Correlation of Clinical Manifestations and C - reactive protein Level to Patients' Outcome of Acute Corrosive Poisoning

Document Type : Original Article


1 Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

2 Forensic Medicine and Clinical Toxicology Department. Tanta Faculty of Medicine, Tanta University, Egypt.


Caustic injury remains an important public health problem despite various regulatory efforts to reduce its occurrence.  The aim of this study was to assess the correlation of initial clinical manifestations with patient outcomes and to evaluate the role of initial C-reactive protein (CRP) level as a prognostic marker in patients with acute corrosive poisoning. This prospective study was conducted on fifty-two patients with history of acute corrosives exposure in Tanta Toxicological Unit. Personal, toxicological data and vital signs were recorded, general and local examination (lips, tongue, palate and skin), routine laboratory investigation (arterial blood gases, liver & kidney function tests, C-reactive protein) and chest X-rays were performed to all patients on hospital admission. Patients were divided to either improved or complicated (chest complication or surgical interference). Most of the patients (53.8%) were in the age group (1-5 years), from rural regions and poisoning occurred accidentally (94.2%) by oral route (78.8%) with sodium hypochlorite (clor) (36.5%). The majority of patients suffered from gastrointestinal (GIT) symptoms. Higher number of patients who suffered from dysphagia and chest crepitation had significant complications. Statistically significant association was evident between patients’ outcome and each of modes of exposure, pre-hospitalization period, vomiting, respiratory manifestations, CRP level and X- ray finding. Additionally, the prediction of complication by a percentage of 72.2% may occur if CRP level increased more than 11.5 mg/dl. However, exclusion of complication in 80.5% of cases may occur when its level is less than 11.5 mg/dl. Hence, it may be useful as a prognostic marker for acute corrosive poisoning complications.