ESR, CRP ???? Anyone know?

chile168
chile168 Member Posts: 384
edited 5. Mar 2010, 15:09 in Living with Arthritis archive
I have today received copy of letter from rheumy and it says ESR 23 which I understand it normal - thank god.

CRP is 4 - Anyone now normal range?

Was not too happy as she says "becoming quite disabled by condition" :(

Would be great if anyone knows.

Eve

Comments

  • annie_mial
    annie_mial Member Posts: 5,614
    edited 30. Nov -1, 00:00
    Eve, these are non-specific inflammatory markers and the details of the ranges vary from area to area and lab to lab.

    If you have neither of these markers raised, it doesn't mean you don't have arthritis.........just that there is no indication of which type it might be with these routine tests.

    There are more specific tests done now, but all inflammatory arthritis conditions are treated in much the same way, so in many cases the actual type is irrelevant.........they just want to get the symptoms under control as soon as possible to prevent as much joint damage as they can.

    In all the 10+ years I have had arthritis I have never had raised ESR and CRP levels, but I have two different kinds of arthritis at least plus another more serious condition arising from one of them. So I am classed as 'sero-negative polyarthritis', 'sero-negative = no raised inflammatory counts' 'polyarthritis = many kinds of arthritis'.

    This is a bit garbled, cos it's the first time I've tried to put it into words, but I hope it helps.

    Annie
  • jenzie06
    jenzie06 Member Posts: 708
    edited 30. Nov -1, 00:00
    I agree with Annie, they are inflammatory markers, the higher they are the more inflammation you are meant to have.
    My CRP marker last time was 32. Although just had a brainwave and looked at my maternity notes, its got my blood tests in the back apparently CRP between 0-10 is considered 'normal'.

    I did have one blood test which said my urate levels were 600+ (I think they got to 600 and didn't bother to count anymore). This led the medical student and over enthusiastic registrar to say I had Gout as well as RA and Fibro. Consultant said it was another indicator of inflammation (I was having a flare at the time so I believed him!).

    Is this of any help?
  • chile168
    chile168 Member Posts: 384
    edited 30. Nov -1, 00:00
    Hi girls,

    Thank you for your reply. It's late but I can't sleep.

    Most of the time she tells me my ESR is slightly raised and glad this time is normal even though my hands, knees and feet have been swollen solidly for two weeks. Was not too sure about CRP and since you have taken the time to explain that one, Im glad is also normal.

    Your replies are truly appreciated xxxxxxxxxxxxx

    Eve
  • clairy
    clairy Member Posts: 29
    edited 30. Nov -1, 00:00
    Hi,

    Like the others said the normal ranges do vary between labs (my G.P and Hospital use different labs both have different ranges), also things like if your male or female and you age etc can have an effect.

    For me my consultant looks for CRP <10 and ESR <15, but like i said different labs etc

    If you doc is saying that 23 is normal then i wouldn't worry to much, but next time you get bloods done ask them what the normal ranges are and they will be able to tell you what your lab ranges are.
  • chile168
    chile168 Member Posts: 384
    edited 30. Nov -1, 00:00
    Thanks Clairy that's a good idea hun.

    I have old copies of previous blood tests from GP and clear what was normal and what wasn't. My eyes popped out like this :shock: as I went through the list.

    The one from rheumy looks double dutch and don't understand it at all.

    Nice one hun x

    Eve
  • jennyanydots
    jennyanydots Member Posts: 49
    edited 30. Nov -1, 00:00
    Re the ESR inflammatory tests …..How can reference ranges be different across the country and why would they differ from area to area .. the condition is the same !... I am confused about this ... I have had raised ESR lots of times and different doctor seem to attach different amounts of concern about it … some say is normal and some say its a grey area !….

    I also have thyroid disease and have heard this said before about reference ranges differing with this condition... if they are going to say the tests are normal all of the time then why bother doing them …. Is there any point …. like one member mentioned on this thread that her feet and legs where visibly swollen but got a negative test ? ...
    jenny

    I have also been diagnosed with polyarthrits and never new what it meant ... but the differing reference ranges puzzles me ... any ideas as to why they differ ??

    annie_mial wrote:
    Eve, these are non-specific inflammatory markers and the details of the ranges vary from area to area and lab to lab.

