Observation of C - Reactive Protein and Absolute Neutrophil Count in Children With Pneumonia in a Tertiary Care Hospital

Abstract

Pneumonia is one the leading cause of mortality in children in India. It has been seen that C-reactive protein and absolute neutrophil count plays an important role in pneumonia. Therefore objective of this study was to co relate the level of C- reactive protein and Absolute neutrophil count (ANC) with the severity of pneumonia in children. A cross sectional descriptive study was carried out among all patients, aged from 6 months to 14 years, admitted to department of paediatrics, IMS and S.U.M Hospital, Bhubaneswar. Various parameters were taken which were: age, gender, anthropometry, signs and symptoms at the time of admission, chest x ray, blood culture, C- reactive protein (quantitative) and Absolute neutrophil count (ANC) levels were measured on day 1 , 3, and 5 of admission.  C - reactive protein and Absolute neutrophil count (ANC) levels are directly proportional to severity of pneumonia and can be used as a predictor of severity of pneumonia in children. 65.2% of the study participants were males. The study participants had bimodal age distribution with majority (3/4th) lying between <1 year and 1-3 year age group. 22.47% were between 3-10 years of age. The mean age was 2.42 years and standard deviation was 2.37 years. 80.9% of the participants had respiratory distress. 88.8% of the participants had complaint of cough in the study. 39.4% of the participants had normal chest x-ray finding, 10% had features of consolidation in chest x ray. About 20 patients had growth in blood culture with organisms like E.coli, Klebsiella, Staph and Streptococcus. 57 patients in study were having mild pneumonia, 15 had moderate and 17 had severe pneumonia. The ANC at day 1 ranged from 334 cells/mm³to 32255cells/mm³, at day 3 from 205 cells/mm³to 34256cells/mm³ and at day 5 from 937cells/mm³ to 23465cells/mm³. Similarly, the CRP at day 1 and 3 ranged from 0.1 to 21.95 mg/dl  and at day 5 from 0.1 to 8.2 mg/dl.  The ANC at day 1 was significantly correlated with CRP at day 1. Similarly, ANC at day 3 was significantly correlated with ANC at day1, ANC at day 5, CRP at day 1 and CRP at day 5. The ANC at day 5 was significantly correlated with ANC at day 1, 3 and CRP at day 1 and 5. The CRP value at day 1 had significant correlation with ANC at all 3 days and CRP at rest two days. CRP at day 3 had significant correlation with CRP at day 1 and 5. Additionally, CRP at day 5 had significant correlation with ANC at day 3, 5 and CRP at day 1, 3.