HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Does High ESR Levels With Rheumatoid Arthritis Indicate?

Posted on Thu, 12 Jun 2014

Question: My ESR is increasing now it is 46 mm
CRP serum is 1.85
Uric acid is now 6.5 from 8.5
Anti CCP. 134.60
RA serum 27.70

Answered by Dr. Anshul Varshney (1 hour later)

Brief Answer:
Rheumatoid Arthritis

Detailed Answer:
Dear Mr XXXXXXX
Welcome to Healthcaremagic.
Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.

By analysing your reports it is evident that you are suffering from Rheumatoid Arthritis.

Since you have not mentioned the reference range of reports of your laboratory, i am considering the standard reference range and still you fall into diagnosis of "Seropositive Rheumatoid Arthritis".

ESR is a marker of inflammation and disease activity.
If it is increasing it means disease activity is NOT under control.

I would like to know a few more details to help you better:
1. Since how long are you suffering from such problems?
2. Do you have severe joint pain and morning stiffness?
3. Do you have any respiratory problem?
4. Any frequent reddening of eyes?
5. What was your previous ESR level?
6. What medications are you taking for Rheumatoid Arthritis and uric acid?
7. Are you able to carry on with normal life activities?

This is my personal opinion based on details available here. If you still have any other query, you may please ask me and answer these questions preferably in point wise manner.
Stay Healthy.
Dr Anshul Varshney , MD

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (2 hours later)

1. From 15/03/2014,uric acid problem for last 3 year
2No joint pain , slight stiffness in finger in the morning,feeling some pain in left side toes.
3.No
4.yes some time
5.Esr level 2/06/2012. 16,
23/11/2013 40
22/05/2014. 46
6.Tab Febustat 40 mg
Folvite 5mg, Folitrax 15 mg,HCQS 200mg,MUSRAN-ER600mg (SOS)
BON- K2, BON DK 60K,
7.yes going for morning walk, using metro to going to office.

Answered by Dr. Anshul Varshney (2 hours later)

Brief Answer:
Detail Follows

Detailed Answer:
Dear Friend.

You are currently taking the right medications.

But it is important to get Liver Function Test and Xray Chest before we start Folitrax.

So, in case not done, please get it done.
Since you are pain free, you don't require any other special treatment.

I would suggest you to take HCQS 200 mg twice a day.

Follow this treatment for 6 months, and then repeat :
1. ESR
2. Anti CCP levels
3. Liver Function test.

If there is worsening of reports or you get aggravation of pain and stiffness, we would consider adding or to put you on following :
1. Low dose Steroids
2. Monoclonal Antibodies like Rituximab.

Currently the treatment you are getting is acceptable.

If you have any further query please ask me.

Stay Healthy.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (10 hours later)

Thanks for reply.

I have done Liver function test also.

AST (SGOT). 34. <50 22/05/2014. ALT (SGPT). 43. <50. GGTP 12 <55
32.90. 23/11/2013. 28.30. 13.60
19. 02/06/2012. 20.

Any other report is required pl let me know.Too much of medicine is giving sleepy whole the day.pl advice.

Answered by Dr. Anshul Varshney (5 hours later)

Brief Answer:
Detail Follows.

Detailed Answer:
Dear Friend

Your LFT is normal. What is required now is monitoring when on Methotrexate.

I would advise you to get LFT done every 2 monthly.

Currently no other investigations are required.

You should continue with the same treatment, and to review with me after 3 months with ESR, Anti CCP, CRP.

If you have any further query, please ask me, else you may close the discussion and rate it.
Stay Healthy.

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar