Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group CRP level swing - thoughts?

Hello everyone,

Well at my last appointment with my rheumy we decided that because my blood test in March showed CRP of 33.3 and ESR of 27 and we had tried 2 x NSAIDs (didn't touch inflammation levels) and sulfasalazine (I was allergic), that we would start the tests to try and qualify me for TNF therapy.

I went to do all the tests on Thursday, and picked up Xrays and results today. Xray as I knew (from a previous MRI) showed severe sacroiliitis, TB screening was clear, everything on track. But my blood test showed that my CRP was 5.1 with ESR 3! I was shocked. How did it reduce so much without me being on any meds?! Has anyone had this before?? My CRP has been consistently above 12 since 2008... and suddenly it plummets to 1/6th of what it was within 2 months, most of which I was off meds. It's good news, but the pain is the same, but now I no longer qualify for anti-TNF treatment here in Australia (need either CRP > 10 or ESR > 25)... and I'm also very puzzled.

The only thing I can think is that the three weeks I took sulfa before I got the allergic reaction was actually effective in bringing down inflammation, but I thought sulfa took a while to make a difference. The doc said that 3 weeks wouldn't have done much. This blood test was just really going through the motions to get the paperwork ready for anti-TNF, which I now no longer qualify for...

Any thoughts??

not really sure, other than the sulfa drug like you suggested, but really i don't know much about that, or just the idea of flares and in between flares,

my numbers haven't fluctuated that much,
but when in a modest flare, my ESR and CRP were both close to 10,
then other times when doing pretty good, closer to 5,
one time one of the numbers even lower, i think, i'd have to look them up,
never had the blood work done when in a major flare but probably should get the script for those measurements and then go in when doing really poorly.

so maybe to test this out, if you flare like i do, maybe have the script all set and go when you are doing physically your worst.

unless you haven't seen any kind of correlation like this.

i also had a nuclear bone scan done, and it was interesting because the things that hurt the most on me, the things i would have predicted to be the most inflamed simply based on the symptom of pain, were the brightest, and that test and my pain correlated very nicely as well.

so for me, timing the test to my symptoms would be the thing for me to do in the future, as i've been building up confidence that my pain really is from inflammation and i really can correlate it in a quantitative sense as well.

and so sorry about this, i know how frustrating this must be for you,
finally on the road to being able to at least try the biologics and then having the option taken away, hopefully only temporarily.

Hi noogle,
Your strange like me I came of Humira after having swine flu and wasn't on any thing except pain killers and my CRP and ESR went down to normal.Doctors were mystified no explanation.Having blood tests again soon so see what's happening now they should be up as I'm flaring.

Kevin

Noogle-That is odd that you don't feel any better. Maybe good days are just around the corner for you, ie:remission.


Kevin-sorry your flaring..ouch.


-Donette

[Hi

I think you can use prednisolin ( something like that- will get back with the exact name ) to increase your inflamation rate in the blood

Only for a week or two

If everything is ok and you are not eligible just because of the crp levels then def u can go for it

You can talk to your doctor about it

One of my friend did the same to qualify for the biologicals

Hope you get them soon

Best of luck

quote=noogle]Hello everyone,

Well at my last appointment with my rheumy we decided that because my blood test in March showed CRP of 33.3 and ESR of 27 and we had tried 2 x NSAIDs (didn't touch inflammation levels) and sulfasalazine (I was allergic), that we would start the tests to try and qualify me for TNF therapy.

I went to do all the tests on Thursday, and picked up Xrays and results today. Xray as I knew (from a previous MRI) showed severe sacroiliitis, TB screening was clear, everything on track. But my blood test showed that my CRP was 5.1 with ESR 3! I was shocked. How did it reduce so much without me being on any meds?! Has anyone had this before?? My CRP has been consistently above 12 since 2008... and suddenly it plummets to 1/6th of what it was within 2 months, most of which I was off meds. It's good news, but the pain is the same, but now I no longer qualify for anti-TNF treatment here in Australia (need either CRP > 10 or ESR > 25)... and I'm also very puzzled.

The only thing I can think is that the three weeks I took sulfa before I got the allergic reaction was actually effective in bringing down inflammation, but I thought sulfa took a while to make a difference. The doc said that 3 weeks wouldn't have done much. This blood test was just really going through the motions to get the paperwork ready for anti-TNF, which I now no longer qualify for...

Any thoughts?? [/quote]

Seems strange. How frustrating for you.

My CRP and ESR have been dropping but I'm on methotrexate and prednisone so it's hardly surprising. However, I still have significant pain so the whole thing is a bit puzzling to me as well.

I'll be curious if you learn anything useful.

I also experienced a drop in CRP & ESR after only a short time on SSZ. I was only taking it for a week or so and still on a very small dose at that time and had read that it takes about six weeks at full dose to have any effect so I stopped taking it as I presumed it must have been one of the other things that I was doing that was causing the improvement in CRP & ESR. My levels continued to drop after stopping SSZ but I can't rule out that it was the SSZ that had an effect, especially as it is suspected to have antibiotic properties. Maybe it works a lot faster in some people.

Dont you just hate that!
when do you have your next appointment with rheumy? what does he/she reckons? Does he/she want you to come back when ESR and CRP escalate?

Sorry about the pain flaring, the bitter cold front from last week wouldnt help much. Keep warm. Or catch a cold will elevate inflammtion

Take care.