate . The purpose of the paper was to determine whether two clinically active antirheumatic compounds , cyclosporin A ( CS A ) and methotrexate ( MTX ) were efficacious in the treatment of adjuvant arthritis ( AA ) in rats , as measured by reduction of paw inflammation , lymphocyte activating factor ( LAF ) activity and the acute phase response . parameters of the acute phase response consisted of plasma fibronectin ( Fn ) , C reactive protein ( CRP ) , albumin and iron . Rats injected with freund s complete adjuvant on day 1 , developed systemic arthritis , which was quantitated by measuring non injected paw swelling on day 17 . When compared to normal animals , AA rats had significantly ( P less than or equal to 0 . 01 ) increased : ( 1 ) splenic LAF activity ( 100 increase ) , ( 2 ) plasma Fn ( 58 ) , and ( 3 ) CRP ( 122 ) , as well as abnormally reduced levels of : ( 1 ) plasma albumin ( 53 reduction ) , and ( 2 ) iron ( 54 ) . orally dosing AA rats from days 3 to 17 with the immunoregulatory drugs , CS A ( 3 and 5 mg / kg ) or MTX ( 0 . 5 and 1 mg / kg …

A practical test and its value in rheumatoid arthritis. (1989 Sep)
A practical test and its value in rheumatoid arthritis . A practical test distinguishing some pathological conditions from the healthy state is described and a preliminary study on the value of this test for determining the disease activity in rheumatoid arthritis ( RA ) is presented . In this disease , the test was found positive in 97 of the cases , while rheumatoid factor ( RF ) was present in 57 , C reactive protein ( CRP ) in 83 , and elevated erythrocyte sedimentation rate ( ESR ) in 93 cases . When the activity of the disease disappeared , the test became negative . This test may be useful in RA for determining the active phase and evaluating treatment .

The therapeutic effects of an engineered human anti tumour necrosis factor alpha antibody ( cdp571 ) in rheumatoid arthritis. (1995 Jul)
The therapeutic effects of an engineered human anti tumour necrosis factor alpha antibody ( cdp571 ) in rheumatoid arthritis . Pro inflammatory cytokines such as tumour necrosis factor alpha ( TNF alpha ) have been implicated in the pathogenesis of rheumatoid arthritis ( RA ) , and have therefore become therapeutic targets . An engineered human antibody , cdp571 , that neutralizes human TNF alpha was administered intravenously in single doses of 0 . 1 , 1 . 0 or 10 mg / kg to patients with active RA ( n 24 ) . The effects of the antibody were compared in a double blind fashion with those of placebo ( n 12 ) . In an open continuation phase patients were given either 1 . 0 or 10 mg / kg . We found that cdp571 was well tolerated and caused reductions in markers of disease activity such as erythrocyte sedimentation rate ( ESR ) and serum C reactive protein ( CRP ) : this was confirmed by a reduction in the disease activity score ( DAS ) . there was a reduction in the number of tender joints , maximal in degree and duration after 10 mg / kg . patients also documented a reduction of pain and relief of arthritis symptoms . The effects of 10 mg / kg cdp571 on ESR , CRP , tender joints , pain and symptom relief compared to placebo were statistically significant at weeks 1 or 2 . The continuation phase …

Response of soluble IL 2 receptor levels during gold therapy for rheumatoid arthritis. (1994 Aug)
response of soluble IL 2 receptor levels during gold therapy for rheumatoid arthritis . soluble IL 2 receptor ( sil2r ) levels were measured at week 0 and week 24 in the sera of 27 patients with active rheumatoid arthritis who had taken part in a chrysotherapy study . At entry ( wk 0 ) although sil2r levels were significantly elevated in the rheumatoid patients there was no significant correlation with a clinical disease activity score , C reactive protein ( CRP ) or rheumatoid factor ( RF ) . after 24 weeks of chrysotherapy there was no significant change in sil2r levels although the clinical activity score , CRP and RF were significantly reduced . however , measurement of sil2r in 7 patients who had obtained clinical remission following 38 73 months of gold treatment showed significantly lower levels of sil2r than patients with continuing active disease .