A comparison of C-reactive protein and Serum Ferritin as Acute Phase Reactants in Venous Thromboembolism

Abstract

Background: Serum ferritin and C – reactive protein are nonspecific markers of inflammation. They have been useful in predicting the outcome of stroke.

Aims and Objectives:  High sensitive C-reactive protein (hs-CRP) and serum ferritin were analysed in patients with venous thromboembolism (VTE) as a preliminary study to determine their usefulness in predicting VTE.

Materials and Methods: Serum ferritin and hs-CRP were analyzed in 37 consenting patients with VTE by Enzyme Immunoassay. The type of VTE, risk factors for VTE, and haematological parameters were obtained from 
the case files. Twenty healthy individuals, mostly blood donors also had their sera analyzed for hsCRP and serum ferritin. The study was conducted between June and November 2012.

Results: The mean age of the patients was 56±18.3yrs, 16 had identifiable risk factors while no risk factor was identified in 21 patients (idiopathic group). The mean haematocrit was 35±6.5%, four individuals had values less than 30% of which 3(75%) were in the idiopathic group. The mean MCH and MCV were 27.1±3.1pg and 79.4±10.5fl respectively, low MCH was observed in 70% of patients while more than half (59%) had elevated hs-CRP (>10μg/L). The mean serum ferritin was 373.9±331ng/ml, the mean serum ferritin was lower for those with elevated Hs-CRP (333.5μg/L vs 484.6μg/L; p=0.57). The mean serum ferritin was similar in those with or without identifiable risk factors (373.8 vs 373.9ng/ml), those with risk associated VTE had non-statistically significant higher values of CRP than those with idiopathic VTE (68% vs 61% respectively, p>0.05). The mean serum ferritin and hs-CRP of the control was 74.7ng/ml and 3.5μg/L respectively.

Conclusion: Neither CRPnor serum ferritin appear discriminatory enough for predicting type of VTE.