PMR symptoms but low CRP levels: Hi ... I haven't... - PMRGCAuk

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PMR symptoms but low CRP levels

Chokkers
Chokkers

Hi ... I haven't posted before but I had a diagnosis of PMR and GCA in April 2018. Since then it has been the usual roller coaster of Pred and I am now on Methotrexate subcut injections 20mg as well as 3.5mg Pred. My last few blood tests have shown that my CRP level is 5 but I am still experiencing PMR type symptoms of pain and stiffness. My rheumatologist says that if my CRP is so low it can't be PMR symptoms and it must be something else. Is anyone else having the same experience. I am really puzzled.

Rosy

10 Replies
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DorsetLady
DorsetLadyPMRGCAuk volunteer

Hi Rosy,

Afraid by your Rheumy may be wrong...blood levels don't always have to be raised - in fact in up to 20% patients never are.

Do you have enough tablets to try and go up to, say 5 or 6mg for a few days and see if that makes a difference? 5 days should give you the answer - if you feel better then the odds are PMR, if not then it may well be something else.

Whatever the outcome, you can then drop back down to 3mg if no better, or 4mg if there is some difference. If you do notice a difference so, then can I suggest you use a slower taper - by 0.5mg per time and maybe stagger it like this -healthunlocked.com/pmrgcauk...

Chokkers
Chokkers in reply to DorsetLady

Hi Dorset lady, I can never really remember a time not being stiff and sore even on a high dose of Pred. I am definitely going to discuss the possibility of adrenal insufficiency when I see my rheumy next month. Thank you I appreciate your reply.

PMRpro
PMRproAmbassador

I have NEVER had a raised CRP and the ESR was never out of normal range despite awful symptoms. Some people may have raised levels initially but if they flare while on pred they never develop the acute response (the posh medical name for the ESR and CRP going up). No-one knows why, it is just so.

However - has he bothered to do a synacthen test to assess your adrenal function? If they are not starting to top up the pred dose it is possible you are suffering secondary adrenal insufficiency and very occasionally patients suffer from muscle and joint pain as well as the more common fatigue etc.

Chokkers
Chokkers in reply to PMRpro

I have an appointment with my rheumatologist next month. I will discuss adrenal function with him. Thank you for your response.

My CRP was always very low, between 1-2 and I was still told I have PMR

Chokkers
Chokkers in reply to mepoly20

Thank you.

My CRP and ESR have never been high except on one occasion with an infection. I have PMR & GCA and my old G.P. felt that I had very mild PMR because of my low blood results 😱😱xx

PMRpro
PMRproAmbassador in reply to Jackoh

What makes them think it is mild because markers are low? You'd struggle to find much lower than mine - 16 (I think) years later ... Maybe I'd rather have had a shorter sharper version ...

Jackoh
Jackoh in reply to PMRpro

Yes my ESR at its highest was 18 and has always been about 10/11. I’m just really glad to say it was my OLD GP, we didn’t really get on too well 😜

PMRpro
PMRproAmbassador in reply to Jackoh

OLD as in former, ex ... ;)

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