What is the role of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels in the diagnosis of acute pericarditis?

Updated: Apr 02, 2019
  • Author: Sean Spangler, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

Erythrocyte sedimentation rate (ESR) and CRP levels are usually elevated in pericarditis. High-sensitivity CRP (hs-CRP) levels are elevated in 78% of cases of acute pericarditis. Thus, an elevated CRP level may confirm the diagnosis of acute pericarditis. A normal value does not exclude a diagnosis of acute pericarditis; in some patients, the hs-CRP increases later, supporting the use of serial testing in patients with an initial negative result. Most patients showed normalization of CRP level by 2 weeks and all patients by 4 weeks. Persistently elevated hs-CRP level was a marker for increased risk of reoccurrence. Serial monitoring of hs-CRP level weekly may be warranted to follow disease activity and guide the appropriate length of therapy, with continuation of treatment doses until the CRP level normalizes. [33]


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