CRP

[DeliaGray]

Hi again, yesterday I received my results from my monthly blood test. I was diagnosed with GCA last July. My pred level is now at 13. My Rheumy wrote me an email saying that my CPR had risen. I have been following all of your advice and have been reducing very slowly with his permission. I don't know if the measurements correspond with those of the U.S. We are supposed to be at a normal range of < = 0.5

MIne has fluctuated between those points since taking pred. I started at 80 mg. My CRP was then 15. This week's test result showed mine to be 1.6. Obviously that is of some concern. My question is has anyone experienced this, and is it a sign of a relapse? What is considered to be dangerously high? My Rheumy will get back to me this week, but I would like your imput please.

Thank you for all of your advice and help.

[Celtic PMRGCAuk volunteer]

Delia, a raised CRP can point to a flare in inflammation levels, but it can also rise in response to other things going on in your body such as infections/viruses. Are you experiencing any returning GCA symptoms? Here in the UK a normal CRP is considered anything below 5. Certainly, if my CRP markers increased during my journey with PMR and GCA, my rheumy advised increasing my steroid dose just in case. However, if you have no sign of increasing GCA symptoms at present, then perhaps ask for the test to be repeated in a week or so to see if it has improved. Meanwhile, certainly don't attempt any planned reduction in steroids, and remain alert for any visual problems, seeking immediate advice if necessary.

[PMRpro Ambassador]

There should never be a knee-jerk reaction to a single out of trend result in ESR or CRP that isn't accompanied by symptoms - the correct thing to do is repeat it. I had one rogue raised CRP, it was back to the normal range less than a week later. All sorts of things in the laboratory can lead to a single dodgy result and as Celtic has said, other things can affect CRP, including chest infections which are capable of sending CRP up to 6 using your units.

To have got from 80mg down to 13mg in under 10 months is pretty fast in GCA by UK standards but as CEltic has said, don't reduce further and wait for your rheumy's next contact. As I say, I would hope he'd want the CRP checked as the first step.