Kashyap Bineeta, Gupta Neha, Dewan Pooja, Hyanki Puneeta, Singh N P
1Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, 110095 India.
Flat no. C-402, Vimal CGHS LTD, Plot-3, Sector-12, Dwarka, New Delhi, Delhi 110078 India.
Indian J Clin Biochem. 2020 Apr;35(2):211-217. doi: 10.1007/s12291-018-0806-2. Epub 2019 Jan 1.
The utility of C-reactive protein (CRP) as a marker of disease severity, therapeutic response and prognosis in tuberculosis has been suggested. This study aims to determine the levels of high sensitivity CRP (hs CRP) among the pediatric tuberculosis cases. A case control study was conducted on 60 clinically diagnosed (clinical findings and radiography and/or contact history and/or Mantoux test) or microbiologically confirmed (smear and/or culture and/or Cartridge based Nucleic Acid Amplification test positive) pediatric tuberculosis cases ≤ 12 years. hs CRP levels were estimated in the cases and healthy controls using ELISA. Median levels of serum hs CRP were significantly higher in pediatric tuberculosis cases (25 mg/l) as compared to controls (0.530 mg/l). No significant correlation was found with age, gender, site of tuberculosis or presence of dissemination. Lower levels were found with palpable lymphadenopathy. Levels were not significantly different between microbiologically confirmed cases and those who were negative by one or more of the microbiological tests of staining, culture and cartridge based nucleic acid amplification test. hs CRP can be used in diagnostic algorithms of pediatric tuberculosis to rule out tuberculosis. Further studies could help in determining the prognostic and therapeutic response of hs CRP among children leading to better management.
已有研究表明C反应蛋白（CRP）可作为结核病疾病严重程度、治疗反应及预后的标志物。本研究旨在测定小儿结核病病例中高敏CRP（hs CRP）的水平。对60例临床诊断（临床症状、影像学检查及/或接触史及/或结核菌素试验）或微生物学确诊（涂片及/或培养及/或基于 cartridge 的核酸扩增试验呈阳性）的12岁及以下小儿结核病病例进行了病例对照研究。采用酶联免疫吸附测定法（ELISA）对病例组和健康对照组的hs CRP水平进行了评估。小儿结核病病例血清hs CRP的中位数水平（25mg/l）显著高于对照组（0.530mg/l）。未发现与年龄、性别、结核部位或播散情况存在显著相关性。可触及淋巴结肿大的病例hs CRP水平较低。微生物学确诊病例与经染色、培养及基于 cartridge 的核酸扩增试验中一项或多项微生物学检测为阴性的病例之间，hs CRP水平无显著差异。hs CRP可用于小儿结核病的诊断算法以排除结核病。进一步的研究有助于确定hs CRP在儿童中的预后及治疗反应，从而实现更好的管理。
