Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
140 Doctors are Online

What causes elevated CRP level? - Online Doctor Chats

Date : 19-Apr-2014
User rating for this question
Very Good Posted in: X-ray, Lab tests and Scans
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User:Hi
I am generally fit & healthy, I have IBS. I have been having problems for the past four weeks: I have RLQ pain, intermittant RUQ pain, Paraesthesia RLQ, Loss of balance on right side, relative weakness on right leg (75%), Fasiculations (intermittant), Abdominal distenstion, raised ALT. A contrast CT and pelvic and abdominal ultrasound have shown no pathology, CRP is
Doctor:
Let me read your query for few minutes to be able to have a good discussion here.
User:Ok, thanks.
Doctor:all right, I have read your query
Doctor:Sorry about your health concerns
Doctor:Since your CT and ultrasound reports are normal, I do agree with your GP about relating it to stress
Doctor:Since, no organic causes are noted on CT or scan, I would like to look at other possibilities here
User:If I do not feel stressed, is there an evidence-based way of determining whether it is stress?
Doctor:You could watch over the symptoms yourself
Doctor:There are no objective ways to check the same
User:What is the DD if stress is removed?
Doctor:Yes, I am coming to that point
Doctor:The abdominal pain symptoms along with stress can be due to pre-existing IBS itself
User:IBS is intermittant and moves around the abdomen.
User:It does not stay in the same place for 4 weeks
User:It is a different type of pain from IBS
Doctor:Like Vitamin B12 deficiency
Doctor:apart from this, the loss of balance on right side, relative weakness on right leg (75%), Fasiculations (intermittant)- these symptoms could be neurological
Doctor:or even calcium deficiency
Doctor:The second DD for it is non-specific colitis in which again the radiology reports are normal
User:As far as I know blood tests are normal although I do have folic acid deficiency
Doctor:This improves with a course of intestinal antibiotics and probiotics followed
Doctor:Folic acid deficiency can cause Paraesthesia and weakness in the legs, along with fasciculations
Doctor:How about the Vitamin D level
Doctor:what is your B12 levels along with Calcium?
User:Everything normal except folic acid (low), ALT (raised), TSH (raised, but T4 is normal).
Doctor:May I know the TSH level in number, also the ALT
Doctor:?
User:The GP did not tell me TSH though T4 is 19 (range 10-24). ALT is around 80.
Doctor:Please do get that checked, the TSH number
Doctor:The raised ALT at 80 is still fine
Doctor:It may be caused by the strong pain killers that you are taking
User:My GP said TSH is irrelevant if T4 is normal
Doctor:I would suggest you to not take much pain killers
Doctor:No, that is not right
User:Apparently ALT is supposed to be 34
Doctor:The value of TSH is more important
Doctor:Also when T4 is normal
User:If I do not take painkillers I cannot function at all, but i can stop the one that I know can cause raised ALT.
Doctor:Because, in subclinical hypothyroidism TSH is elevated while T4 is normal
Doctor:This needs medication
Doctor:Yes, the normal value of ALT is to be at 34
Doctor:However a value of 80 is acceptable as well
Doctor:The value is significant only when it runs in hundreds like 200 or 300
Doctor:good, stop that medicine
User:What else is in the DD for severe continuous abdominal pain, RLQ, made worse by sitting upright, relieved slightly by lying flat (supine)?
Doctor:Appendicitis is a classical DD
Doctor:Right ureteric colic or stone is one other DD
Doctor:Salpingitis is a DD too
Doctor:Along with ectopic gestation if you are sexually active
User:Is appendicitis definitely ruled out by CRP
User:Pregnancy has been ruled out
User:Pelvic USS rules out uteric stone
Doctor:No, appendicitis cannot be ruled out that way
User:My GP thinks it can
User:What should I tell him?
Doctor:It is mostly clinical diagnosis and if the symptoms are consistent, one can go ahead with the surgery of removal of appendix
Doctor:You did not mention about your bowel state
Doctor:Or you constipated or having loose stools now?
User:Bowel state has returned to normal following constipation treated by laxatives
Doctor:Please ask him to re-evaluate you
User:Do you have any other ideas about what this could be?
User:Are there any auto-immune disorders that could present like this?
Doctor:I mostly suspect non-specific colitis as I told you initially
Doctor:No,
Doctor:auto-immune disorders do not present solely with abdominal symptoms
User:Wouldn't colitis cause fever, bowel problems and raised CRP or ESR or WBC?
Doctor:not really, when it is non-specific and sub clinical infection
User:How can I get my GP to consider the possibility of sub-clinical infection?
Doctor:Going by your symptoms, and perhaps a simple stool routine test
Doctor:like I said, subtle changes need not show up on radiological investigations
User:Can subtle changes cause severe pain lasting for four weeks?
Doctor:yes, pain can last for four weeks but not severe
Doctor:It is usually mild to moderate in intensity
User:Thank you for chatting with me, I will ask my GP to re-evaluate the situation.
Doctor:Wish you quick recovery and good health
Doctor:It's my pleasure
User:Thanks, bye.
Doctor:Thank you too
Doctor:Bye
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor