Clinical Utility of Acute-phase Reactants in Medicine

Pratap Signh, Sanjay Kumar, Mukesh Verma, Subodh kumar Mahto


Acute-phase response is the sum of the systemic and metabolic changes occurred by release of acute-phase proteins in response to an inflammatory stimulus. The most important ones of these acute-phase reactants are erythrocyte sedimentation rate, C-reactive protein, fibrinogen, procalcitonin and ferritin. The most widely used ones are ESR and CRP while fibrinogen and ferritin are less commonly used. The other acute-phase reactants have limited role in routine clinical use. ESR and C-reactive protein have traditionally been used as markers for inflammation in infectious and noninfectious conditions. These markers have significant role in early diagnosis, in differentiating infectious from noninfectious causes, as a prognostic marker and in antibiotic guidance strategies. Procalcitonin and CRP are most commonly used in this regard. Although CRP is more specific than ESR, yet because of the high cost and limited availability, it has restricted clinical usage in developing countries. Not all acute-phase reactants behave the same way when stimulated; the concentration of some increases while others decrease in plasma.


Acute-phase reactants, Erythrocyte sedimentation rate, C-reactive protein, Fibrinogen, Ferritin, Procalcitonin

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