CRP up to 48 but only slight discomfort

[LJhome]

Hi all after being on steroids for 3 years I managed to get down to 0 using the very slow nearly stop method. I have been off now for two weeks and am experiencing slight discomfort so had my bloods done. The crp is 48 up from 5 but I have only a slight discomfort. Should I just see how things go or should I go back. I do have an infected toe and am on antibiotics so I guess it could be that but I also have the slight discomfort in my arms. Help!

[PMRpro Ambassador]

I'd suspect the raised CRP is a mix of the infected toe and the beginnings of a flare - which could be happening because of the stress of the infection.

A single raised CRP or ESR shouldn't result in a knee jerk reaction of raising the pred dose BUT since this is a rather unclear situation - the symptoms must be taken into consideration. You KNOW you feel those niggles are PMR don't you? If it were me I'd take a couple of mg - which obviously was enough before and see if you feel better. It is such a low dose you have managed to get to that it would be a real shame to let a bit of inflammation build up to where you'd need much more to sort it out. What a shame the infection coincided with the end of the drop to zero - because it's really muddied the water.

[Celtic PMRGCAuk volunteer]

Ljhome, how unfortunate getting a toe infection just after reaching remission! It is possible for CRP to rise in line with any infection. I think only you will be able to tell if the "slight discomfort" in any way resembles the symptoms of PMR that you have experienced in the past, for example is the discomfort in similar areas of your body? Even just the stress itself of suffering a toe infection and its probable pain can cause not only a rise in CRP but also a relapse so soon after coming off steroids. Hmm, what to do? I think, if it was me, and it was only "slight discomfort", I would give it another few days, having lots of rest (no lifting of heavy objects, etc), and then get the blood test repeated. And cross everything! Good luck!

[piglette]

I agree with PMRpro, you had your bloods done because you felt things were not quite right, nothing to do with your toe. I would take a couple of mg as PMRpro suggests. You can always reduce again when things are OK.

[Annodomini]

That's quite a steep increase in your CRP. I had a big increase early in the year. Was down to 5mg but went back up to10. However, I think the culprit has been a series of sinus infections which have never quite cleared up and the rheumy is inclined to agree with me, I had a blood test done today and would be very surprised if the CRP was down near normal! A nasty bacterial infection could well have been responsible for your raised CRP and triggered a flare. Hope all resolves itself without further problems.

[LJhome]

Thank you for your responses. I will restart today at around 2ngs and see how it goes. Not so scary this time around as I know what it is and that it can be controlled. Thanks again everyone.

[Nap1]

I wouldn' t take a chance, take a small dose for a while. Most infections do not raise the crp or sed rate.