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CRP Levels determine treatment?

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Crohn's Disease
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nikki0294
Regular Member
Joined : Sep 2007
Posts : 219
Posted 9/17/2007 6:20 PM (GMT -8)
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)

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athensgirl
Regular Member
Joined : Apr 2007
Posts : 254
Posted 9/17/2007 10:56 PM (GMT -8)

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

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CrohnieToo
Veteran Member
Joined : May 2003
Posts : 9448
Posted 9/18/2007 6:50 AM (GMT -8)
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.

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onebloodonelife
Veteran Member
Joined : Feb 2006
Posts : 842
Posted 9/18/2007 7:53 AM (GMT -8)
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.
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immunosci
Regular Member
Joined : Jun 2006
Posts : 326
Posted 9/18/2007 8:03 AM (GMT -8)
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
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nikki0294
Regular Member
Joined : Sep 2007
Posts : 219
Posted 9/18/2007 8:30 AM (GMT -8)
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
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CrohnieYogi
Regular Member
Joined : Oct 2006
Posts : 389
Posted 9/18/2007 8:42 AM (GMT -8)
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!
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immunosci
Regular Member
Joined : Jun 2006
Posts : 326
Posted 9/18/2007 8:54 AM (GMT -8)
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
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