Classic Measures of Inflammation

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Hey guys,

?  I just came back from a visit with my rheumatologist and she had just done another blood workup and we were going over the results.  I measured 6.3 on the HS (high sensitivity) CRP measure and 21 on sed rate.  She said that these measures put me in a middle ground somewhere between no indicator of inflammation and serious inflammation. 

?My recollection though, has been that I have never gone very high on those measures of inflammation and furthermore it is very common for people with AS to not necessarily score very high on measures of systemic inflammation. 

?So I wanted to check with others out here.  Am i wrong about this?  Have you guys who have been diagnosed with AS scored higher on these tests?  I'm really more interested in just the people who are suspected of AS or a related spondyloarthropathy.  Not the people who may have other autoimmune diseases also contributing to the picture

?One other point of clarification.  There are two different kinds of CRP tests being given these days.  One is the standard CRP test and the other is the HS(high sensitivity) CRP (also known as a cardiac CRP).  For a normal CRP test my 6.3 would not be considered high but for a high sensitivity CRP my 6.3 is considered about twice what would be considered high risk for cardiac complications. 

?But again, my question is more simple.  Do you guys who have been diagnosed with an AS related condition do you also score high on sed rate and either of the CRP measures?

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10 Replies

  • Posted

    Yes. My CRP levels were high. I don't know about high sensitivity tests compared to standard tests. My level was 12. It first was at 4, 9 and 12 is the last I saw. It's completely normal for AS patients to have. My Rheumatologist was not concerned. I don't recall what the ESR was.

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  • Posted

    Thanks for getting back to me.  It would make a difference which test you took.  I would guess you had the standard CRP test because that is the typical test given to someone with a suspected autoimmune disease.  Generally above 8 is considered elevated in that test.  I believe my cRP level was 7.6 in the standard test so not high there.  I believe that my rheumy wanted me to get  the standard CRP but that was miscommunicated to the lab.  The HS CRP is apparently a cardiac marker more than a rheumatological one but I will be speaking to my cardiologist about it tomorrow.
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  • Posted

    If anyone else could please chime in on this, I'd really like to know if it is typical for AS sufferers to score high on measures of systemic inflammation like some of the other autoimmune diseases like RA.

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    • Posted

      I rarely have high CRP or esr even when pain (inflammation type) is high along with fatigue and nausea and headache, I wish I did have a clearer definition or distinction of inflammation.  All the best
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  • Posted

    Mine crp never went above 1 and esr always 2 to 9.

    tested 12 times,

    even day when doctor admit me in hospital for 5 days, esr was 2 and crp was negative.

    Its so fustrating,

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    • Posted

      But again, I'm not sure if that is significant.  I still don't have a feel for whether someone who truly has AS will always have elevated scores in those tests.  I believe that with rheumatoid arthritis those markers of inflammation are critical in making a diagnosis.  If you don't see those obvious signs of inflammation you won't get diagnosed with RA.  Is that also true of AS???  I still don't think I have the answer to that.  My last rheumy questioned my diagnosis because my CRP and ESR were not grossly elevated.  At worst those measures have only been mildly elevated in my tests. 

      ?By the way, rheumatologists seem to be switching away from those classic measures of inflammation when testing RA patients.  In order to see whether the new biologic drugs are helping someone with rheumatoid arthritis they are going to a new test called Vectra DA.  It uses 12 different markers which they combine into a single score.  It apparently is a more reliable test of whether the drug has the RA under control.  As usual, research and results in RA is way ahead of research in AS. 

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    • Posted

      And actually I found the following information on a good arthritis research website from the UK.

      "A blood test can sometimes show if there's inflammation in the body. You'll probably have one or more of these tests:C-reactive protein (CRP)

      erythrocyte sedimentation rate (ESR)

      plasma viscosity (PV).

      These all test for inflammation, so they give similar information. Different laboratories use particular tests. Only 30–40% of people with ankylosing spondylitis have inflammation that can be picked up in a blood test, so in many cases these blood tests will be normal.?"

      ?I guess that last statement tells me what I have suspected for awhile.

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  • Posted

    I score high on ESR but not CRP unless I have an infection going on in body as well.

    My SIJ X-RAY showed sacroiliitis and this was confirmed with a nueclear bone scan

    I have enthesitis (inflammation at the site of insertion of tendons and ligaments to bone). which come in flares and are getting so bad that I've had to get steroid injection in those sore areas.

    I started Humira 2 weeks ago and now I don't have lower back pain upon waking. I still have pain in SIJ as I had them both injected around 9 days ago. Still waiting for it to take effect. In the mean time I'm in Percocet every 3 hours just to function and complete everyday tasks.

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