Different CRP readings: Different CRP readings. One... - PMRGCAuk

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Different CRP readings

Nap1 profile image
Nap1
19 Replies

Different CRP readings. One CRP reading was called cardiac and it was 9.35 high other CRP reading was called quant which was 9.8. Both of these do not look anything like what I have done at the hospital these two were done by lab core. And the last one done at the hospital was 0.34 and the normal is 0.80. My rheumatologist says the first two readings are normal they sure don't look normal to me I went back to the hospital on Thursday and just had an ESR and CRP and hope to have those numbers tomorrow. Pro you said the numbers were high and they did seem high to me. Rheumatologist says they are normal but this is the guy who thinks that 45 on a sed rate is normal to the same guy who had four patients go blind. I did raise the Prednisone to 12 and I started taking something for the tension which helps for about six hours during the day and I take the Klonopin as well at night. I would love to know how the equation is figured out when it is converted because if you don't take your blood tests at the same place you never know what they really are and less you know the conversion... you walk around like an idiot like me. If the hospital now on is 0.80 perhaps one of those numbers are correct and I am a little high. Can you give me some insight please. Thank you

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TooSore profile image
TooSore

Do either of the results give you a normal range? I ran into something similar when looking at rheumatoid factor. Luckily my sister is a med tech and was able to explain that the results differed because the labs used different tests. Both were negative even though the numbers looked very different.

You'll know more tomorrow and maybe your gp can help explain the tests?

PMRpro profile image
PMRproAmbassador

Sorry - I'd need a lot more information to comment on that. Just numbers doesn't mean anything. You need to know the units and the lab's own normal range - which should always be quoted in brackets after the result. As TooSore says, different labs use different techniques and even using the same techniques the results may have slightly different normal ranges (which is due to their quality control, the exact set-up of their equipment and whether the Pole Star was in alignment with Capricorn while the wind was from the west..) Seriously though, it is far better to always use the same lab if you can and to check the ranges every time. Even the same lab will change the equipment and the patient may not get a notification.

I think that if anyone claims a sed rate of 45 is normal their judgement is perhaps questionable. And anyone who has had 4 GCA patients lose their sight should perhaps be avoided?

Nap1 profile image
Nap1 in reply to PMRpro

Finally got the numbers from the Hosp that I understand CRP is 2.38 normal is 0.80. High and went up in 2 weeks from 0.34. ESR is 19 norm is (0-30). I'm comfortable with the ESR two weeks ago it was at 25. I did go up to 12 mg of pred. based on the CRP. Should I stay on the 12 for while. It's unusual for my CRP to go up like that Thanks.

PMRpro profile image
PMRproAmbassador in reply to Nap1

Have you got a cough or cold? That increases CRP too.

The generally received wisdom is that you should not increase a dose on the basis of a single elevated reading. You should repeat it and see if there is a trend. And if you have reduced the dose, check the bloods to be sure they haven't risen, So yes - I'd give it a few days, and if you have no symptoms of anything there is no reason not to try a SMALL reduction.

Nap1 profile image
Nap1 in reply to PMRpro

Thanks. I feel good. Taking klonipin in am and pm. It helps with the awful stress of building a house without me there. Finding new docs. And furniture buying. My heart rate also Did a flip flop from 60 to 90. No apparent reason. I'm keeping an eye on that. BP is good. Getting close to moving date. Actually can't wait for new group. of docs. One that doesn't think 45 sed rate is normal. Will watch CRP and heart rate.

Nap1 profile image
Nap1 in reply to PMRpro

Pro got the CRP which I understand and it was 2.38 and the norm is 0.80. ESR was 19. I am not sick I am just stressed out. But I just learned today that I have to go for a Brest ultrasound. Just a little more to stress me out. The Clonopin works well. Rheumatologist put me on 20 for a few days I started today. I think that's too high what do you think And if I stay on 20 for a few days I will take another blood test And hope it goes down. If you too think 20 is too high please tell me. Really don't know what to do. Now having to do the ultrasound that might be another reason for the CRP to be high. Terrific Please write soon thank you

PMRpro profile image
PMRproAmbassador in reply to Nap1

20mg is a perfectly normal starting dose for PMR. I'm sure the rheumy had a reason but you would have to ask him! Usually they are desperate to reduce so he must have something in mind!

Nap1 profile image
Nap1 in reply to PMRpro

Pro when I saw him on Wednesday with the CRP that I believe he didn't understand I went up to 12mg from 11. he told me to reduce because he did not understand the CRP. It was high when he told me to reduce.The next day when he received his CRP done by the method he's familiar it was 2.38 normal 0.80. he then told me go up to 20. I'm afraid since this is the doctor that had four patients go blind that he is jumping the gun by upping to 20. What I would like to know from you is when I get into the normal range what can I safely go down to and how long can I be on 20 before a quick reduction. He is on vacation for the next two weeks and his office is totally unfamiliar with GCA. ESR is 19.

