Prognostic Value of C - reactive protein in Pediatric Tubercular Patients on ATT

Objective: To determinechange in CRP levels inpediatric tubercular patients on ATT so as to prognosticate them. Method:CRP level of different types of Tubercular patients (200 cases) on ATT were compared with 60 healthy controls .The selection of Tubercular patients was based on Kenneth jone’s criteria .CRP level were recorded at admission , at 1 month, at 3 – 6 months of therapy .There mean and standard deviation and Significance of the results were determined statistically . Result: In study group CRP was positive in 97 % of cases .Highest serum CRP was observed in TBM and Miliary tuberculosis ( 37.5 ± 13.61 μg /ml and 28.0 ± 2.82 μg /ml ) which denotes the activity of disease .The mean initial serum CRP in Pulmonary ,TBM , Miliary and Abdominal tuberculosis were 12.15 ± 4.89 μg /ml , 37.5 ± 13.61 μg /ml , 28.0 ± 2.82 μg /ml and 23.33 ± 2.49 μg /ml respectively , after 1 month of treatment 9.27 ± 1.13 μg /ml , 14.04 ± 3.36 μg /ml , 12.67 ± 1.15 μg /ml and 10.67 ± 4.16 μg /ml respectively and after 3—6 months of treatment 6 ± 1.12 μg /ml in all four types of tuberculosis . This decline in CRP level correlates with clinical improvement . Conclusion: It is concluded that serial serum CRP levels are useful in monitoring the course of antituberculartherapy irrespective of types of tuberculosis . It provides anearly indication of response to treatment. The persistence or insignificant decline of CRP with treatment may tell us about inadequate treatment or development of resistance and thus help us to re-evaluate the patient condition. Thus serum CRP levels have led to better insight in the understanding of disease severity which plays an important role in clinical outcome of disease.