CRP vs. Sed Rate and Disease implications

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jeanneac
Veteran Member


Date Joined Feb 2009
Total Posts : 1812
   Posted 7/18/2010 10:36 AM (GMT -7)   
My Nurse Practitioner was looking over my lab results. SHe said she wasn't real worried about my having lupus b/c my CRP was normal. My sed rate however, is elevated. She felt the CRP was more indicative or sensitive than the sed rate. Any thoughts about this?? My rheumy didn't work up my positive ANA with further tests for lupus, just for sjogrens and scleroderma, which were negative.
d 1/09 with colitis sigmoid colon with some diverticular disease as well
IBS, high BP, fibromyalgia, Mixed Connective Tissue Disease
claritin, diovan, progesterone, VSL#3 probiotic, Vit. D, colazal, plaquenil, nexium for reflux, wellbutrin, 5 mg prednisone/day.
Blood test positive for Crohn's via prometheus ibd serology panel ASCA
Positive ANA, LOTS of joint pain followed by a recent set back with the colitis.


Bsime
Veteran Member


Date Joined Apr 2006
Total Posts : 1298
   Posted 7/18/2010 2:41 PM (GMT -7)   
That's true but elevated SED rate is always a red flag.  How you feel is the best indicator of disease activity....REGARDLESS of what the labs say.
 
If you have been diagnosed with mctd you probably will have lupus symptoms if you don't already but every case is different.  Lupus hit me pretty hard but polymyositis nearly did me in and crippled me.  Scleroderma was nothing except for raynauds. 
 
5 years later I am in remission and lead an active life despite all the damage done to my body...mainly muscles.
 
I would advise you not to fuss over every lab but be alert to changing or new symptoms.  You are only on 5mg of pred which is a very low maintenance dose and plaquinel which is not one of the stronger meds to control mctd.  If you are doing OK then you are lucky to have a mild case that is controllable.  Like I said enjoy life but be alert to new symptoms.  If you develop lupus symptoms most likely you will know long before it registers in your labs.  An elevated sed rate just says that some inflammatory process is going on but not necessarily lupus.  Sed rate is not disease specific.
 
Bill
MCTD (lupus, scleroderma, polymyositis).  Diagnosed 2005.  Kidney, liver, GI tract, dysphagia, raynauds, Barretts esophagus, quadriplegic in 2005.  Recovered and now active in skiing, tai, chi, hiking, golf.  Meds: prednisone 2.5mg, imuran 25mg, amlodipine, benazapril, omeprazole, potassium, folic acid, vitamins, maxide and various supplements and vitamins.
 
Remain optimistic and you can overcome the odds.


jeanneac
Veteran Member


Date Joined Feb 2009
Total Posts : 1812
   Posted 7/18/2010 5:05 PM (GMT -7)   
I felt like she was trying to dismiss me a bit since my CRP wasn't elevated-:) I see a NP for my basic things and have a rheumatologist but I did want to check out what she said about the CRP. She probably didn't know what she was talking about.
I think we've caught these things in the early stage for me. But I am very symptomatic with joint pain, some muscle pain and fetigue. The 5 mg of prednisone and plaquenil are not keeping things quiet for me either. He had me on 10 mg for just a week before he tapered me down. I just want to feel better-:) Tired of feeling bad.
Sounds like you have made a remarkable recovery since 2005. That must have been very scary for you.
d 1/09 with colitis sigmoid colon with some diverticular disease as well
IBS, high BP, fibromyalgia, Mixed Connective Tissue Disease
claritin, diovan, progesterone, VSL#3 probiotic, Vit. D, colazal, plaquenil, nexium for reflux, wellbutrin, 5 mg prednisone/day.
Blood test positive for Crohn's via prometheus ibd serology panel ASCA
Positive ANA, LOTS of joint pain followed by a recent set back with the colitis.


Bsime
Veteran Member


Date Joined Apr 2006
Total Posts : 1298
   Posted 7/18/2010 6:15 PM (GMT -7)   
I was too busy trying to deal with being a quadriplegic with a feeding tube.  Just was not ready to be totally disabled without a fight.  I was very fortunate to have great docs and therapists who helped me to get vertical and independent again.  For the past 4 years I have been rehabbing on my own and made a one of a kind recovery given the extreme nature of my case.  Life is good.
 
You should not be dealing with a nurse practitioner.  Most rheumys only see a handful of mctd cases in a career and they are complicated, unpredictable and require a doctor with experience and interest in treating you.  I would seek a second opinion from an experienced rheumy.
 
If you feel like crap, you are sick...regardless of your labs.  Your nurse practioner is well intended I am sure but way out of her pay grade.  I had 2 rheumys with 25-30 years experience each who called in a world famous clinical researcher to consult on my life threatening case.  Few cases of mctd are like mine but any AI disease can be complicated and potentially life threatening. 
 
Bill
MCTD (lupus, scleroderma, polymyositis).  Diagnosed 2005.  Kidney, liver, GI tract, dysphagia, raynauds, Barretts esophagus, quadriplegic in 2005.  Recovered and now active in skiing, tai, chi, hiking, golf.  Meds: prednisone 2.5mg, imuran 25mg, amlodipine, benazapril, omeprazole, potassium, folic acid, vitamins, maxide and various supplements and vitamins.
 
Remain optimistic and you can overcome the odds.


jeanneac
Veteran Member


Date Joined Feb 2009
Total Posts : 1812
   Posted 7/18/2010 7:45 PM (GMT -7)   
Thank God for modern medicine and good docs that got you well.


I do see a rheumatologist with many years of experience (he's in his 70's) but I also have a primary care nurse practitioner. She likes to see my lab work. Why I don't know, I wasn't there for anything rheumatological-:) I just needed my TSH done! Still, for a PCP I need a real doctor. She is sweet but like you said, out of her league. That accompanied with the 2 hour waits in her office make me want to change. My challenge is that I live in a small town and there aren't a lot of docs here. I am glad the rheumatologist doesn't rely on just the labs but I wonder if he will be reluctant to put me on heavier meds with just a positive ANA. It takes the plaquenil such a long time to work.
d 1/09 with colitis sigmoid colon with some diverticular disease as well
IBS, high BP, fibromyalgia, Mixed Connective Tissue Disease
claritin, diovan, progesterone, VSL#3 probiotic, Vit. D, colazal, plaquenil, nexium for reflux, wellbutrin, 5 mg prednisone/day.
Blood test positive for Crohn's via prometheus ibd serology panel ASCA
Positive ANA, LOTS of joint pain followed by a recent set back with the colitis.

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