Inflammatory Markers

ESR and CRP are lab tests that rheumatologists often order.

I though that these numbers were meaningful.  It turns out I was wrong: 

Whatever the value of knowing normal values for ESR and CRP in the general population, the values have little meaning in patients with RA who are not representative of the general population.

I thought that these labs gave some indication of disease activity.  It turns out I was wrong:

there is no clear rational cutoff for activity (or for normality) of ESR/CRP in RA.  Many people with active RA have inactive values of ESR/CRP and many with inactive RA have active values.

These quotes are from The Many Myths of Erythrocyte Sedimentation Rate and C-Reactive Protein, in Journal of Rheumatology.  Very interesting article.

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3 thoughts on “Inflammatory Markers

  1. Wow – that is very interesting. I used to have very high ESR numbers but I haven’t in years. I’ve often wondered why, if my sed rate was “normal”, I still had symptoms.

    • It’s not that those tests are meaningless, just that specific lab values in RA patients don’t mean what they do in someone without RA.

      If I read the article right, changes for a specific patient could reflect that patient’s disease activity. It would not be at all indicative of that person’s disease severity compared to a different individual’s lab values.

      I know for myself that I can predict – based on how I feel – whether those lab values will be higher or lower. I’m starting to wonder about the point of paying for tests that confirm what I already know.

      Can other people predict how much their ESR/CRP have changed from one appointment to the next?

      • I usually cannot predict what those values will be, although lately I have been having pain without the severe inflammation I used to have in childhood. Much of my pain now seems to come from permanent joint damage sustained years ago.

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