High and persistent C-RP blood results, but no classic PMR symptoms

[Marinescience]

Hi all: Following the excellent advice here, I have been tapering quite successfully and was at 0.75 mg/week when my CRP blood work was high, and did not come down as I increased prednisone to 2 mg/day. I do not show any classic PMR symptoms, except background headaches with a pulsing characteristic which seems to reflect my heart rate. My (very good) GP spoke with a rheumatologist, who stated that in rare cases, areas of localized inflammation can persist over the course of the disease. I see the rheumatologist Jan. 30, and I understand he will be checking for localized inflammation, possibly using some form of CT scan.

My questions: is this localized inflammation known in this Forum? If so, what are the treatments? Finally, I believe the inflammation may remain in my head (I did have GCA at the beginning of the course of the disease). Is it reasonable to live with such inflammation for a further six weeks or so before I see the rheumatologist?

I show the CRP results and the Prednisone dosages over the last three years in the attached graph below.

Thanks in advance for your thoughts.

[piglette]

Inflammation can occur for all sorts of reasons. Even a cold. The real question is how do you feel? I have had raised CRP and ESR ever since I was diagnosed with PMR. This is my graph.

CRP GRAPH

[Marinescience in reply to piglette]

Thank you! PMPro had also reminded me of this back in October, and she and others pointed out it could be a cold or other infection. But since then, I have spent about five weeks in New Zealand relatively symptom-free (apart from pulsing head-aches), and my blood work upon return indicated a persistent high CRP level. So the period of high levels extends over about two months, too long for a cold I think.

When my tapering was going well, I was pretty much symptom-free and with a low CRP level. The unexplained increase is a little bothersome, but I will await the final verdict from the rheumatologist.

[piglette in reply to Marinescience]

No one has ever found the reason for my inflammation markers going up and down. As you can see one spike is over 120.

[PMRpro Ambassador]

CRP is not specific to PMR/GCA - many things can raise it and some people simply have a high level without being able to identify why. And you aren't alone here - as piglette has demonstrated.

I, on the other hand, have only once had a raised CRP: on a day when I had severe arrhythmia episodes.

[Marinescience in reply to PMRpro]

Thanks PMRpro, I understand the point. It certainly would a step forward if the research community came up with a more specific marker! Have you heard of others speaking of localized inflammations, as my rheumatologist has been suggesting?

[PMRpro Ambassador in reply to Marinescience]

Not that I can remember - must have a look around ...