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Forum Name: Hematology Topics

Question: C-reactive protein and Factor V Leiden


 lynndcr - Mon Jul 19, 2010 3:49 pm

I recently had an elevated C-reactive protein of 13.52. My endocrinologist said it must be due to my having an clotting disorder. Is Factor V Leiden a known cause of elevated C-reactive protein or should I have this further evaluated?
 Dr.M.Aroon kamath - Sat Jul 31, 2010 10:53 am

User avatar Hi,
A fair amount of clinical/research work on C-reactive protein (CRP)levels, other acute phase reactants and their relevance as a risk factors for myocardial infarctions, metabolic syndrome, diabetes, atherosclerosis, arterial thrombosis, hypertension etc, gets reported from the city of Leiden in the Netherlands (where incidentally, Factor V Leiden was first identified in a family).

The elevated CRP levels have been shown(in some of these studies) to increase the risk of myocardial infarctions(coronary thrombosis) but, not the risk of venous thrombosis. Is it possible that you are mistakenly referring what you came across in relation to protein C?

Apart from this there is just one other connection that i can think of- All clotting factors (including factor V) are synthesized in the liver except for Von willebrand factor (vWF) – which is synthesized by the endothelial cells of blood vessels as well as by the platelets.The acute phase proteins (including C-reactive protein) are also synthesized by the liver. In conditions causing acute stress, the liver starts to manufacture acute phase proteins at the expense of the clotting factors, thus resulting in a bleeding diathesis.Thus, there is this known 'inverse' relationship between C-reactive protein and factor V.

A highly sensitive C-reactive protein (hs-CRP) assay is now available.This is very useful in assessing the cardiovascular risk.

CRP is a non-specific marker of inflammation. As a prognostic indicator,it lacks specificity. Apart from acute and chronic inflammations, infections, and autoimmune diaorders, levels may be increased in certain malignancies as well
(ex; colon cancer). Persistent, marked and unexplained elevations hs-CRP (greater than 10.0 mg/L), should lead to tests to exclude non-cardiovascular causes.

Your C-reactive protein levels are indeed very high(normal levels upto 4.9mg/L). Women taking HRT will have higher levels of CRP. You will need to be fully investigated to exclude non-cardiovascular causes among others.Your doctor will be the one best placed to guide you through this.
I hope this information is helpful.
Good luck!

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