Serum C-reactive protein in acute biliary pancreatitis. Is it a reliable marker for the early assessment of severity of the disease?
BACKGROUND
The cut-off point of serum C-reactive protein to differentiate the mild from the severe form of acute pancreatitis is still debated; data concerning the C-reactive protein pattern in assessing the severity of acute biliary pancreatitis are lacking.


OBJECTIVE
To define the best cut-off point in differentiating the severe from the mild form of acute biliary pancreatitis.


METHODS
Fifty patients with acute biliary pancreatitis: 34 patients with mild pancreatitis and 16 with the severe form of the disease were studied.


METHODS
Serum C-reactive protein concentrations were assessed in all patients upon admission and for the following 5 days.


RESULTS
No significant difference in serum C-reactive protein levels was found in the first 2 days in patients with mild pancreatitis compared to those with the severe form of the disease. Using a cut-off point of 11 mg/dl, the sensitivity of serum C-reactive protein in assessing the severity of acute pancreatitis during the first two days of the study was 9% and 57%, the specificity, 93% and 81%, and the accuracy 71% and 74%, respectively.


CONCLUSIONS
Serum determination of C-reactive protein in the first 48 hours of the disease is not a reliable marker of the severity of acute biliary pancreatitis.
Pezzilli
R
R
Emergency Department and Central Laboratory, Sant'Orsola Hospital, Bologna, Italy.
Billi
P
P
Cappelletti
O
O
Barakat
B
B
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000150:complications*; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology; D011336:Probability; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D015415:Biomarkers; D002097:C-Reactive Protein