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Concerns about recent CRP test.

Posted , 3 users are following.

mary68968
mary68968

I just returned from my rheumatologist's office & my CRP was 10 mg.  On September 15th it was <2.9 mg. so i am going back to 8.5 mg. prednisone as opposed to 7.5.  what could have caused this increased inflamation?  stress?  very disappointing.  seems like a big increease in a short period of time.  any suggestions would be appreciated.

thanks

  mg.="" so="" i="" am="" going="" back="" to="" 8.5="" mg.="" prednisone="" as="" opposed="" to="" 7.5. ="" what="" could="" have="" caused="" this="" increased="" inflamation? ="" stress? ="" very="" disappointing. ="" seems="" like="" a="" big="" increease="" in="" a="" short="" period="" of="" time. ="" any="" suggestions="" would="" be="" appreciated.="" thanks="">

thanks

 >

0 likes, 12 replies

12 Replies

  • EileenH
    EileenH mary68968

    Posted

    Are your symptoms also worse? 

    They should, however, check the CRP with another blood sample to make sure it is really raised - all sorts of things can lead to a strange reading - not least it being the wrong sample/result put on your file. A single test that is out of the expected range should be checked. I have had one single raised CRP - the following week it was back to normal.

    • mary68968
      mary68968 EileenH

      Posted

      Thanks Eileen,

      I have felt a bit sluggish, but not that differently.  You know it's weird, I get test results by email from the lab, but did not get the CRP result for this blood test only the ESR reading, which was 22 & in Sept. it was 19.  So maybe someting is amiss.  They have always sent all the results to me before.  Don't see the doc for 2 months so do you think it's a good idea to go up to 8.5 & stay there?

      Also got a shot (prolia) because I did not want to take pills for bone loss.  Seems like the easiest way.  So far no side effects.  Just thought others might be interested.  In the US it's covered by medicare.

       

    • EileenH
      EileenH mary68968

      Posted

      I think it might be a good idea to call your doctor and see what they think. It isn't recommended to just increase the pred for an isolated raised blood value unless their symptoms suggest it might be necessary. 

      Prolia is available on the NHS too - but only after you have tried the cheaper bisphosphonates and other alternatives and been unable to tolerate them for some reason. For many medications there are such hierarchies - you work through the options first.

  • twigjean
    twigjean mary68968

    Posted

    Both ESR ( Erythrocyte Sedimention rate ) and CRP ( C Reactive Protein) are non specificate tests for imflamation. So they can be eleveded for any reason - toothache any infection,etc. - not just PMR. I'm in the States and it appears our CRP is reported different units. I think the ESR is in mm (mil meters) which is the same in both countries. We generally use CRP's here as it a more ACCURATE test. Eg. Not procedure dependent. I like to think in terms of, times normal. Not sciencific just general.  I don't how these tests compare. I'm a retired Medical Technologist. (Clinical laboratorn)
    • EileenH
      EileenH twigjean

      Posted

      I'd use the word specific rather than accurate I think although I see what you mean - ESR must be set up within a few hours while CRP is less time dependent apart from anything else and CRP rises for fewer indications. The literature suggests that using both ESR and CRP is best and more specific in the context of PMR but that they are only a guideline, the decision should be clinical, i.e. symptom-led.

      I got the impression from Mary's post that the report of <2.9 meant the result was in their normal range - which means the 10 figure is significantly elevated. meant="" the="" result="" was="" in="" their="" normal="" range="" -="" which="" means="" the="" 10="" figure="" is="" significantly="">

    • twigjean
      twigjean EileenH

      Posted

      My lab normal range CRP.  .3 - .75 mg/ dL  dec liter

                                         ESR < 20="" or="" 30="" mil="" meters="" (="" age="" and="" sex="" related)="" uk.=""  =""  =""  =""  =""  =""  =""  =""  cpr="">< 8 l liters.   ( a demical point diffence)

                             esr same

      crp is a chemical test and esr is a hematology test. in today's world of chemical analyzes chemistry test are not dependent on procedures. 

      looking at the normal ranges her crp is barely elevated ( cause other than pmr)  and her esr is not elevated by age.

      something to keep in mind when looking at lab tests - it's like getting on the scale to check your weight -there is a slight variation. you are not always going to get the same number from lab tests. i could go into the qc but it is too much information. labs are very tightly controlled by regulations.

