Rationality in determination of inflammatory parameters in suspected acute inflammation

Selma Rujanac, Fejzo Džafić, Fatima Jusupovic, Almira Ćosićkić, Amela Bećirović, Amer Čustović

Abstract


Introduction: Inflammation represents tissue homeostasis, body's most powerful defense mechanism, almost completely non-specific with respect to the quality of noxae, and is present in any tissue. Inflammation can be acute or chronic. Acute inflammation has rapid action and short duration, from a few minutes to several days, and is characterized by exudation of fluid and plasma proteins, as well as by a dominant accumulation of neutrophils. Acute phase inflammatory markers commonly used for diagnostic purposes are C-reactive protein (CRP), erythrocyte sedimentation rate, and white blood cell count also known as leukocytes.

Materials and methods: Materials used in this study were patients' laboratory results collected from laboratories in the medical institution " Health Center Donji Vakuf" in DonjiVakuf in the period from 1st February to 1st May 2015. For the purposes of this paper we analysed the values of leukocytes, neutrophils, erythrocyte sedimentation rate and the CRP. The study was carried out on a sample of 200 participants - 100 adults and 100 children. The process of determining the values of leukocytes and neutrophils was done by an automated hematology analyzer Sysmex electronic XP300 produced by the Sysmex company (Japan). To determine CRP values in adult participants, we used their blood serum and ran it through the biochemical analyzer BT 1500. Determination of CRP values in children participants was carried out from capillary blood samples using the NycoCard READER II. The erythrocyte sedimentation rate was measured using a modified Westergren method.

Results: The outcome of the statistical analysis has shown that the mean value of leukocytes in children is higher compared to the same value in adults. This parameter is more varied in children (46.91%) than in adults (45.68%). The mean value of neutrophils in children is also higher compared to the same value in adults. This parameter had a higher variation coefficient in adults (58.87%) than in children (51.40%). However, the mean value of the erythrocyte sedimentation rate, after the first and second hours in adult patients is higher than in children. Variation coefficients of this parameter are higher in adult patients after the first hour, whereas they appear to be higher in children after the second hour. The Pearson bivariate correlation has shown the existence of a statistically significant relationship between the values ​​of leukocytes and neutrophils ​​in both studied groups. A positive correlation in the group of adult patients is present in the values ​​of leukocytes and erythrocyte sedimentation rate after the first and second hours, but this difference was not statistically significant.

Conclusion: The results of this study have shown a high percentage of positive results with erythrocyte sedimentation rate after the 1st and 2nd hours and CRP (95%, 81% and 61%), and quite a low percentage of the reference values of leukocytes and neutrophils (33% and 26%) for the total number of participants. Partial correlation has shown that elevated values of white blood cells, as a control parameter, are associated with the combination of the values of leukocytes and neutrophils in adults (p = 0.030), as well as in children (p = 0.000). This data confirms the results of the Pearson bivariate correlation, implying that with an elevated leukocyte count, comes an increase of the value of neutrophils and CRP.


Keywords


inflammation, inflammatory parameters, leukocytes, neutrophils, CRP, erythrocyte sedimentation rate

Full Text: PDF

DOI: 10.5457/ams.v45i1-2.440