Can anyone help with explaining the different readings between ESR and CRP. For instance my ESR can go down to 34 (ref 1 -35)
from being high at 79 and my CRP is H 38.6 mg/l (ref: 0.0 - 5.0), from being high in the 80's 4 months ago. I realise CRP is inflammation marker. What I am asking, what is the difference between a lower ESR and having a high CRP on same blood test? or what could be the meaning of this?
My Dr could not explain this to me, maybe it makes little difference having one high and one low etc.
Track
I would say find another Dr.
They are both totally non-specific indicators of an inflammatory process going on in the body and actually I'm not surprised your doctor couldn't explain it - I doubt most people could!
ESR is measured by seeing how fast the red blood cells settle to the bottom of a tube - sedimentation rate - and it increases because various proteins coat the red blood cells and make them slippier. CRP (C-reactive protein) is one of those proteins the body produces in response to inflammation.
In fact - some people don't get one or the other (or both) increasing even in inflammatory diseases, mine have never budged from "normal range". A normal range of 1-35 is actually a bit old-fashioned, it is now thought that anything above about 20 suggests there is something going on. So if your "personal normal" is in single figures - it may be that 35 is still pretty high for you. Are you PMR symptoms all under control? Which is what is really important.
However - are they absolutely sure about the PMR diagnosis? I saw something recently suggesting a persistently raised CRP can be found in some autoimmune disorder or other - but having said that, I can't remember what it was. Mea culpa...
Track, two tests carried out in different ways but both reacting to inflammation in the body (they can go up and down at the drop of a hat, for instance with chest infections/viruses etc), and it seems that your ESR has returned to normal whilst your CRP is lagging behind. Many medics consider the CRP to be a more reliable marker of inflammation, and certainly in my experience, my CRP numbers often tended to lag behind the ESR during my PMR/GCA days. The inmportant thing is that your markers are heading in the right direction, so just ensure that you keep having the tests repeated, and certainly before each and every steroid dose reduction, to ensure that the readings remain on a downward spiral.
And I also have found a paper about a patient with a high CPR that was actually decided to be interference from something else in the testing! She had been investigated for 8 different other illnesses before that!
Ah, this might explain why my doctor selected to regularly check only ESR, not both.
Thank you Eileen I was waiting for your response, new you would have the correct response.
My PMR is now quite under control, only very small niggles in my legs and I have so much more energy now. Down to 7mg Pred. with the slowly does it method which has been very successful.
Thank you,
Track
Thanking you for your reply, much appreciated.
I am still having abnormal FBC's, seeing Haemotologist in a couple of weeks, this could be interfering as well with CPR results , I am having monthly FBC until I see the Haemotologist.
Hi. The way it was explained to me was that the ESR for some, gives a further look into the future compared to CRP. This is helpful if you can't decide whether aches and pains are flares or not, if ESR is falling hopefully they are not !
What's wrong with the FBCs?
Strange idea - since both are based on past events!
A good point Eileen ! Maybe better to say that the ESR is more current and CRP takes a bit longer to 'catch up' with state of play ?
Not necessarily - it also rises quickly in some cases. They are both so non-specific they are only very rough guides anyway.Unfortunately some doctors take them as gospel!
As everyone says, we all respond differently but so far my levels seem to follow this pattern. Hope I'm not tempting fate
What is most important is to establish how they work for YOU - YOUR normal range, your signs and symptoms. Some people have symptoms long before the bloods change, others never have a change while still on pred - and mine simply never changed! Normal ESR is 4, it did once reach the dizzy heights of 7. CRP never changes.
Thanks...No wonder we need this forum, I now wonder if I am right to ignore day long small to moderate muscle pains? Have never had the tiredness people talk about either ! I basically ignore the symptoms and am currently 10/11mgs alternate days for next 2/52
WCC and Platelets go up and down, neutrophils H, Lymphocytes L, Monocytes H, RDW High, MCHC L, MCH L, Dr is hoping Prednisone is doing this, have had this problem for the past 6 months. I am down to 7mgs of Pred. now, hoping to reach 4mg in a few months. No problem with my FBC when on high Prednisone only when lowering did it occur.