      got you normal from a uk medical web site hope this is of value 8="" l="" liters.=""  ="" (="" a="" demical="" point="" diffence)=""  =""  =""  =""  =""  =""  =""  =""  =""  =""  =""  =""  esr="" same="" crp="" is="" a="" chemical="" test="" and="" esr="" is="" a="" hematology="" test.="" in="" today's="" world="" of="" chemical="" analyzes="" chemistry="" test="" are="" not="" dependent="" on="" procedures. ="" looking="" at="" the="" normal="" ranges="" her="" crp="" is="" barely="" elevated="" (="" cause="" other="" than="" pmr)=""  and="" her="" esr="" is="" not="" elevated="" by="" age.="" something="" to="" keep="" in="" mind="" when="" looking="" at="" lab="" tests="" -="" it's="" like="" getting="" on="" the="" scale="" to="" check="" your="" weight="" -there="" is="" a="" slight="" variation.="" you="" are="" not="" always="" going="" to="" get="" the="" same="" number="" from="" lab="" tests.="" i="" could="" go="" into="" the="" qc="" but="" it="" is="" too="" much="" information.="" labs="" are="" very="" tightly="" controlled="" by="" regulations.="" got="" you="" normal="" from="" a="" uk="" medical="" web="" site="" hope="" this="" is="" of="">

                             esr same

      crp is a chemical test and esr is a hematology test. in today's world of chemical analyzes chemistry test are not dependent on procedures. 

      looking at the normal ranges her crp is barely elevated ( cause other than pmr)  and her esr is not elevated by age.

      something to keep in mind when looking at lab tests - it's like getting on the scale to check your weight -there is a slight variation. you are not always going to get the same number from lab tests. i could go into the qc but it is too much information. labs are very tightly controlled by regulations.

      got you normal from a uk medical web site hope this is of value>

    • EileenH
      EileenH twigjean

      Posted

      Just like to say I was also a clinical biochem technician and am perfectly well aware of who does which test, QC and the variations in lab tests. 

      I also I said it isn't recommended to increase pred doses in response to a single aberrant reading - it could be the start of a trend which should be monitored. In PMR it is symptoms which should be king and not slightly variable blood results.

    • EileenH
      EileenH

      Posted

      I also forgot to mention that while her ESR is "not elevated by age" if I was told my ESR was 22 I would be worried. The highest it has been during my entire time with PMR was 7, it is usually 4.

      There isn't a decimal point difference between the CRP ranges - they are absolute figures and one is per dl and one is per litres. Of course per litre is 10 times per dl.

    • twigjean
      twigjean EileenH

      Posted

      Sorry to offend. You have shared much information with me, and positively influenced the coarse of my treatment.
    • mary68968
      mary68968 EileenH

      Posted

      I guess my concern is that the CRP is 10.4  slightly out of the normal range & the ESR is 22 wihch is within the normal range.  The CRP (according to this blood test) has increased a lot since my last reading, which showed no inflammation at all.  I just saw my doctor Thursday & he was not concerned & I don't go back for 2 months, but I am curious why the big difference between the two tests & seeing as I am a worrier hoping for a little more info.  I know blood tests are not the only factor, but so far I have been lucky enough for them to be fairly consistent & never jumping backward like this.  I feel pretty well so that it not a problem it just seems like a gray area & I am curious about it. 

      You have been incredibly helpful in the past & I thank you for your help.  There is so much with PMR that is not easily expalined & my medical knowledge is nothing to write home about.  smile

    • EileenH
      EileenH mary68968

      Posted

      You are quite right - and that is why I feel the test should be repeated in a couple of weeks or so. The difference could be accounted for by a whole range of things - important ones or less so. There is no need for panic yet!

      I know it is very easy for people like twigjean and me to be very laid back because we have worked in the field and are aware of the fallibities of tests. But here it is fair to say that if you feel pretty well there is no need to panic - maybe the next bloods will be back to what you are used to. Or the ESR may also rise a bit, there is often a delay as CRP is felt to rise faster and is valuable because of that. Some doctors fiddle about with pred doses on the basis of the blood tests - and a bit of laid-backness doen't always hurt. Masterly inactivity it used to be called!

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