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What Do Elevated Levels Of CRP And ESR Suggest?

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Posted on Thu, 6 Aug 2015
Question: Hi, i am 38 yrs. Am female. Started seeing a Rheuamatologist a few yrs ago because my ESR and CRP were extremely elevated. Chronic pain thru my body. Had total hip replacement 4yrs ago. Still with chronic pain, fatigue, lack of concentration, stiffness and pain in joints, herniated l4-l5 disc in my back w radicular pain. am seeing a psychiatrist for major depression and anxiety. suffer from hypothyroidism. My rheaumatologist tried me on prednisone and it was effective in bringing the esr and crp down as well as my pain . but was not a long term solution so he took me off and tried me on methotrexate injection and plaquinil, these did not help me at all, they were not effective. I am now off of them and have been diagnosed with Fibromyalgia. But he cannot explain my raised levels of ESR AND CRP... He ruled out RH.. He tried to get second opions on the crp and esr but the specialist he refured me too would not take me on as i have fibromyalgia. i am anaemic and take supplements now but am waiting on an endoscopy to rule anything out. I am wondering what your thoughts are? Could this still be RH and Fibro? what do you think.
doctor
Answered by Dr. Suresh Heijebu (2 hours later)
Brief Answer:
RH cannot be ruled.Autoimmune screen is mandate in your case.

Detailed Answer:
Hi Mam,

I understand your concern.

I have have gone in detail your medical history.

I would like to straight away tell you that Fibromyalgia will not cause such persistent elevations of ESR and CRP.

RH cannot be completely ruled.

Based on the clinical findings a connective tissue disorder is a prime suspicious diagnosis.

I advise you to get a complete autoimmune screen panel-aka ANA testing and Anti CCP antibody panel.

This testing is extremely important in your case.

RH can be ruled out only if Anti CCP is negative.

Anemia,Disc pain,Hypothyroidism and Gut problems are a part of the spectrum of any CTD.

Further crucial management is based on the test results.

Post your further queries if any.
Thank you.






Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Suresh Heijebu (29 hours later)
Hello,

Are these tests (ANA AND ANTI FFP ANTIBODY PANEL) not standard for a rheumatologist to run??
doctor
Answered by Dr. Suresh Heijebu (19 hours later)
Brief Answer:
These tests are routinely run by a Rheumatologist.

Detailed Answer:
Hi Mam,

I understand your concern.

These tests are routinely run ,ordered and interpreted by a Rheumatologist.

I wonder why these are not advised in your case.

Post your further queries if any.

Thank you.
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. Vinay Bhardwaj
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Answered by
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Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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What Do Elevated Levels Of CRP And ESR Suggest?

Brief Answer: RH cannot be ruled.Autoimmune screen is mandate in your case. Detailed Answer: Hi Mam, I understand your concern. I have have gone in detail your medical history. I would like to straight away tell you that Fibromyalgia will not cause such persistent elevations of ESR and CRP. RH cannot be completely ruled. Based on the clinical findings a connective tissue disorder is a prime suspicious diagnosis. I advise you to get a complete autoimmune screen panel-aka ANA testing and Anti CCP antibody panel. This testing is extremely important in your case. RH can be ruled out only if Anti CCP is negative. Anemia,Disc pain,Hypothyroidism and Gut problems are a part of the spectrum of any CTD. Further crucial management is based on the test results. Post your further queries if any. Thank you.