PMRpro profile image
PMRproAmbassador in reply to Nap1

There is no answer I'm afraid! The only way you can know is by re-checking the CRP or just going by symptoms. He's disobeying the basic rule - no knee jerk reaction to a single reading with no symptoms. Once your CRP is down you can start to reduce - but you will have to keep checking the CRP (if that is what you are going by) as you reduce. 20mg isn't a particularly high dose, if he is away for 2 weeks you could try 15mg and see what that does first, He won't know will he...

Nap1 profile image
Nap1 in reply to Nap1

Hi. Went to 20 when CRP was 2.38 norm o.80 ESR was19. Norm 0-30. Now after 3 days of 20 CRP is 1.5 and ESR is up to 34. GP thinks rheumatologist jump the gun going to 20. Rheumatologist on vacation GP thinks go down to 15 . Had 4 days on 20. Don't know why ESR moved that quickly . 8 days prior 19. What do you think CRP going down ESR going up

PMRpro profile image
PMRproAmbassador in reply to Nap1

Typical! I agree with your GP to be honest.

Nap1 profile image
Nap1 in reply to PMRpro

Tomorrow it's 15 and let's see what happens. Hate going down when ESR is 34. And CRP is not normal yet but just maybe theirs was all a glitch. Thanks PRO. Let's all have a good weekend.

Nap1 profile image
Nap1 in reply to Nap1

Well didn't reduce from 20 to 15. Having a problem with stress and I think the PMR is back. Having shoulder and neck pain which I haven't had in years. Also could be the stress. Having fatigue and in general I don't feel well. If the ESR was it 34 and the CRP 1.58, maybe I should stay on 20 a little longer. I am just plain scared and confused. SUgar went crazy and I do not eat carbs. Might be some of the supplements and of course I went up on the predisone. This move to New Jersey was not supposed to be so stressful. What do you think about staying on 20 for a while. Will take another blood test Tuesday which would have given me 8 days on 20. Let's see what the numbers say. Mine are usually on target. Thank you. Thought I could get through this weekend without writing.

PMRpro profile image
PMRproAmbassador in reply to Nap1

You really do need to discuss this with a doctor - if the PMR symptoms are increasing despite the pred dose it could be one of at least 2 things: it may be progressing to become full-blown GCA, PMR can be a symptom of GCA and some patients do go on to have the diagnosis of GCA made. Or it suggests it isn't PMR at all but some other illness causing the PMR symptoms.

Nap1 profile image
Nap1 in reply to PMRpro

Pro if you recall I have had full blown GCA since June 2015. It's been under control and reducing nicely up until two weeks ago when I went from 11 mg to 10. That along with the stress is what did me in. I have been reducing by .5 mg a month. Had one blip where I had I had a cold and root canal but things went back to normal. It's just this two week period of extreme stress that has put the numbers up and the achiness can be the PMR which would not be unusual. Rheumatologist on vacation and my real question is if numbers are coming down towards normal is it dangerous to reduce from 20 mg to 15 mg after being on the 20 only eight days. I started on 40 almost 2 years ago when diagnosed with GCA.

PMRpro profile image
PMRproAmbassador in reply to Nap1

I don't think I would reduce from 20 to 15 in one go - I would go via 17.5mg. At most I would drop to 17.5mg for the moment and I would wait until the blood test to do it. Once the stress of the move is past you can look at it again.

You cannot do it all AND reduce your pred dose - you have to compromise somewhere.

Nap1 profile image
Nap1 in reply to PMRpro

Thank you

Nap1 profile image
Nap1 in reply to Nap1

Omg yesterday ESR up t 43 and CRP 2.08. Was on 20 for week. Just took 30. Can't seem to get this under control. 5 days prior ESR 34 and CRP 1 58. That's a quick jump. Can't believe I'm doing this with stress of the move. But must get this under control. Rhumy still on vacation. GP ok with 30. Should I have tried 25 first? I did panic. Eyesight can go at any time. What do you think. 25 or 30. It's just moving fast for me. I do not have scalp or headache pain.

PMRpro profile image
PMRproAmbassador in reply to Nap1

Listen to your GP - he can see you.

The ESR and CRP are just guides - it is the symptoms that are most important. Accept the 30mg and stop worrying - because that just adds to it all. Get the move done, whatever dose you need to do it.

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