PMR, Prednisone

Depending on the lab where your blood is tested, a normal CRP is in the 1-3 range, and from 3-7 it gives evidence of cardiovascular inflammation.  Above 7, the CRP shows only a non-specific type of muscular inflammation, like PMR. The CRP is not a disease specific test, nor is the ESR (erythrocyte sedimentation rate), so the clinical symptoms of where you hurt, stiffness, and age, to name a few, are as important in making a diagnosis of PMR. 

burt you say that CRP levels indicate levels if non specific inflamation in the body, which is precisely what I was lead to believe, yet you continue to say that CRP levels between 3-7 is evidence of cardiovascular inflamation? Therefore are you saying that raised CRP levels of between 3-7 is a certain indication of cardiovascular inflamation?

i am aware that PMR in some cases does affect the heart, but not in all cases, because if what you are saying is correct then why are we all not rutinely having our heart function tested as part of our recovery plan if our CRP levels were between 3-7?

both of you have me worried now!!! Regards, tina

"CRP is a protein that was first isolated from the plasma of patients with pneumococcal pneumonia in 1930. The protein was so named because it binds to the C-polysaccharide of the pneumococcus. It was later found that the protein appeared in plasma during many infectious or inflammatory conditions.CRP is synthesized in the liver. Its physiologic role is to bind to phosphocholine expressed on the surface of dead or dying (apoptosis) cells in order to activate the complement/immune system, which enhances phagocytosis by macrophages. Levels of CRP begin to rise within 2 hours of an insult, and has a half-life of about 18 hours. The rapid action of CRP makes it a participant in the acute or first phase of the inflammatory process, which is why it is often called an "acute-phase protein."

Rapid, marked increases in CRP occur with a wide variety of disorders including infection, trauma, tissue necrosis, malignancies, and autoimmune disorders. Since a large number of disparate conditions can increase CRP production, it cannot be used to diagnose a specific disease such as rheumatoid arthritis. CRP is merely an indicator or biomarker of a disease process that is causing cell death due to inflammation.

Today, a high-sensitivity CRP test, usually designated as hs-CRP, measures low levels of CRP using laser nephelometry. Several studies suggest that an elevated hs-CRP is predictive of coronary heart disease. Arterial damage results from white blood cell invasion and inflammation within the walls of coronary arteries. A high hs-CRP, therefore, is a rough proxy for cardiovascular risk. The widespread use and publicity surrounding the association of hs-CRP with heart disease may have obscured its diagnostic role in pain and other non-cardiac conditions. If a pain patient has an elevated hs-CRP, it simply means that there is an active focus of inflammation—be it in the heart, CNS, or elsewhere in the body—and efforts must be made to eliminate it."

and

"It is important to remember that both CRP and hs-CRP become elevated in a wide range of acute and chronic inflammatory conditions such as infections, rheumatic arthritis, many other inflammatory diseases, and many cancers. These conditions cause release of interleukin-6 and other cytokines that trigger the synthesis of CRP by the liver.

Because there are many disparate conditions that can increase CRP and hs-CRP, an elevated CRP level does not indicate a specific disease.

Due to its poor sensitivity and low negative predictive value, measurements of hsCRP can not be used to rule out disease.

Most clinical guidelines have emphasized that data from experimental research, epidemiological studies, and large clinical trials do not provide conclusive evidence for the routine use of hsCRP measurements for risk prediction.

At this time, there is insufficient evidence to recommend widespread use of hs-CRP in clinical practice."

As burt has said - a sustained very high CRP suggests that there is some major inflammation present. What the high specifity CRP suggests - only suggests - is there is some low grade chronic inflammation going on. Also somewhere - not necessarily in the cardiovascular system though it probably usually is of the patient is healthy. It is all associated with theories that long term low grade inflammation is the cause of certain diseases. It is probably associated with many things - but correlation is not always causation. hs-CRP is much much lower - CRP is measured down to about 3-5mg/l, hs-CRP is measured down to about 0.3mg/l - so well within the usual sorts of levels acceptable in a healthy individual.

The hs-CRP is of interest in otherwise healthy people who might be at risk of a heart attack at some later time - but even then, it may happen, it may not. But if there is a risk you can look at lifestyle changes to reduce that risk.