CRP increasing

[Meg1711b]

Hi! Started on 20mg pred in Dec 2014 for PMR, with CRP of 16 and normal SED rate. By January, CRP down to 6, and pred to 15mg. Since then I've been mostly at 10 mg pred. Only minor pain, but fatigue and brain fog severely limiting what I can accomplish. Walking is fine, but going up a flight of stairs is a real struggle-but not painful. Can often get 4 or 5 reasonably good days in a row, before fatigue confines me to the couch for a day or so.

Anyway, July my CRP was up to 11, so Dr. Increased pred for 1 week to 15mg, 1 week to 12.5mg, then back to 10. My recent October blood tests showed CRP higher than ever at 26, and SED is high now too, at 40. Increased to 12.5 mg pred 2 weeks, and felt better. For last week have been on 11.5 mg pred.

I was shocked by the results as I would have said I was making some small improvement, with good days getting better, and bad days not quite so debilitating.

Should I be reducing with CRP & SED levels increasing like that?

I see Rhumy later this week, but she has also recently allowed me to make my own pred adjustments.

Would appreciate any thoughts on this. Thank you.

[PMRpro Ambassador]

If the CRP and ESR levels are increasing and you feel better in yourself I think your doctor should be looking to see if there are any other things going on, particularly since the ESR wasn't raised before. Of course - ESR will rise in response to a cold and even CRP rises if you have a chest infection.

PMR and other forms of arthritis can appear identical in the early stages - but the usual distinguishing factor is the response to pred and ability to reduce, That said - I'd suggest that that 2-week taper simply wasn't enough to clear out a flare and you maybe need to go back to 15mg for 6-8 weeks, sort out all the symptoms as far as possible - and then try reducing in much smaller steps, 2.5mg at a time is quite a lot for many people, simply far too much for others and 1mg at a time is quite enough. Many of us even spread it over a few weeks:

healthunlocked.com/pmrgcauk...

[Annodomini in reply to PMRpro]

My CRP has not been stable this year and in fact has never been lower than 11. I suspect recurrent sinus infections and my rheumy was inclined to agree. I'm awaiting the results of last week's blood test which I think may confirm my suspicions. ESR has been normal. Maybe there is something similar going on with you that has nothing to do with your PMR.

[Meg1711b in reply to Annodomini]

Thank you and pmrpro for your replies. I was having some UTI type symptoms at the time so perhaps that caused my CRP to rise. I am not as anxious about the increase after reading your posts. I am trying hard to pace myself and am seeing some small, but positive results.

[Meg1711b in reply to Meg1711b]

Just wanted to post that a recheck of my CRP 3 weeks later showed it down from 26 to 11.