Studies on C-Reactive Protein, Erythrocyte Sedimentation Rate, White Blood Cell and Differential White Cell Counts in Patients Diagnosed with Rheumatoid Arthritis in Owerri, Nigeria
Authors: C Aloy-Amadi Oluchi , C Umah Valentine , R Emeka-Obi Obioma , Okechukwu Akogu , C Ezeh Caleb , Nnodim Johnkennedy 
Published: January 2025

Background: Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease characterized by persistent synovial inflammation, joint pain, and progressive joint damage. It affects approximately 1% of the global population, disproportionately impacts women and is associated with significant morbidity, reduced quality of life, and economic burden. Aim: This study was aimed at determining the changes in some haematological parameters and C-reactive protein in rheumatoid arthritis patients attending Federal University Teaching Hospital, Owerri, Imo State, Nigeria. Methods: A cross-sectional study was carried out from the month of June to August, 2023, and all subjects who gave a written informed consent were enrolled in the study. The study population consisted of 50 rheumatoid arthritis and an equivalent number of age matched apparently healthy patients who served as controls. The procedure was carried out at the Federal University Teaching Hospital, Owerri, and standard operating procedures were followed. The results of the tests were analyzed using SPSS version 21. Eight millilitres of venous blood sample was collected at the ante-cubital vein aseptically, 4ml was dispensed into ethylenediaminetetraacetic acid containers for the estimations of erythrocyte sedimentation rate (ESR), white blood cell (WBC) and differential white cell counts, while the remaining 4ml was dispensed into plain containers for the determination of C-Reactive Proteins. The EDTA and plain containers were properly labeled with the subject’s name, sample number and date of collection. The blood sample dispensed into the EDTA containers were stored in a refrigerator at 40C while the serum was stored in a freezer at -200C prior to use. Results: The mean values of TWBC, (15.04 ± 13.98) cells/μl, neutrophils (62.67 ± 16.08) %, eosinophils (5.47 ± 3.39)%, and monocytes (4.70 ± 3.12)% were significantly raised in rheumatoid arthritis patients when compared to controls (8.93 ± 2.35) cells/μl, (51.52 ± 10.79)%, (28.07 ± 10.12)%, (3.28 ± 2.54)% and (1.80±1.29)% (p = 0.031, p= 0.000, p= 0.001, p= 0.002 and p=0.000). The mean values of lymphocytes (28.07 ± 10.12) %, was significantly reduced in rheumatoid arthritis patients when compared to controls (40.48±10.92) %. The mean value of ESR (50.16 ± 40.87) mm/hr and C-reactive protein (79.16 ± 55.55) mg/dl were significantly increased in rheumatoid arthritis patients when compared to controls (6.89 ± 2.09) mm/hr and (8.32 ± 3.03) mg/dl respectively (p= 0.000 and p=0.001). There were no significant differences in the mean values of WBC, neutrophils, lymphocytes, eosinophils, monocytes, ESR and C-reactive protein in male rheumatoid arthritis compared to female rheumatoid arthritis patients (p=0.886, p=0.695, p=0.881, p=0.652, p=0.341, p=0.516 and p=0.434). A significant positive correlation of C-reactive protein occurred with ESR, WBC and neutrophils in rheumatoid arthritis patients (r=0.32, p=0.011, r=0.44 and p=0.021, r=0.54, p=0.043), and a non-significant positive correlation with lymphocytes, monocytes and eosinophils (r=0.87, p=0.179, r=0.96, p=0.317 and r=1.06, p=0.398). Conclusion: Rheumatoid arthritis is associated with increase in total white blood cell, neutrophils, eosinophils, monocytes counts, ESR and C-reactive protein. Lymphocytopenia is linked to rheumatoid arthritis. Therefore, monitoring the parameters in rheumatoid arthritis is essential for diagnosis, disease activity assessment, and management.