Hi. Does anyone know about CRP levels please

[Nikkilama]

Hi. The only result I have had that has been substantial proof of something wrong was this. My CRP level was 107 then the week after it was 5.

I'm still not diagnosed but at least it proved something concrete.

Does anyone know why it would flare up then down so very quickly. And importantly, if it always does, then is it just pure chance if they take bloods on the right day. I found this on line

"CRP rises within two hours of the onset of inflammation, up to a 50,000-fold, and peaks at 48 hours. Its half-life of 18 hours is constant, and therefore its level is determined by the rate of production and hence the severity of the precipitating cause. CRP is thus a marker for inflammation that can be used to screen for inflammation."

If I can find out if it's a common occurrence to flare up and down quickly I can tell my doctor. Who admits to being puzzled and not know why it would do so.

She has agreed to take CRP again next week to see what it's like which I'm grateful for, but how much of this is pure chance on hitting the right day and time?

I would be very grateful for any knowledge or experience of you guys. Many thanks. 🦋

[Hidden]

Hi, Not sure if this will answer your question if the GP couldn't but I will tell you what I know. CRP on its own will measure acute signs of infection but not specific infection. As it is a reactive protein made in the liver, It can rise an fall quite quickly. It can be used once someone is diagnosed with an autoimmune condition to indicate a flare but there needs to be other blood results to prove the auto immune condition at first like, positive ANA or raised ESR. The CRP alone is just a sign of infection at that time.

[Nikkilama in reply to Hidden]

Thank you. I did have raised ESR. This info helps me. For some reason this sort of info has been hard to find. 🌻

[Hidden in reply to Nikkilama]

I believe there are leaflets on this site that show the criteria. If not the American Lupus website gives a clear 11 part criteria some bloods some symptoms.

[Nikkilama in reply to Hidden]

Many thanks for taking the time to write to me.

[Nikkilama in reply to Hidden]

Awesome. You have written that so well! I understand a lot better 🌻

[Fennella02]

ESR is another non-specific marjer of inflammation which could also be infection. ESR rises and falls much more slowly. I've had a CRP of 150 after a bout of flu but it never goes up when I flare. Testing antibodies and complement too would be beneficial.

[Nikkilama in reply to Fennella02]

Thank you. All this is a big help 🌻

[Leave-me-alone]

CRP. It is a reflection of inflammation or infection. I had it in my foot. Also went from 110 to 5 after medication. I had scan done to to locate the inflammation and infection. Not in my joint but in my tendon.

[sarahsch]

Hi, not a Dr, but have also looked into this.

There are 2 inflammatory markers - CRP & ESR. In the "normal" population, Drs look at CRP as it rises quickly with inflammation caused by Infection. However Lupus is the exception.

In a Lupus flare CRP will usually not rise (there are some exceptions). This is believed to be due to the inhibition of CRP by type 1 interferons present in Lupus.

ESR on the other hand is used to monitor Lupus. Thus no/low CRP with raised ESR along with a clinical presentation of inflammation in an SLE patient indicates inflammation caused by flare, & can be used to distinguish this from inflammation caused by infection.

However, ERS is slow to respond. One reference indicated it would take 2-3 days before you would monitor an increase level, & 7 days before it peaks. Of course a patient is likely to present early before ESR shows (you won't wait a week to seek help!)

Thus entirely possible to be in Lupus flare & show nothing on the inflammatory markers, but find most GP's & some Rhemys don't understand this.

Worth knowing & reminding them when appropriate.

Sarah x

[Nikkilama in reply to sarahsch]

That was incredibly helpful. Thank you. I'm trying to learn about all this as fast as I can. As I seem to have to argue my case all the time. And without this kind of knowledge it's easy to be railroaded. Is there by chance a book on this you can recommend. Or have you picked up all this as you have gone along. ?

Once again thank you for your support. 🌻

[sarahsch in reply to Nikkilama]

Hi Nikkilama,

Sorry for not replying sooner. Been feeling really rough for last few weeks.

I think I would recommend a book from Lupus UK titled "Lupus Diagnosis & Treatment" It contains a good deal of information in a simple to understand way.

The CRP/ESR info came from further internet research, but you do need to ensure the source is well respected.

I have been to A&E and the Drs with badly swollen hands & an arm that feels like a rudder band has been wrapped & pulled tightly around it. They couldn't get any blood from it, but got sample from other arm easily. Then told me everything was OK with blood tests - inflammatory markers OK. But there was obvious & visible inflammation. So I set about researching what had gone wrong.

Sarah x

[Nikkilama in reply to sarahsch]

Thank you very much Sarah. I really appreciate you taking the time to write to me. Especially when you feel rough. I do hope your latest inflammation gets better soon. Wishing you peace and light. 🌻✌🏻

[Hidden in reply to sarahsch]

Sarah thanks for this it really helped me too. I have primary Sjögren's rather than Lupus but you've made me think. Both markers have always been elevated with me but in the past my ESR (or PV as my new area calls it) has been really high even though my CRP has only sometimes been around 5 or 6. At other times, when very sick with infections my ESR has been around 80 and my CRP has gone up to 160 - but days later, after IV antibiotics or while on steroids, it's been as low as 2.5 where my ESR has still been steadily rising along with what I think of as flare pain. Hospital doctors explained that my ESR/ PV shows autoimmunity where my CRP only shows infection and acute inflammation. You've helped me to understand this better I think.

Mostly my CRP sits at between 11 and 15 now where my PV is usually still very high when i feel unwell with flares. The doctors then assume that I'm not flaring because my CRP isn't raised enough - despite high PV/ESR.

So my own thinking is that the PV/ESR is the useful marker for active disease because it's less responsive to temporary infections and is a far more reliable marker of inflammation relating to Sjögren's for me.