C Reactive Protein (CRP) & Diagnosis of Diskospondylitis (DS)

C Reactive Protein (CRP) & Diagnosis of Diskospondylitis (DS)

William Bush VMD, DACVIM (Neurology) Salon G ? 9:40 AM

Sunday, April 2, 2017 bbush@

Grand Teton National Park, August 2015

Thanks

? Sarah Trub, DVM, BVNS Neurology Resident ? David Brewer, DVM, DACVIM ? Matt Paek, VMD, DACVR ? Stephen Werre, BVM, MsC,PhD ? Dan Cuff, DVM, DACVIM, Residency Advisor ? Martin Young, DVM, DACVIM ? Mike Higginbotham, DVM, DACVIM ? Jessica Barker, DVM, DACVIM ? Joli Jarboe, DVM, DACVIM ? Lisa Lipitz, VMD, DACVIM ? Casey Neary, DVM, DACVIM

Take Home Points

? CRP is remarkably useful biomarker in many veterinary diseases including diskospondylitis (DS)

? In DS, admission and follow-up CRP useful in predicting outcome and may help direct treatment

? Clinical presentations and/or CRP may not distinguish steroid responsive meningitis (SRMA), immune mediated polyarthroapthy (IMPA) or diskospondylitis

Today's Agenda

? Discuss CRP's role as an acute phase protein and biomarker in IMPA, SRMA, human and veterinary diskospondylitis

? Briefly compare signs with IMPA, SRMA and Diskospondylitis along with human vertebral osteomyelitis (VO)

? Discuss the role of CRP in the management of diskospondylitis and VO

Acute Phase Protein Response

? Host survival during the critical early stages of the attack

? Part of innate host defense system which predates the acquired immune response

? Non-specific and complex reaction occurring shortly after tissue injury whose purpose is to restore homeostasis and remove cause of the disturbance

Ceron JJ, et al. Acute phase proteins in dogs and cats: current And future perspectives. Vet Clin Path Vol 34 / No 2 / 2005 p. 85-99

Acute Phase Protein Response

? Very fast and develops before specific immune response and sometimes before clinical signs

? Non-specific because develops secondary to tissue damage from infection, immune, neoplastic, traumatic and other causes

? Regulate immune response, inflammation, protect against infection, and assist in repair and recovery of damages tissue

Ceron JJ, et al. Acute phase proteins in dogs and cats: current And future perspectives. Vet Clin Path Vol 34 / No 2 / 2005 p. 85-99

Acute Phase Protein Response

? Fever, leukocytosis, increased cortisol, decreased thyroxine, iron, and zinc as well as lipolysis, gluconeogenesis and muscle catabolism

? Positive APP increase during response and include C reactive protein, serum amyloid A, haptoglobin, alpha-1-acid glycoprotein, ceruloplasmin, and fibrinogen

? Most made by mostly hepatocytes upon stimulation from IL-6, Il-1, and TNF- alpha

Ceron JJ, et al. Acute phase proteins in dogs and cats: current And future perspectives. Vet Clin Path Vol 34 / No 2 / 2005 p. 85-99

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