INFLAMMATION

[joat]

Saw the Rheumy nurse yesterday who said I had no inflammation and that my CRP was 5. I said I had hoped it would be lower and then she replied that for my age the range was 0-5 and I was at the top. Am I wrong in believing that I have inflammation?

[PMRpro Ambassador]

Really need to know more context to comment.

If you are on enough pred to manage the inflammation then your figures will be low. The truth is found by the lowest level you can get to yourself- not the fact the figure is "within normal range" That applies for a large population of healthy people, it isn;t the figure any one person can have and it be OK.

[joat in reply to PMRpro]

I am on 7mg a day for GCA having slowly reduced from 10mg after a flare a couple of months ago.

I know that the Pred is doing its job but it was the nurse saying that I had no inflammation that confused me as I believed CRP at 5 showed inflammation.

[PMRpro Ambassador in reply to joat]

It might. It might not. It depends what YOUR personal normal is. And there are differning normal ranges - what does you local lab say? But far more important is: do you have symptoms? Other things affect CRP, not jsut GCA.

[joat in reply to PMRpro]

Thank you to those who replied. Should have spent more time thinking why Nurse said no inflammation. ESR was 12 so all is going the right way.

[PMRpro Ambassador in reply to joat]

Yes - keep a note of the numbers. If you are really nerdy-inclined draw a graph. As long as the trend is downwards it is all good. A single raised number without a return of relevant symptoms shouldn't cause a fuss either - it should be redone a week or so later. If it is continuing to rise, a closer look may be called for.

[kulina in reply to PMRpro]

Yes, I keep a graph and record CRP and ESR, the meds that I take at the time and how I feel. Looking back, it is all very interesting to see how a simple sinus infection can raise the numbers, etc.

[joat in reply to kulina]

I started a daily record of how I felt and what I was able to do from the start of taking Pred and I also get printouts of my blood results. Use it to remind me that I am better than I was this time last year!!

[Christophene in reply to joat]

We also need to remember that a blood test is out of date quickly; about 3 months. If you are interested in a trend, and you don't mind doing it, it's fine.

[PMRpro Ambassador in reply to Christophene]

It can be out of date in a week if anything happens.

[Christophene in reply to PMRpro]

You're so right.

[DorsetLady PMRGCAuk volunteer]

If your GCA is still active - which is highly likely, then you are producing inflammation every day - BUT the Pred you are taking is controlling it.

So the nurse is not quite correct - you probably do have inflammation - but not enough to cause a problem - and that’s good - it shows the Pred is working.

The only time you will know you have NO inflammation is when you come off the Pred and your readings are still within the normal range.

[HeronNS]

I always get worried when I see other people worried about a CRP number much lower than mine has ever been. I only got into single digits this year in February and haven't had any tests since then... . My doctor says the number is fine, but who knows?

[Christophene in reply to HeronNS]

Yes, who knows with this disease; it seems very mysterious to me. Why did I feel super good for 6 weeks, and now blah again.

[PMRpro Ambassador in reply to Christophene]

Possibly because, like most autoimmune disease, the underlying disease activity varies over time? And is influenced by other things going on in life that poke at the immune system? From the common cold to stress - but that aspect probably does vary a lot depending on the person.