Rising CRP and ESR

[Buchanan16]

Following on from my post couple weeks ago I have just had my mums latest bloods and her CRP has now risen again from 12 to 15 and her ESR from 29 to 34.I've just spoken to our doctor who has been great and he has said he would like it repeated in 2 weeks again but he doesn't want to rush into increasing her steroids as she is still looking well and feeling okay.

He said that her ESR is still within normal range albeit not normal for her and lots of things can cause it to rise and although her CRP has also risen it's a slow rise given it was over 300 when diagnosed.

He did say that if she starts to feel unwell or shows any signs of pmr/gca to call him back and we can increase steroids to get it back under control.

I'm happy to go with his guidance just now but just wanted to get your thoughts. Do you think we are OK to wait couple weeks till next test. I do think I panic a bit especially as my mum is happy to leave it all in my hands.

The only other thing is my dad is due to go in on Monday to get a squamous cell carcinoma removed from his face which he has been told not to worry about as it will be straightforward but I know both him and my mum are worried about it so maybe that's contributing to her numbers who knows.

As always I appreciate all support provided from this wonderful group.

[SnazzyD]

If it were me, I’d go with the GP. They have, to their credit, acknowledged that your mum will have her own personal coasting level and it isn’t normal for her. A repeat is a good thing because it will show a possible rising trend rather than a blip. The GP is ready and willing to increase Pred if any symptoms arise.

You say she is feeling well. Is that in all ways? As you probably know, ESR/CRP aren’t specific to PMR/GCA.

[Buchanan16 in reply to SnazzyD]

Thanks SnazzyD my gp called me right back when I queried results and I know if I've any issues I can call him right away. My mum is looking better than.she has since diagnosis and feeling well apart from usual aches an 87 year old gets she says.

I'm not sure what's causing rise I just hope it doesn't continue and settles down over next couple weeks.

[piglette]

It really depends how your mother feels. If she is feeling fine, things should be OK. If she has started a cold for example, her readings could go up.

[Buchanan16 in reply to piglette]

She is feeling well in herself and looking great just now.

[PMRpro Ambassador]

I think you have a very good GP there - he is saying the same as I would say.

DL will tell you - the stress of a poorly husband sent her markers up!

[Buchanan16 in reply to PMRpro]

Yes he is really good and my mum is a worrier so it could be that.

[DorsetLady PMRGCAuk volunteer]

As PMRpro has said my markers went up with late hubby - mis/late diagnosis of terminal liver cancer on top of long term coronary issues -many months trying to convince doctors it wasn’t what they assumed… but what would a spouse know!

My GP panicked [understandably perhaps considering her previous performance] with high reading although no symptoms whatsoever and increase Pred… I never did have any symptoms of a flare… but the Pred may have helped me cope better on the mental side, so heigh ho.

So do agree her GP is being sensible and monitoring situation. Hope all goes well with your dad’s procedure - and hopefully that will have the desired effect on your mum’s readings…

[Buchanan16 in reply to DorsetLady]

Thanks for this yes I'm hoping that's mayb been something to do with the rise as I've mentioned before my mum is a terrible worrier so hopefully when my dad has had his procedure she will calm down. Hearing her counts are up a bit is enough to have her panicking and wondering what that means and if she needs to up pred what will rheumy think when we see her in March as she was wanting her of steroids by then and my mum is terrified of upsetting her. I've tried reassuring her that if we need to increase pred it will be with our gp approval and she's not to worry.

[Buchanan16 in reply to DorsetLady]

Can.i ask did your readings increase by much?

[DorsetLady PMRGCAuk volunteer in reply to Buchanan16]

ESR only tested -and they went from low teens to high 30s -I’m away from home at moment so can’t give accurate figures -only have iPad/iphone

..actually just remembered this post - 😊

healthunlocked.com/pmrgcauk...

[PMRpro Ambassador in reply to DorsetLady]

So you also don't know if she's got a bit of a cold or anything?

[Buchanan16 in reply to PMRpro]

she doesn't seem to have anything .

[Buchanan16 in reply to DorsetLady]

Thanks for this DL made really interesting reading and the fact that like my mum you didn't have any return of gca symptoms.As I said our gp has been great since diagnosis very attentive and always at end of a phone or face to face app any time we need him but that may be down to fact that like yourself the whole surgery missed the warning signs of pmr and then gca by treating my mum for long covid for 9 months just giving various pain killers until she wakened up blind in one eye and we rushed her to hospital where consultant ophthalmologist immediately diagnosed gca.

Since then they have been super attentive to both my parents.

[PMRpro Ambassador in reply to Buchanan16]

Funny that!!!!

[PRL1957 in reply to DorsetLady]

HI, DL,

That is an interesting and informative post. Raised ESR and CRP might 'just' be a bodies response to other 'stuff' that is happening - not PMR/CRP.

Two weeks ago, I had some 'bloods' done. I skipped gleefully to the GP surgery (well, walked carefully - there was snow and ice on the ground), expecting to have a nice set of 'normal' results, since my PMR seems to have gone now. (I have been off prednisolone for 9 months.) Indeed, most of my results came back within normal bounds, but my CRP and ESR were 25 and 35.

In the absence of any other obvious causes, I put it down to having got over a bit of a cold a few days before the blood samples were taken.

By the way - I love the picture at the top of your post! But how on Earth would you hope to get two cats pulling the chariot in the same direction? Talk about herding cats...

[DorsetLady PMRGCAuk volunteer in reply to PRL1957]

More than likely effects of cold…tht wht we always question why some doctors put so much credence on them…

Cats … you forget we Viking goddesses have magical powers - even with cats…😺

[PMRpro Ambassador in reply to PRL1957]

The correct procedure is to repeat the blood in a week or two - is there a rising trend? But a one-off rise is just that.

[Persevere99]

Hi

Devils claw, a herbal anti inflammatory, reduced my Crp in 2 weeks.

All the best

Persevere

[DorsetLady PMRGCAuk volunteer in reply to Persevere99]

Whilst DC may have worked or you, we always suggest that patients check for issues when considering taking herbal medicine alongside prescribed ones.

Devils claw should not be taken with many medications and don’t think Buchanan16 Mother who has other issues should be taking anything without first checking for interactions.