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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 1/2019

Open Access 01-01-2019 | Inflammatory Disorders

Relevance of erythrocyte sedimentation rate and C-reactive protein in patients with active uveitis

Authors: Fahriye Groen-Hakan, Laura Eurelings, Jan van Laar, Aniki Rothova

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 1/2019

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Abstract

Purpose

To relate erythrocyte sedimentation rates (ESR) and C-reactive protein (CRP) values to different uveitis entisties.

Methods

A retrospective study of patients with a first episode of active uveitis visiting the Erasmus University Medical Center, uveitis clinic, Rotterdam, the Netherlands, was performed. Levels of ESR and CRP were determined within 2 weeks and 1 week after onset of uveitis, respectively. Uveitis had to be of unknown origin at that moment. The specific etiologic groups were related to ESR and CRP values.

Results

The majority of patients with uveitis had ESR and/or CRP values within the normal limits and no association of ESR and/or CRP with the specific cause of uveitis was observed. However, elevation of ESR ≥ 60 mm/h and/or CRP ≥ 60 mg/L was mostly seen in patients with systemic immune-mediated diseases (8/59, 14% of all with immune-mediated diseases) or systemic infectious causes (7/38, 18% of all infectious uveitis). Patients with ocular toxoplasmosis typically exhibited normal ESR and CRP (9/11, 82%) while patients with endogenous endophthalmitis had elevated ESR and/or CRP in 6/7, 86%. Sarcoidosis-associated uveitis showed predominantly elevated ESR (13/24, 54%; range 20–59 mm/h in 11/13, 85%). Human immunodeficiency virus–positive patients had more often elevated ESR values when compared to the remainder of patients (9/11, 82% vs. 64/163, 39%, 18%, P = 0.009). The cause of uveitis was established in 19/20 (95%) of patients with ESR ≥ 60 mm/h and/or CRP ≥ 60 mg/L.

