C-reactive protein levels in acute pancreatitis and its clinical significance


  • Juthika Abhijit Deherkar Department of Surgery, Bharati Vidyapeeth, Medical College, Pune, Maharashtra, India
  • Ayush Pandey Department of Surgery, Bharati Vidyapeeth, Medical College, Pune, Maharashtra, India
  • Shahaji Deshmukh Department of Surgery, Bharati Vidyapeeth, Medical College, Pune, Maharashtra, India




C-reactive protein, Acute pancreatitis, Ranson’s score


Background: Acute pancreatitis is one of the most common problems faced by surgeon in their practice. Alcohol being one of the most important etiology in country like India. The most common line of management has always been conservative until and unless surgery is indicated for its complications. Till date amylase and lipase have been used as diagnostic tool for it however certain prognostic tools like CRP are still under evaluation. Thus we have made an attempt to evaluate its significance as a prognostic tool in this study.

Methods: A hospital based observational comparative prospective study was done with 100 patients to measure C-reactive protein (CRP) levels in patients of acute pancreatitis and evaluate if CRP levels predict the severity of pancreatitis.

Results: The mean serum CRP level of patients with Ranson’s score <3 was significantly higher as compared to mean serum CRP level of patients with Ranson’s score ≥3 (10.54±5.00 mg/l vs 7.29±3.94 mg/l). There was significant association of serum CRP and Ranson’s score of patients.

Conclusions: The rapid response of CRP to changes in the intensity of the inflammatory stimulus suggests that it might be valuable in the assessment and monitoring of acute pancreatitis. It was observed in our study that measurement of CRP level is a simple method to assess the severity of disease.


Opie EL. The etiology of acute hemorrhagic pancreatitis. Bull Johns Hopkins Hosp. 1901; 182.

Steinberg W, Tenner S. Acute pancreatitis. N Engl J Med. 1994;330:1198.

Trapnell JE. Role of early laparotomy in acute pancreatitis. Ann Surg. 1967;165(1):55.

Ranson JH. The timing of biliary surgery in acute pancreatitis. Ann Surg. 1979;189:654.

Howard JM. History of Pancreas. The pancreatic club, Inc.

Vinish DB, Abishek V, Sujatha K, Arulprakash S, Solomon R, Ganesh P. Role of bedside pancreatic scores and C-reactive protein in predicting pancreatic fluid collections and necrosis. Indian J Gastroenterol. 2017;36:43-9.

Del Prete M, Castiglia D, Meli M. Prognostic value of C reactive protein in acute pancreatitis. Chir Ital. 2001;53(1):33-8.

Parmar D, Parihar S. To evaluation of C-reactive protein in acute pancreatitis by semi qantitative method and its correlation with prognosis: a hospital based study. Int J Med Res Prof. 2015;1(3):206-8.

Kaplan M, Ates I, Oztas E, Yuksel M, Akpinar MY, Coskun O, et al. A new marker to determine prognosis of acute pancreatitis: PLR and NLR combination. J Med Biochem. 2018;37:21-30.

Trivikraman R, Chayampurath R, Malieckal JI. Validity of bedside index of severity in acute pancreatitis score in comparison with C reactive protein in assessing the severity of acute pancreatitis. Int J Res Med Sci. 2016;4:5248-51.

Vijayakumar HM. Use of C-reactive protein as predictor of severity of acute pancreatitis. RGUHS J Med Sci. 2012;2(2):88-90.

Joshi M, Joshi AA, Gokhale A, Gokhale A, Manay P, Gadhire M, et al. C-reactive protein levels in acute pancreatitis and its prognostic significance. J Evol Med Dent Sci. 2013;2(48):9404-9.

Ustundag Y, Sarıtas U. C-reactive protein levels together with the ranson scoring system to differentiate the mild and severe forms of acute pancreatitis. Turk J Gastroenterol. 2017;28:157-8.

Sharma S, Shrivastav C, Jain S. Early prediction of severity of acute pancreatitis role of C-reactive protein. Int J Curr Res. 2014;6(08):7881-3.

Gurleyik G, Cirpici OZ, Aktekin A, Saglam A. The value of Ranson and APACHE II score and serum level of C-reactive protein in early diagnosis of severity of acute pancreatitis. Ulus Travma Acil Cerrahi Derg. 2004;10(2):83-8.

Pezzilli R, Billi P, Miniero R, Fiocchi M, Cappelletti O, Maria A, et al. Serum interleukin-6, interleukin-8, and β2microglobulin in early assessment of severity of acute pancreatitis: comparison with serum C-reactive protein. Dig Dis Sci. 1995;40(11):2341-8.






Original Research Articles