Blood Test ESR

[daw50]

I am beginning my sixth year with PMR/GCA. I take Prednisolone have been taking Methotrexate for five years and have regular blood tests. However, five months ago my GP stopped requesting the ESR test. I asked about this at the hospital and was told that the CRP test is more accurate for these conditions. Has anyone else come across this or could it be a money saving exercise? I live in London. Thank you

[polkadotcom]

No, they are right, both measure inflammation markers in the blood and while the inflammation they find is attributable to any condition, the CRP is now believed to be the more accurate marker. They both only tell you that there is inflammation present not what is causing it.

[daw50 in reply to polkadotcom]

Ok thank you, that is reassuring to know.

[PMRpro Ambassador]

As polkadotcom says they are both only indicators of the presence of inflammation. The ESR is affected by several factors including the time from taking the sample to the test being set up - if it is more than 4 hours then it is inaccurate anyway. Blood taken in a GP practice rarely reaches the lab in that time. That doesn't apply for CRP. As early as the 1940s it was suggested the ESR was fairly pointless and a test called plasma viscosity was recommended instead - but very few labs have the equipment even now!

Studies showed that CRP is more sensitive in PMR (unless of course you are a person where it doesn't change at all like me!). If it was raised initially it is slightly better than the ESR for monitoring PMR but even a severe cold or a chest infection (especially) will send it up so you shouldn't react by raising the pred dose to a single raised value - only if it is persistently raised.

[daw50 in reply to PMRpro]

Thank you for your reply. My bloods have been on a roller coaster ride since the outset and are only now beginning to settle (hopefully).

[bowler]

I live on the borders Suffolk and Cambridge, and my bloods were always sent to Bury St., Edmund's Suffolk, [ they always did both ESR /CRP ] However just recently our surgery have switched to Addenbrook's Hospital Cambridge and they will only do CRP.

As PMRpro said if it's more than 4 hours to test the ESR it's probably inaccurate. Our hospitals are over 20 miles away from the surgery so my bloods sat there all day !

[Bailybiscuit in reply to bowler]

I have my blood tested at Addenbrookes and I have my CRP and ESR tested. Before that it was only my ESR.

[bowler in reply to Bailybiscuit]

I think sometimes it all depends on what the Dr. at the time requests, some differ only wanting the CRP, and not the ESR, or the other way round, or both.

[daw50]

Thank you. I wasn't aware that ESR blood was no good if tested after 4 hours, the replies have helped enormously.

[Maxine-59]

Check with your surgery what time the hospital transport collects the bloods from the surgery. I go to the hospital for my bloods in the morning to ensure the bloods are at the path lab in good time .

[bowler in reply to Maxine-59]

our surgery gets it's bloods collected around 3.30 pm, so they are sitting about quite a long time, [ unless they are refrigerated , or would that make a difference ?]

I have regular blood tests for other health issues apart from my GCA , and as I said in my previous post, my nearest hospital Addenbrooks is a 40 mile round trip away, so there's no way I would do that journey every time, and park my car there at exorbitant prices,

[Bailybiscuit in reply to bowler]

I get mine done at Sainsburys, I go about half an hour before they finish collecting it and then it will take less than half an hour to get to the hospital. I can park free too. I didn't realise about the accuracy depending on how long blood is hanging about.

[bowler in reply to Bailybiscuit]

That's good re getting your bloods done at Sains. our one doesn't have that facility, I live in a village and our "blood nurse" only works till 1pm. even if I asked for a later appointment it would still be a while before it reached the hospital and then the lab

I have had GCA for 16 years so had this problem for a long time,

however up till recently, like you I did't realise there was a time factor re an accurate test, Makes me wonder if I have been getting a right reading all these years for my ESR ! as I have never been off pred in all these 16 years

[Bailybiscuit in reply to bowler]

It does make you wonder, although mine was high with the drs blood tests, then they were normal and seem the same with Sainsburys. It is just that I don't feel normal, I expect to see higher numbers to go with the pain.

[bowler in reply to Bailybiscuit]

I know what you mean about the numbers and symptoms/pain. I did say that I wondered about my b/tests results in the past, but I usually go by my symptoms and not the number. My ESR was only around 40 when diagnosed.

I recently had a flare yet my CRP was only 6 ESR 11

[Bailybiscuit in reply to bowler]

My ESR was 5 this week and my CRP less than 4, but I feel they should be high. I don't know if it is the Seronegative arthritis and don't even know if you get raised CRP and ESR levels with that or any type of arthritis. My ESR was about 80 when diagnosed with pmr.

[bowler in reply to Bailybiscuit]

I would think you would get raised inflammatory markers with arthritis

[daw50]

Thank you Bowler. My ESR was 88 on dignosis. What a difficult disease for the doctors to diagnose and for us to live with at times.