PMID- 11055657
OWN - NLM
STAT- MEDLINE
DCOM- 20010322
LR  - 20191210
IS  - 0036-5548 (Print)
IS  - 0036-5548 (Linking)
VI  - 32
IP  - 5
DP  - 2000
TI  - C-reactive protein and fever in neutropenic patients.
PG  - 515-20
AB  - The predictive value of daily C-reactive protein (CRP) monitoring to distinguish 
      causes of fever in neutropenic patients was studied retrospectively. A total of 
      143 fever episodes during 113 consecutive hospitalizations were studied in 71 
      patients who had been referred for chemotherapy or haemopoietic stem cell 
      transplantation (HSCT). There were, on average, 1.3 fever episodes per hospital 
      stay, attributed to: infection (55, 27 invasive bacterial, 5 fungal, 3 viral and 
      20 probable infections); acute graft vs host disease (GvHD) (20); drugs (22); 
      transfusions (7); and not attributable (39). 130 (91%) fever episodes were 
      accompanied by a rise in CRP, 6 (4%) episodes were fatal. Maximal CRP levels 
      (CRPmax) and maximal temperature (Tmax) were higher in invasive bacterial 
      infections than in aGvHD and higher in aGvHD than in drug- or transfusion-related 
      fever (p < 0.0001). Temperature and CRP rose in parallel. A total of 16 patients 
      developed grade II-IV aGvHD by day 11 (9-21) (median, range) after allogeneic 
      HSCT. Acute GvHD was preceded by fever for 3 d (1-7), and by CRP increase for 5 d 
      (0-15) (p < 0.0001). CRP monitoring may be useful to distinguish between causes 
      of fever. Very high CRP levels tend to be associated with invasive bacterial 
      infections. CRP is not an early warning sign. An increase in CRP and fever may 
      precede other clinical manifestations of aGvHD.
FAU - Arber, C
AU  - Arber C
AD  - Department of Internal Medicine, Kantonsspital Basel, Switzerland.
FAU - Passweg, J R
AU  - Passweg JR
FAU - Fluckiger, U
AU  - Fluckiger U
FAU - Pless, M
AU  - Pless M
FAU - Gregor, M
AU  - Gregor M
FAU - Tichelli, A
AU  - Tichelli A
FAU - Schifferli, J A
AU  - Schifferli JA
FAU - Gratwohl, A
AU  - Gratwohl A
LA  - eng
PT  - Journal Article
PL  - England
TA  - Scand J Infect Dis
JT  - Scandinavian journal of infectious diseases
JID - 0215333
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Body Temperature
MH  - C-Reactive Protein/*analysis
MH  - Child
MH  - Female
MH  - *Fever/etiology
MH  - Graft vs Host Disease/*physiopathology
MH  - Hematologic Neoplasms
MH  - Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Infections/*diagnosis/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Neutropenia/*complications
MH  - Retrospective Studies
EDAT- 2000/10/31 11:00
MHDA- 2001/03/27 10:01
CRDT- 2000/10/31 11:00
PHST- 2000/10/31 11:00 [pubmed]
PHST- 2001/03/27 10:01 [medline]
PHST- 2000/10/31 11:00 [entrez]
AID - 10.1080/003655400458802 [doi]
PST - ppublish
SO  - Scand J Infect Dis. 2000;32(5):515-20. doi: 10.1080/003655400458802.