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C-reactive protein in measles
I Roine1, W Ledermann, N Arrizaga
1Hospital Luis Calvo Mackenna, Santiago, Chile.
Insights
C-reactive protein (CRP) levels can indicate measles severity in children. Elevated CRP during measles suggests a more severe case or complications like pneumonia, aiding early detection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Chemistry
Background:
- Measles is a highly contagious viral illness. Early identification of severity is crucial for timely intervention.
- Serum C-reactive protein (CRP) is a biomarker for inflammation and infection.
Purpose of the Study:
- To evaluate the utility of C-reactive protein (CRP) levels as an early indicator of measles severity and complications in children.
- To correlate CRP levels with clinical classifications of measles (mild vs. severe) and the presence of complications.
Main Methods:
- A cohort of 72 children with early measles (1st-3rd day of rash) was studied in Santiago, Chile.
- Serum CRP levels were quantified using nephelometry from finger prick samples.
- CRP levels were compared between children with mild measles and those with moderate to severe measles, and during different stages of illness (early vs. late) with and without complications.
Main Results:
- Mean CRP levels were significantly lower in children with ordinary measles (19 mg/l) compared to primarily severe measles (65 mg/l; P < 0.001).
- During late measles, mean CRP was 19 mg/l in uneventfully recovered children (n=35) but significantly higher (123 mg/l; P < 0.001) in those with complicating pneumonia (n=22).
Conclusions:
- Quantitative C-reactive protein (CRP) determination serves as a valuable alarm signal in managing measles.
- Elevated CRP levels during measles are indicative of disease severity or the presence of complications, particularly pneumonia.
Abstract:
Seventy-two children with early measles (1st-3rd day of rash), presenting at two centres in Santiago, Chile, were classified as having mild ('ordinary measles', n = 50), or moderate to severe measles ('primarily severe measles', n = 22). The level of serum C-reactive protein (CRP) was determined by nephelometry from a finger prick sample. The mean CRP value in ordinary measles, 19 mg/l, was significantly lower (P less than 0.001) than in primarily severe measles where the mean CRP was 65 mg/l. During late measles (5th-8th day of rash), the mean CRP was 19 mg/l if the child recovered uneventfully (n = 35), whereas the mean level of 123 mg/l (P less than 0.001) was encountered when the child suffered from complicating pneumonia (n = 22). We conclude that the simple quantitative CRP determination is a useful alarm signal during the course of measles: elevated levels point to severity or complications in recovery.