Pediatrics: Pediatrics |

High Sensitivity C-Reactive Protein (hsCRP) as a Biomarker of Treatment Response After the Intensive Phase Among Pediatric Patients With TB FREE TO VIEW

Annalee de Leon-Manalo, MD; Ma. Dulce Requiron-Sy, MD; Maria Encarnita Limpin, MD
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Philippine Heart Center, Quezon City, Philippines

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):965A. doi:10.1016/j.chest.2016.08.1068
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Childhood tuberculosis has an increasing incidence worldwide. Its occurrence represents an important event indicating a recent transmission usually from an infectious adult. The identification of a surrogate biomarker for treatment response and risk for poor outcome in tuberculosis will be a beneficial tool in the patient’s management. Thus, a biomarker like high sensitivity C-reactive protein (hsCRP) was proposed to be a prognostic marker in this study.

METHODS: Children diagnosed with tuberculosis based on the Philippine Pediatric Society and National Tuberculosis Program guidelines were included in the study. Clinical data were reviewed and recorded, and blood samples were collected for serum hsCRP determination at 2 point of time (before treatment, and after the intensive phase). Data analysis was done using Stata SE version 12. Mean, standard deviation, frequency, percent distribution, paired T test and scatter plot were used. The level of significance is set at 0.05.

RESULTS: There were 40 subjects diagnosed with pulmonary tuberculosis who participated the study. Twenty-three were male (57.5%) and 17 were female (42.5%). The age ranges from 1 to 18 years with a mean age of 8.6 + 5.5. Out of the 40 participants, 32 had completed the study. In this study, the analysis of data showed that the level of serum hsCRP after the intensive phase of treatment is significantly lower compared to the level before treatment (p value of 0.0002). On the other hand, body mass index (BMI), which is being used as one of the objective parameters of treatment response in children, demonstrated a statistically significant difference before and after the intensive phase at a p value of 0.0007. High sensitivity C-reactive protein and BMI were indirectly correlated, however, it was statistically insignificant before and after 2 months of treatment at p value of 0.26 and 0.35, respectively.

CONCLUSIONS: This study has shown that there is a statistically significant lower serum hsCRP level and statistically significant improvement in BMI after the intensive phase of treatment among pediatric patients with tuberculosis, however, there is a weak indirect correlation between the 2 parameters. It is the therefore concluded that hsCRP can only be an additional tool to evaluate treatment response after the intensive phase of therapy.

CLINICAL IMPLICATIONS: It is important for the clinicians to have good monitoring parameters on treatment efficacy in patients with tuberculosis. The inability to do so will contribute to the poor outcome and continued disease transmission.

DISCLOSURE: The following authors have nothing to disclose: Annalee de Leon-Manalo, Ma. Dulce Requiron-Sy, Maria Encarnita Limpin

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