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C-reactive protein (CRP), a comparison of pre- and post-mortem blood levels
1Department of Pathology, University Hospital of Tromsø, 9038 Tromsø, Norway. patluh@rito.no
Insights
Post-mortem C-reactive protein (CRP) analysis can detect ongoing inflammation before death. Elevated CRP levels in post-mortem blood are reliable, even with frozen samples or up to six days after death.
Area of Science:
- Forensic Pathology
- Clinical Chemistry
Background:
- C-reactive protein (CRP) is a key biomarker for inflammation.
- Assessing pre-mortem inflammatory status through post-mortem analysis presents unique challenges.
Purpose of the Study:
- To evaluate the reliability of post-mortem C-reactive protein (CRP) levels as an indicator of pre-mortem inflammation.
- To determine the stability of CRP in post-mortem blood samples and assess potential influencing factors.
Main Methods:
- Blood samples were collected during autopsy from 26 inpatients with elevated CRP levels.
- Post-mortem CRP values were compared with ante-mortem CRP measurements (within 24h prior to death).
- Analysis included assessment of CRP stability over time and the impact of sample freezing.
Main Results:
- Post-mortem CRP levels showed an average decrease of 35% compared to ante-mortem values.
- CRP levels remained relatively stable for up to six days post-mortem, irrespective of the time interval.
- No elevated CRP was found in healthy individuals deceased due to accidents, indicating low false-positive risk.
- Frozen blood samples yielded reliable CRP analysis using specific immunometric assays.
Conclusions:
- Elevated post-mortem CRP is a reliable marker for pre-mortem inflammatory processes.
- CRP analysis in post-mortem blood is a valuable tool for forensic investigations, particularly for individuals without prior medical records.
- The stability and reliability of post-mortem CRP analysis support its use in routine autopsies.
Abstract:
During autopsy of 26 inpatients with elevated CRP levels (14-536 mg/l) blood was taken from the femoral vessels and analysed for the content of CRP. The post-mortem CRP values were compared with the results of CRP analysis performed within the last 24h before death. This showed that the post-mortem values of CRP in average were reduced with 35% compared to the ante-mortem values. The decrease in CRP levels was not significantly influenced by the time interval from death until blood was drawn for analysis, at least up to 6 days. When blood taken from healthy individuals killed in accidents was analysed, no elevated CRP values were observed, indicating that there is negligible risk for false positive results. It is also shown that frozen blood can be used for CRP analysis if an immunometric kit assay based on whole blood is applied. The results demonstrate that an elevated level of CRP in post-mortem blood is a good marker for an ongoing inflammatory process prior to death. CRP analysis may therefore be a helpful tool in post-mortem examinations, especially in non-hospitalised individuals without medical records.