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Crohn's Disease Forum » General IBD Discussion » C reactive protein level-please help!


11-23-2011, 10:56 PM   #1
Mountaingem
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C reactive protein level-please help!

I just got my first C reactive protein test results back. My level is 9, and I have been flaring for about three months, both joints and bowel. I slowly have improved, but still am having some issues. My ESR is 5; it never goes up very much, not even when my small bowel abcesses. My white cell count was 14 a month ago; now it is 10.

I know plently here have it MUCH higher. My question is: When does it become a cause for concern? I want to make sure my doctors follow up so it doesn't end up being a whole lot worse. I am on Remicade and the doctor will decide next week whether to raise the dose again.
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11-24-2011, 01:55 AM   #2
Rebecca85
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I think if you are ill, that should take precedence over blood tests. If your markers don't typically show much, then any change is cause for concern.
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11-24-2011, 04:59 AM   #3
DustyKat
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Yikes! I submitted a reply a few hours ago and it's gone!

Weeeell, after my experience with Sarah I don't necessarily look to blood results to give me the answers I seek. If they have always been true to you then it may well be different. In Sarah's case her blood tests always returned normal even when she was seriously ill, on the other hand, Matt's tests go off at the slightest hint of a problem.

I now tend to look at the whole picture, if there are physical symptoms present that the bloods don't reflect then I take my lead from the symptoms that are there.

I don't know that there is any number, as such, that you could look to but rather the context in which the CRP is being monitored. If you were in remission then any number outside normal range may be a problem. If you were flaring and receiving treatment then you would be looking for a consistent decline in the CRP. If you were receiving treatment and considered stable then a continually rising CRP after two consecutive tests to me would be a matter for concern.

Just my two cents worth...
Dusty. xxx
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11-24-2011, 07:17 AM   #4
StarGirrrrl
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I'd call a CRP of 9 normal, as most labs agree the normal range is 0-10 or 5-10. But as Dusty says with CD blood results do not always reflect symptoms and how ill you are.
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2006. Tummy issues (more IBD than IBS).
2009 joint pain/worsening tummy issues.
CRP 20-36 2006-now. C3/C4 inflammation markers huge,
2014 IDA & low B12.

June 2014 admitted to Hospital 3 nights as emergency transfused 2 units of blood. Dangerous case of anaemia.
Caught by pure chance!
Cause currently unknown but suspected CD.

Waiting on blood & stool results from January.

Hoping to stop anaemia treatment soon & lower B12 daily dose!
11-24-2011, 07:46 AM   #5
archie
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It really is what is normal for you with regards inflammatory markers, both you ESR and CRP are within normal limits but it has to coincide with how you are feeling. Your WCC has decreased but at 14 would indicate an infection but since it has returned to 10 it is clearing. Your best to get repeat bloods and tally the results if they are increaseing then maybe a cause for concern. Personally I'd go with how your are feeling also like everyone else has said.
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11-24-2011, 05:27 PM   #6
kllyeve
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My sed rate (ESR) and CRP are completely normal yet my colonoscopy says my disease is mod - severe. I go mostly by pain symptoms and how well I tolerate eating to determine my concern level.

Would be much nicer to be able to have a blood test to determine disease progress, but I'll probably end up having another colonoscopy after I get onto Remicade(awaiting approval) to determine if it has worked.
11-24-2011, 05:42 PM   #7
Mountaingem
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Well I think I got my answer. I woke up at 2 a.m. flaring, so far and have spent most of the day sick. Back to GI on December 1.
11-24-2011, 11:41 PM   #8
Richard414
 
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wish my crp and sed rates were that low. 10 days ago before going back on Pred, my CRP was 97 and sed rate in the 60's. (I have j-pouch so my ulcerations are showing up as pyoderma gangrenosum)
11-25-2011, 12:05 AM   #9
Mountaingem
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@Richard-So sorry you're suffering so much. My disease is gram negative, so my ESR never goes up very much, even when I have abscesses in the ileum and fistulas. This is the first time I've had the crp test that I know of.
11-25-2011, 01:26 AM   #10
David
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Mountaingem, I'm familiar with gram negative/positive but I'm curious what the association is with Crohn's Disease and how it affects ESR?

Thank you!
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11-25-2011, 01:44 AM   #11
Mountaingem
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Some Crohn's patients have an abundance of gram negative bacteria in the gut that triggers the inflammation, and this causes the ESR rate to give a false low reading. The CRP however will get an accurate reading, and this gives the doctors a better idea as to what exactly is causing the inflammation, in conjunction of course with CBC tests.

Some of my flares are treated with a 6-8 week course of Flagyl and Cipro with Prednisone, and this will completely knock it out; whereas Prednisone alone will actually make it worse.
11-25-2011, 01:46 AM   #12
David
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Very interesting, I didn't know this, thank you! Are stool samples tested for the bacteria? Do you happen to know of any good online reading on this subject matter?
11-25-2011, 01:49 AM   #13
Mountaingem
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Yes, I am forever taking these little packages back to the lab lol! You have to do the three stage one-the yellow lid, red lid, and actual fresh sample. If you just do the red one it won't turn up.

Incidentally for those who have joint issues as well, I have had the Rheumatologist draw fluid off of the joint and it also will test positive for gram negative bacteria. Apparently it's common with RA and Psoriatic Arthritis as well. Trust me, the stool sample is much easier.
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