Serum C-Reactive Protein and Erythrocyte Sedimentation Rate as Inflammatory Markers in Patients with Rheumatoid Arthritis at a Hospital in Anambra State, South East Nigeria

Inflammatory biomarkers such as C-reactive protein and erythrocyte sedimentation rate are routinely used to assess disease activity and monitor treatment response in patients with rheumatoid arthritis. This study evaluated serum CRP and ESR in rheumatoid arthritis patients attending Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, South East Nigeria. A case-control study was conducted among 80 confirmed rheumatoid arthritis patients and 40 healthy age-matched controls. Serum CRP was measured by latex agglutination and quantified by immunoturbidimetric method, while ESR was determined by the Westergren method. Disease activity was assessed using the Disease Activity Score 28. Complete blood count and rheumatoid factor were also performed. Mean serum CRP was significantly elevated at 28.6 mg/L in patients compared to 3.1 mg/L in controls. ESR was markedly raised, with a mean of 58.4 mm per hour in patients versus 12.7 mm per hour in controls. Both markers showed strong positive correlations with Disease Activity Score 28. CRP demonstrated slightly superior sensitivity for detecting disease flares compared to ESR. Female patients had higher mean CRP values than males. Patients on disease-modifying antirheumatic drugs had lower inflammatory marker levels than those without treatment. The study supports concurrent use of CRP and ESR in monitoring rheumatoid arthritis activity and recommends standardised laboratory protocols for inflammatory marker assessment in rheumatology units across South East Nigeria. Keywords: C-reactive protein, erythrocyte sedimentation rate, rheumatoid arthritis, inflammation, Anambra State