    If you have neither of these markers raised, it doesn't mean you don't have arthritis.........just that there is no indication of which type it might be with these routine tests.

    There are more specific tests done now, but all inflammatory arthritis conditions are treated in much the same way, so in many cases the actual type is irrelevant.........they just want to get the symptoms under control as soon as possible to prevent as much joint damage as they can.

    In all the 10+ years I have had arthritis I have never had raised ESR and CRP levels, but I have two different kinds of arthritis at least plus another more serious condition arising from one of them. So I am classed as 'sero-negative polyarthritis', 'sero-negative = no raised inflammatory counts' 'polyarthritis = many kinds of arthritis'.

    This is a bit garbled, cos it's the first time I've tried to put it into words, but I hope it helps.

    Annie
  • chile168
    chile168 Member Posts: 384
    edited 30. Nov -1, 00:00
    Hi Jenny,

    I would have to agree, why bother with tests if they differ??? My question exactly.

    My hands and feet as always swollen yet supposedly tests are normal, I'm confused about it. My rheumy stated on letter that I have a lot of synovitis in my hands. She also stated that I'm becoming quite disabled by the condition.

    As you say the condition is the same, it behaves the same. Does it mean, that if tests are normal in our area and according to our local labs, would we then have to worry if we moved areas???? Utterly confused.

    Eve
  • annie_mial
    annie_mial Member Posts: 5,614
    edited 30. Nov -1, 00:00
    Sorry, I'm a bit late coming back in on this as I haven't been too good.
    That explanation of mine wasn't clear.......ESR and CRP will indicate any kind of inflammation, not just that associated with arthritis.
    Mine have never been raised as far as the arthritis goes even when obviously in the grip of a huge flare, but they did just jump to the skies when I had a severe chest infection!

    As I understand it they are used as a first-line and first-time indication of inflammation for any condition, the idea being that if they indicate inflammation in the first place, it is immediately obvious that there is something wrong and this can be dealt with relatively quickly. It's those of us without those immediate markers, but clearly with an illness who then present the problems requiring further investigation to determine what it is. We are the unlucky ones as it then takes time to sort out not only which further tests are necessary, but what the results of those tests mean, before a diagnosis can be made. This consequently means a delay in getting those results and eventually the right meds.

    As for the results themselves, again as I understand it they are calculated on an individual basis which takes in height, weight, sex and age. Where I am CRP is ok if the result of the calculations give single figures, i.e. less than 10, and ESR - for me - should be somewhere between 20 - 30. I'd better just add in here that consultants themselves also vary in their ideas of what they think is a raised marker!

    However, I believe for the labs doing these tests, the guidelines on how the calculations are done have recently been amended, so that while in some cases the results appear higher than before the result is actually OK.

    It seems to me that most doctors/consultants carry out the tests on a continual basis once the first results have been received as it does give them a base-line for future reference.

    Oh dear, if this doesn't help, please get back to me............and I will do my best!

    Annie
  • chile168
    chile168 Member Posts: 384
    edited 30. Nov -1, 00:00
    Hi Annie,

    Thank you for taking the time to explain it. I understand how it can be worked out on age, sex etc but what puzzles me is that consultants themselves do not have a stop marker. Mind you is the same with Lupus, some will diagnose Lupus with certain tests while other won't even though all symptoms are evident.

    Wish they would make up their flipping mind up so we know where we stand.

    Eve x
  • joyful164
    joyful164 Member Posts: 2,401
    edited 30. Nov -1, 00:00
    chile168 wrote:
    Hi girls,

    Thank you for your reply. It's late but I can't sleep.

    Most of the time she tells me my ESR is slightly raised and glad this time is normal even though my hands, knees and feet have been swollen solidly for two weeks. Was not too sure about CRP and since you have taken the time to explain that one, Im glad is also normal.

    Your replies are truly appreciated xxxxxxxxxxxxx

    Eve
    . I never really know what my blood results are.
    If and when I do, I do ask for my results, I am told they are slightly raised, even if I am feeling fine. (that shows the med are working) Most of the time I don't worry. If there is problem, they willring me Why worry.

    Joy
  • jackie1955
    jackie1955 Member Posts: 632
    edited 30. Nov -1, 00:00
    annie_mial wrote:
    ESR - for me - should be somewhere between 20 - 30. Annie

    My nurse gave me this figure too Annie :)

    Jackie