Assessment of C Reactive Protein in Chronic Urticaria as a Marker of Disease Activity and Underlying Systemic Inflammation: A Case Control Study
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 1
Abstract
Chronic urticaria (CU) defined by presence of urticaria (hives), on most days of the week, for 6 weeks or more. No external allergic cause can be identified in 80-90 % of these patients. CRP (C reactive protein) an acute phase response protein has been studied recently as a consequence or as a possibility of non-specific systemic inflammation in CU patients. CRP is a sensitive marker of an underlying systemic inflammation and is triggered mainly as a response to IL-6. We aimed to determine the CRP levels in CU patients and investigate any possible correlation between CRP levels and the severity of chronic urticaria (CU), assessed clinically by urticaria activity scores (UAS). After obtaining the institutional ethics committee approval, we enrolled 40 patients with CU of varying severity as well as 40 sex and age matched healthy participants, following written informed consent. This was a case- control study, carried over a period of 6 months. Each participant was evaluated with detailed history, clinical examination, urticaria activity score (UAS), CRP levels, ASST, haematological and biochemical investigations. The CRP levels were measured by latex agglutination assay. All the data was later tabulated and analysed. Of the 40 patients, 22 (55%) were females & 18 (45%) were males. The male to female ratio was 0.9: 1.1. Among the CU patients, ASST was found positive in 12 patients and negative in the remaining 28 patients. Serum CRP levels were significantly higher in CU patients when compared with healthy participants (0.312 mg/dl vs. 0.156 mg/dl respectively, p = 0.022). Patients with higher CRP levels had higher urticaria activity scores. A significant correlation was observed in patients who had moderate and severe disease activity scores than in those who had mild disease activity score (p < 0.001, p < 0.001, respectively). CRP levels appeared to correlate with the disease activity in 75% of our CU patients who had higher urticaria activity scores. These findings support the relationship of the inflammatory process in CU patients and therefore, CRP may be considered as a marker of the ongoing systemic inflammation in these patients. Further studies with a larger sample size are required to validate the same.
Authors and Affiliations
Dipali Rathod, Ram Malkani, Kalpita Jadhav, Prachi Gole
Keywords
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