Conclusions

The majority of patients with first attack of uveitis had ESR and CRP within the normal limits. Elevated levels of ESR and CRP reflected systemic involvement and high levels of both values were associated with established uveitis cause.
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Literature
1.
go back to reference Groen F, Ramdas W, de Hoog J et al (2016) Visual outcomes and ocular morbidity of patients with uveitis referred to a tertiary center during first year of follow-up. Eye (Lond) 30(3):473–480CrossRef Groen F, Ramdas W, de Hoog J et al (2016) Visual outcomes and ocular morbidity of patients with uveitis referred to a tertiary center during first year of follow-up. Eye (Lond) 30(3):473–480CrossRef
2.
go back to reference Tsirouki T, Dastiridou A, Symeonidis C et al (2018) A focus on the epidemiology of uveitis. Ocul Immunol Inflamm 26(1):2–16 Tsirouki T, Dastiridou A, Symeonidis C et al (2018) A focus on the epidemiology of uveitis. Ocul Immunol Inflamm 26(1):2–16
3.
go back to reference Miserocchi E, Fogliato G, Modorati G et al (2013) Review on the worldwide epidemiology of uveitis. Eur J Ophthalmol 23(5):705–717CrossRefPubMed Miserocchi E, Fogliato G, Modorati G et al (2013) Review on the worldwide epidemiology of uveitis. Eur J Ophthalmol 23(5):705–717CrossRefPubMed
4.
go back to reference Acharya NR, Tham VM, Esterberg E et al (2013) Incidence and prevalence of uveitis results from the Pacific ocular inflammation study. JAMA Ophthalmol 131(11):1405–1412CrossRefPubMed Acharya NR, Tham VM, Esterberg E et al (2013) Incidence and prevalence of uveitis results from the Pacific ocular inflammation study. JAMA Ophthalmol 131(11):1405–1412CrossRefPubMed
6.
go back to reference Haasnoot AJW, van Tent-Hoeve M, Wulffraat NM et al (2015) Erythrocyte sedimentation rate as baseline predictor for the development of uveitis in children with juvenile idiopathic arthritis. Am J Ophthalmol 159(2):372–377CrossRefPubMed Haasnoot AJW, van Tent-Hoeve M, Wulffraat NM et al (2015) Erythrocyte sedimentation rate as baseline predictor for the development of uveitis in children with juvenile idiopathic arthritis. Am J Ophthalmol 159(2):372–377CrossRefPubMed
7.
go back to reference von Elm E, Altman DG, Egger M et al (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344–349CrossRef von Elm E, Altman DG, Egger M et al (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344–349CrossRef
9.
go back to reference Jabs DA, Nussenblatt RB, Rosenbaum JT et al (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol 140(3):509–516CrossRefPubMed Jabs DA, Nussenblatt RB, Rosenbaum JT et al (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol 140(3):509–516CrossRefPubMed
10.
go back to reference Herbort CP, Rao NA, Mochizuki M et al (2009) International criteria for the diagnosis of ocular sarcoidosis: results of the first International Workshop on Ocular Sarcoidosis (IWOS). Ocul Immunol Inflamm 17(3):160–169CrossRefPubMed Herbort CP, Rao NA, Mochizuki M et al (2009) International criteria for the diagnosis of ocular sarcoidosis: results of the first International Workshop on Ocular Sarcoidosis (IWOS). Ocul Immunol Inflamm 17(3):160–169CrossRefPubMed
11.
go back to reference Rosenbaum JT (2017) New developments in uveitis associated with HLA B27. Curr Opin Rheumatol 29(4):298–303CrossRefPubMed Rosenbaum JT (2017) New developments in uveitis associated with HLA B27. Curr Opin Rheumatol 29(4):298–303CrossRefPubMed
12.
go back to reference Okada AA, Stanford M, Tabbara K (2012) Ancillary testing, diagnostic/classification criteria and severity grading in Behcet disease. Ocul Immunol Inflamm 20(6):387–393CrossRefPubMed Okada AA, Stanford M, Tabbara K (2012) Ancillary testing, diagnostic/classification criteria and severity grading in Behcet disease. Ocul Immunol Inflamm 20(6):387–393CrossRefPubMed
13.
go back to reference Levinson RD, Brezin A, Rothova A et al (2006) Research criteria for the diagnosis of birdshot chorioretinopathy: results of an international consensus conference. Am J Ophthalmol 141(1):185–187CrossRefPubMed Levinson RD, Brezin A, Rothova A et al (2006) Research criteria for the diagnosis of birdshot chorioretinopathy: results of an international consensus conference. Am J Ophthalmol 141(1):185–187CrossRefPubMed
14.
go back to reference DeBoer JH, Verhagen C, Bruinenberg M et al (1996) Serologic and polymerase chain reaction analysis of intraocular fluids in the diagnosis of infectious uveitis. Am J Ophthalmol 121(6):650–658CrossRef DeBoer JH, Verhagen C, Bruinenberg M et al (1996) Serologic and polymerase chain reaction analysis of intraocular fluids in the diagnosis of infectious uveitis. Am J Ophthalmol 121(6):650–658CrossRef
15.
17.
go back to reference Paul S (1963) Erythrocyte sedimentation rate in uveitis - a critical analysis. Indian J Ophthalmol 11(1):9–12 Paul S (1963) Erythrocyte sedimentation rate in uveitis - a critical analysis. Indian J Ophthalmol 11(1):9–12
18.
go back to reference Hooper C, McCluskey P (2008) Intraocular inflammation: its causes and investigations. Curr Allergy Asthma Rep 8(4):331–338CrossRefPubMed Hooper C, McCluskey P (2008) Intraocular inflammation: its causes and investigations. Curr Allergy Asthma Rep 8(4):331–338CrossRefPubMed
19.
go back to reference Rosenbaum JT, Wernick R (1990) Selection and interpretation of laboratory tests for patients with uveitis. Int Ophthalmol Clin 30(4):238–243CrossRefPubMed Rosenbaum JT, Wernick R (1990) Selection and interpretation of laboratory tests for patients with uveitis. Int Ophthalmol Clin 30(4):238–243CrossRefPubMed
20.
go back to reference Rosenbaum JT (1990) An algorithm for the systemic evaluation of patients with uveitis: guidelines for the consultant. Semin Arthritis Rheum 19(4):248–257CrossRefPubMed Rosenbaum JT (1990) An algorithm for the systemic evaluation of patients with uveitis: guidelines for the consultant. Semin Arthritis Rheum 19(4):248–257CrossRefPubMed
21.
go back to reference Wade NK, Kevin MD, F.R.C.P.C. et al (2000) Diagnostic testing in patients with ocular inflammation. Int Ophthalmol Clin 40(2):37–54CrossRefPubMed Wade NK, Kevin MD, F.R.C.P.C. et al (2000) Diagnostic testing in patients with ocular inflammation. Int Ophthalmol Clin 40(2):37–54CrossRefPubMed
22.
go back to reference Pepys MB, Hirschfield GM (2003) C-reactive protein: a critical update (vol 111, pg 1805, 2003). J Clin Investig 112(2):299–299CrossRef Pepys MB, Hirschfield GM (2003) C-reactive protein: a critical update (vol 111, pg 1805, 2003). J Clin Investig 112(2):299–299CrossRef
24.
go back to reference Shorr AF et al (2000) Osseous disease in patients with pulmonary sarcoidosis and musculoskeletal symptoms. Respir Med 94(3):228–232CrossRefPubMed Shorr AF et al (2000) Osseous disease in patients with pulmonary sarcoidosis and musculoskeletal symptoms. Respir Med 94(3):228–232CrossRefPubMed
25.
go back to reference Greenberg G, James DG, Feizi T et al (1964) Serum-proteins in sarcoidosis. Lancet 2(7373):1313–1315CrossRefPubMed Greenberg G, James DG, Feizi T et al (1964) Serum-proteins in sarcoidosis. Lancet 2(7373):1313–1315CrossRefPubMed
26.
go back to reference Edelsten C, Pearson A, Joynes E et al (1999) The ocular and systemic prognosis of patients presenting with sarcoid uveitis. Eye 13:748–753CrossRefPubMed Edelsten C, Pearson A, Joynes E et al (1999) The ocular and systemic prognosis of patients presenting with sarcoid uveitis. Eye 13:748–753CrossRefPubMed
27.
go back to reference Samocha-Bonet D, Lichtenberg D, Tomer A et al (2003) Enhanced erythrocyte adhesiveness/aggregation in obesity corresponds to low-grade inflammation. Obes Res 11(3):403–407CrossRefPubMed Samocha-Bonet D, Lichtenberg D, Tomer A et al (2003) Enhanced erythrocyte adhesiveness/aggregation in obesity corresponds to low-grade inflammation. Obes Res 11(3):403–407CrossRefPubMed
Metadata
Title
Relevance of erythrocyte sedimentation rate and C-reactive protein in patients with active uveitis
Authors
Fahriye Groen-Hakan
Laura Eurelings
Jan van Laar
Aniki Rothova
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 1/2019
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-018-4174-7

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