Importance of high sensitivity C-reactive protein in the evaluation of wheezing in children

BackgroundIt is important to determine the presence of asthma in children under the age of 3 with recurrent wheezing. Inflammatory markers have been investigated in the diagnosis and treatment of asthma. The aim of the present study was to investigate the relationship between recurrent wheezing with or without modified asthma predictive index (mAPI) positivity and high-sensitivity-C reactive protein (hs-CRP) level in children aged 6-36 months. MethodsNinety-nine children with recurrent wheezing and 47 healthy children aged 6-36 months were included in the present cross-sectional, case-control study. Those children with wheezing were divided into two groups according to mAPI positivity. ResultsMean serum hs-CRP was higher in the recurrent wheezers than in the control group (0.89 1.7 mg/dL vs 0.12 +/- 1.3 mg/dL, respectively; P = 0.002). There was a positive correlation between serum total IgE and hs-CRP (P = 0,003; r = 0348). mAPI positivity was detected in 46 of the recurrent wheezers (46.5%). There was no significant difference in hs-CRP between the mAPI-positive and -negative groups. The best hs-CRP cut-off for differentiating between the patient and control groups was 0.11 mg/dL on receiver operating characteristic analysis (area under curve, 0.658; 95%CI: 0.571-0.744; P < 0.05; sensitivity, 60%; specificity, 61.7%). ConclusionsHigh-sensitivity CRP can be used to indicate respiratory and systemic inflammation independently of mAPI positivity in wheezy children.