Serum C-Reactive Protein Level in Postsplenectomized Thalassemic Patients
NAPAPORN ARCHARARIT, M.Sc.*, ARREE PORNVORANUNT, B.Sc.***, BUBPHA RACHAKOM, B.Ed. *, SUPORN CHUNCHARUNEE, M.D.**, KALAYANEE ATAMASIRIKUL, M.Sc.***, VICHAI ATICHARTAKARN, M.D.**
Affiliation : * Research Center, ** Department of Medicine, *** Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
C-reactive protein is an established marker for the detection of acute and chronic inflam- matory processes. The most potent stimulator for the hepatic synthesis of this protein is inter- leukin 6. Previous studies have shown that inflammatory cells and inflammatory cytokines, such as interleukin 6, interferon gamma, etc were elevated in postsplenectomized thalassemic patients. The aim of this study was to determine serum C-reactive protein concentration in postsplenec- tomized B thalassemic patients (B thal/HbE postsplenec), and to compare them with those in nonsplenectomized B thalassemic patients (B thal/HbE), postsplenectomized non thalassemic patients (postsplenec), reactive thrombocytosis (RT), chronic myeloproliferative disorders (MPD) and normal adult volunteers. Serum C-reactive protein concentration as determined by an automatic Behring Nephelometer was carried out in 28 B thal/HbE postsplenec, 22 B thal/HbE, 12 postsplenec, 23 RT, 21 MPD, and 26 healthy adult volunteers. The values of CRP in B thal/HbE postsplenec were significantly higher when compared with B thal/HbE, and normal volunteers (4.1±0.7 vs 1.6±0.4 mg/L P = 0.006, and 4.1±0.7 vs 0.45±0.09 mg/L, P < 0.001 ). CRP levels in B thal/HbE postsplenec were also higher than the postsplenec group ( 4.1 ±0. 7 vs 0.!9±0. 7 mg/L P = 0.095). On the contrary, they were significantly lower than those in RT (4.1±0.7 vs 55.4±14.8 mg/L, P = 0.002). However, when compared to those with MPD, the values were not statistically different (4.1±0.7 vs 17.1±12.3 mg/L, P = 0.871). Interestingly, there was a trend towards in- creasing C-reactive protein levels in B thal/HbE postsplenec patients with higher platelet count, although no correlation was observed. Besides the inflammatory process, platelet and/or factor(s) that control(s) thrombopoiesis seem(s) to play a role in the high serum C-reactive protein levels in the studied population.
Keywords : C-reactive Protein, Thalassemia, Reactive Thrombocytosis, Chronic Myelopro liferative Disorders
