What does it mean if you have a blood test which shows elevated C-RP levels but normal ESR?

My mum was diagnosed with Rheumatoid arthritis several years ago but has recently had normal ESR levels so they are rethinking the diagnosis and trying to pawn her off with a Fibromyalgia diagnosis which typically doesn't cause inflammation (which she suffers from several times a month). This past week her hands were swollen so they drew blood again DURING a swelling episode and it revealed a normal ESR but elevated C-RP. Her GP says she has never seen this before and searching the net has proved fruitless for me. Mum has to wait several months to see a specialist (UK health system) but in the meantime I'd like to see if we can get some clarification on how this can be. It seems strange to me that both are inflammation markers, but only one is elevated when she is inflamed! Anybody have any insights?





Thanks!

What does it mean if you have a blood test which shows elevated C-RP levels but normal ESR?
The C-Reactive protein test is more reliable than the Erythrocyte sedimentation rate (ESR) test.





See your lab tests explained at:





http://www.labtestsonline.org





Get an appointment with an orthopaedist to clarify your mom's diagnosis and treatment.





Rheumatic diseases are the result of a defective gene and collagen inflammation, often from a chronic infection. Collagen is present throughout the body, from the eyes, skin and joints to the heart. Hence, the multiplicity of symptoms, depending on the location of the most affected internal organs or body parts.





Rheumatic diseases are diagnosed in much the same way as rheumatoid arthritis, through a number of blood tests showing inflammation:





- Antistreptolysin-O (ASO);


- C-Reactive protein (CRP);


- Erythrocyte sedimentation rate (ESR);


- Rheumatoid factor (RF);


- Immunoglobulins A, E, and G;


- Complement 3 (C-3).





For more than 27 years, I have had seronegative rheumatoid arthritis like 20% of patients with rheumatoid arthritis. The telling signs are the following:


- Joint pain or cracking joints in the lower extremities, feet, ankles, knees or hips in the early 20's or late teens;


- Fatigue, especially after a moderate exercise like a 30 minute walk;


- Blood test showing a negative or low level of Rheumatoid factor (RF);


- Joint deformities of the fingers, after a few years, a specific sign of rheumatoid arthritis;


- Consecutive X-Rays, over several years, showing bone erosion, a consequence of rheumatoid arthritis;


- Generalized arthritis, involving the whole body;


- Blood tests showing elevated levels of C-Reactive protein (CRP) and Sedimentation rate (ESR).





Antibiotics like Minocin, NSAIDs like Voltaren, COX-2 inhibitors like Celebrex, acetaminophen like Tylenol, codeine, and statins like Lipitor are all used to control inflammation and relieve the pain of arthritis.





Regular exercise like walking, biking and swimming is also helpful for most patients. Make sure that you are not overweight as carrying too much weight can only increase the pain of arthritis in the supporting joints of the hips, knees, ankles and feet.





For any form of arthritis, you should consult an orthopaedist who will order blood tests, joint scans and X-Rays to better diagnose the type of arthritis from which you suffer.





The American Academy of Orthopaedic Surgeons at http://www.aaos.org maintains a public online directory where you can find the address and phone number of orthopaedists who belong to the American Academy of Orthopaedic Surgeons. Orthopaedists are listed by geographic location and family name, inside the USA and in most countries.





The membership directory of the AAOS is located at:





http://www6.aaos.org/about/public/member...





The American Academy of Orthopaedic Surgeons maintains a wealth of information online at:





http://orthoinfo.aaos.org





Lyme disease could be a possibility. Ask your doctor to test you for the bacteria causing Lyme disease.





Are there any other cases of arthritis or rheumatic diseases among your relatives? Chronic forms of arthritis are usually prevalent in families where a defective gene is passed on by parents to their children.





There are a few hundred types of arthritis and rheumatic diseases. The good news is that science is progressing rapidly in its understanding of rheumatic diseases.





Antibiotics are now used to achieve full remissions for at least 40%, if not 65% of patients with rheumatoid arthritis. For rheumatic diseases which are less severe, the number of patients making a full recovery can be even more impressive. For more info, please join the antibio group at:





http://health.groups.yahoo.com/group/ant...
Reply:You are right-there is no swelling or inflammation in FMS-








FMS is not a rheumatological condition-a long time ago it was thoguht that it was musculoskeletal-but for teh past 10 years it has been believed to be from a disorder of the Central Nervosu System...





although it is possible to hav an inflammatory conditin such as arthritis and FMS at the same time





There are very few docs actually competant to diagnos FMS