GP appointment and blood tests - will recent steroid injection skew results?

[MsWhistledown]

Afternoon everyone,

I had a GP appointment yesterday to discuss my symptoms. Went through everything that has happened since the summer.

She sent me for blood tests today which included CRP, ESR, Rheumatoid factor and various other tests relating to autoimmune conditions. She insisted I call back for review even if tests come back normal for referral to Rheumatology.

Will the fact that I had a steroid injection 13 days ago skew the results do you think? Will it have reduced the inflammation in my system, even though I am in quite a bit of pain still…?

Many thanks.

[PMRpro Ambassador]

The steroid injection may well damp the inflammation markers - what sort of injection was it?

[MsWhistledown in reply to PMRpro]

Unfortunately, I cannot remember. The doctor did tell me exactly what it was but I have forgotten it already. I think I was in so much pain that day that I wasn’t taking much in.

Would a high platelet count in a full blood count test point to PMR or GCA? I have already received RBC back after blood test this morning. And although I don’t have the lab ranges yet I am pretty sure UK ranges are around 100-400 or 450. Mine has come back as 489….🤔

[PMRpro Ambassador in reply to MsWhistledown]

I don't think that is a level for concern really - pred itself increases the level of platelets in the blood. They get concerned about high platelet counts in the context of certain conditions and other test results or when they don't know WHY it is high. You are on pred - that is why. And they are testing for other things.

[MsWhistledown in reply to PMRpro]

Thanks PMRpro. I’m not on pred. Apart from the steroid injection 13 days ago and the steroid shot In September I don’t take regular steroids. But I expect the steroid injection could have caused similar effects?

[PMRpro Ambassador in reply to MsWhistledown]

It would - it is most apparent shortly after the dose.

[MsWhistledown in reply to PMRpro]

My blood test results have returned with some results highlighted for a “routine appointment.”

ESR 21.00 1.00 - 12.00mm/hr High

CRP <1. 0.00 - 4.90mg/L Satisfactory

Serum ALT level 6 U/L. 10.00 - 35.00U/L Low

Platelet count 489 10*9/L 140.00 - 400.0010*9/L high.

Rheumatoid Factor <10 mIU/L 0.00 - 13.90mIU/L Satisfactory

I am having some nausea and low grade headache symptoms as well a long with the neck and shoulder pain.

[PMRpro Ambassador in reply to MsWhistledown]

There is nothing there that could be said to be very typical of PMR except the raised ESR but even that is extremely non-specific. There are other things the GP should look at too but even if you demand a rheumy appointment I doubt you will get to see anyone very quickly at present and they may even reject the referral - which they are entitled to do so it pays for the GP to do all the relevant tests before referring you. Vit D, vit B screen, anti-CCP, are amongst the things I'd like to see done and corrected if applicable first and there are others no doubt.

[MsWhistledown in reply to PMRpro]

Thanks PMRpro. Will see what they say when I call for the review as the GP insisted. I’m waiting for the anti-CCP result which was on the list of blood tests done yesterday but it hasn’t come through yet.

[PMRpro Ambassador in reply to MsWhistledown]

Fair enough - that will take a few days with turnrounds varying from 3 to 7 working days. Do you know what else was done?

[MsWhistledown in reply to PMRpro]

They did thyroid function, renal profile, liver function, full blood count along with the others I have listed. I think there were a few others with the anti-CCP but can’t remember exactly what they were. Should have noted them down.

[Omakaat]

Well, this is just my personal experience, but a high platelet count in a blood test, always confirms a flare of GCA and PMR. But I take pred all the time, so my inflammation markers are barely raised.

[MsWhistledown in reply to Omakaat]

Thanks Omakaat. I will have to discuss with my GP and also look at the other results as well. I will still insist on being referred to a Rheumatologist regardless of what they might say.