CRP Levels determine treatment?

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nikki0294
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 9/17/2007 7:20 PM (GMT -7)   
Just got off the phone w/ the new gi and he said it looks like severe inflammation as he reviewed the slides.  I was dx 3 wks ago.  He said the CRP was normal and wants me to find out if that was the case from diagnosis as well.  If the CRP and sed rates were normal than remicade might not be the way to go and he would use 5asa's and antibiotics.  He said it was ileal disease mostly.  I am trying to find some info on CRP and outcome or course of treatment using these predictors but haven't been able to come across this.  Anyone have any info on this???
Thx
Chris (newbie trying to find her way through this Crohn's maze)

athensgirl
Regular Member


Date Joined Apr 2007
Total Posts : 254
   Posted 9/17/2007 11:56 PM (GMT -7)   

When I'm in a flare, my CRP is always elevated, together with the WBC.  My disease is also located in the terminal ileum, and I'm having blood tests every 3-4 months just to be on the safe side, and not let the situation get out of control.  Why does he want to try Remicade so soon?  My GI told me that Remicade is used only if all the other medicines have failed, but then again maybe here in Greece they handle Crohns differently.

Anyway, try not to stress too much about it.  The sure thing is that there are a lot of options, it just takes some time to find what's right for you.

Christina

 


CrohnieToo
Veteran Member


Date Joined May 2003
Total Posts : 9448
   Posted 9/18/2007 7:50 AM (GMT -7)   
CRP = C-Reactive Protein. Unreliable as the only method of determining disease activity. As is the Sed rate (ESR) blood test. They are just two of the tools doctors use to monitor disease activity.


You can read about these two tests and others at:

http://my.webmd.com/hw/health_guide_atoz/hw43353.asp

or

http://labtestsonline.org/
 
Here in the US many gastros are real excited about the potential of the biologics to treat IBD and are changing from the step-up approach to treating early IBD aggressively.
 


Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.

Post Edited (CrohnieToo) : 9/18/2007 8:50:58 AM (GMT-6)


onebloodonelife
Veteran Member


Date Joined Feb 2006
Total Posts : 842
   Posted 9/18/2007 8:53 AM (GMT -7)   
My GI has realized that my CRP and SED rates are virtually never elevated, and that for me, they're not reliable at all for monitoring disease activity.
Crohn's Disease for a year and counting
Imuran: 150mg
Humira: got 4 shots on 9/12, still technically waiting for approval from my insurance
Dicyclomine and hyoscamine for intestinal cramping and spasms
www.myspace.com/onebloodonelife
http://studentwebs.winona.edu/catraun4902 <--This link will be changing, but for now it works!


immunosci
Regular Member


Date Joined Jun 2006
Total Posts : 326
   Posted 9/18/2007 9:03 AM (GMT -7)   
My CRP and ESR are very seldom elevated either. It's frustrating when you feel crummy and the doctor says "Well, your sed rate is fine so the Crohn's appears to be mostly under control". We had quite a discussion about that at my last appointment. After looking back at my blood test results from when I was first diagnosed, he realized that my levels did't go up much then and conceded that it probably isn't the best measure of disease activity for me. Duh!

Jen
-Formal diagnosis of Crohn's Disease in ileum in July 2005.
-Experienced what were most likely flares for 12-15 ys.
-6-MP, protonix, cymbalta, wellbutrin, trazadone, miralax, allegra


nikki0294
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 9/18/2007 9:30 AM (GMT -7)   
Jen
Do you have ileitis or disease in predominantly the terminal ileum. Just curious. My CRP and ESR too weren't elevated. I am interested to find out if there is something about our disease that is different than crohns in the colon. Is it more aggressive or more indolent?? I know my doc said that Remicade might not be the best drug due to the lack of elevation in CRP despite severe ileitis. I wish I would have asked more questions when he called because I am so confused.

Thanks
Chris

CrohnieYogi
Regular Member


Date Joined Oct 2006
Total Posts : 367
   Posted 9/18/2007 9:42 AM (GMT -7)   
It sounds like you're on the right track looking for answers. Shortly after diagnosis I went into denial for about a year--and my disease progressed. I am one of the "lucky" ones who produces CRP. (If I understand my dr. correctly, some CD'ers produce it, some don't. And I am "lucky" becuase we can use it as a marker. Even when I am mild, my CRP and ESR are elevated. So it was a HUGE deal when my labs came back normal--for the first time since I was diagnosed.

You asked about the difference in disease when the location is different.... That's the thing about CD. It affects everyone differently. Mine is in the ilium and I have chronic consitpation--not D. The statistic is that only 30% of patients have joint pain--I am one of those lucky ones too.

Be sure to write down all the questions you think of before going back to the doctor. And don't leave the office until you've had the opportunity to ask all of them.

Good luck!

immunosci
Regular Member


Date Joined Jun 2006
Total Posts : 326
   Posted 9/18/2007 9:54 AM (GMT -7)   
Chris

When I was diagnosed my CD was only in my terminal ileum. At the time I was considered a mild to moderate case. I have been in what my doctor calls 'remission' for a little over a year. Until recently when the LRQ pain has returned sporadically (along with some mid-belly pain that's new) and the joint pain is back. I don't know if there is any correlation between CRP or ESR and disease location or severity. As CrohnieYogi said, we're all different.

Jen
-Formal diagnosis of Crohn's Disease in ileum in July 2005.
-Experienced what were most likely flares for 12-15 ys.
-6-MP, protonix, cymbalta, wellbutrin, trazadone, miralax, allegra

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