Farzana Hakim, Amir Rashid, Amer Fakhr.
Comparison of Acute Phase Reactants in Rheumatoid Arthritis patients and Health Adults.
Pak Armed Forces Med J Jan ;67(3):371-5.

Objective: To analyze the acute phase reactants in patients suffering from rheumatoid arthritis (RA) and compare them to healthy controls. Study Design: Cross-sectional comparative study. Place and Duration of Study: This study was conducted at the department of Biochemistry & Molecular Biology Army Medical College, Rawalpindi in collaboration with Rheumatology department Military Hospital (MH) Rawalpindi and Military Hospital Laboratories, from Jan 2016 to Jun 2016. Material and Methods: Approval of this study was given by Ethical Review Committee, Army Medical College (AMC) Rawalpindi. Two groups i.e., group I: normal healthy subjects (n=100) and group II: rheumatoid arthritis patients (n=100) were included in the study. Demographic data: age, gender, ethnicity and marital status of the healthy subjects as well as RA patients was recorded on proforma. Blood sample was collected and patients were monitored for acute-phase response i.e. by evaluating the levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Results: In this study 100 RA patients with 29 males and 71 females were enrolled. Hundred healthy controls included 50 males and 50 females. The mean CRP value of RA patients was 8.44 ± 4.28mg/l i.e. higher as compared to that of controls whose mean CRP value was 6.2 ± 4.6mg/l (p<0.001). Among RA patients, the mean ESR value was 29.0 ± 16.9mm/ hr of and among controls, the mean ESR value was 20.0 ± 9.42 mm/hr (p<0.001). Conclusion: Both CRP and ESR are important disease assessment biomarkers. They were significantly elevated among RA patients as compared to healthy subjects in our study. Moreover due to cost effectiveness these (CRP and ESR) are preferred tests for routine assessment. CRP and ESR provide the much desired information about RA activity and severity that cannot be provided by either of them alone.

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