Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Spondylitis and CRP

Over the last 17 years, I have had quite a few CRP blood tests. Once it was slightly high ( 25), but on all other situations, it has been normal. Once I had severe back pain, and even then it was normal. My rheumatologist said that this is a common finding, that with AS , CRP does not always go up. Is this a finding with others on this forum ?

Yes. Correct. Mine does not go up either, this in spite of inflammation - in the past, quite severe inflammation. My excellent rheumatologist, Dr Millicent Stone, covered this fact in her / my report. CRP is not always heightened in AS.

I think much the same applies to the E.S.R. blood test for inflammation. They don't seem to give as much emphasis to these tests as they used to

Correct Frederick. Has little bearing. When inflammation can be picked up by MRI but they then find that the blood test shows nothing out of the ordinary !
The big reliance on blood test results are rather out the window, like the HA-B27 test, and that old hoary one 'Women don't get AS'! <LOL>
Take care - have a good one -

I was at my rheumatology clinic yesterday. Just a routine thing so nothing worth reporting. They took bloods as they usually do. They are more interested in my salt level than the E.S.R. as I have had problems with my salt levels recently. I expect a good result. I dare say they will also check all the other usual things. Keeps someone in work I suppose.

I was rather hoping against hope to get back on the Anti-TNF but thought not as the wound from the pilonidal sinus problem has not healed yet. Still at least there is no sign of the infection this time so just a matter of waiting for wound to heal. I return to clinic in three months to see how things are progressing by then.

Frederick, I had surgery for a pilonidal cyst back in 2007, which ended up taking about 12 weeks to finally heal. The stitches broke open at one end of the incision and had to heal by secondary intention (from inside out). It had a little infection just after the stitches broke, but it cleared up with antibiotics. I used a seat cushion called a 'Tush Cush', which was awesome. I had one for work and one for my car seat as it was a bucket seat. If you are still sore and having difficulty finding a chair that works well for you, look that up online and see if you think it could help. Best wishes on your healing. I've never had any more issues from the pilonidal cyst and I hope you are just as lucky.

As for the CRP, mine does not go up for PsA inflammation, though it went up when I had pneumonia a couple of years ago. I happened to have blood work done within a week of having a radiofrequency ablation on my SI joint done by my wonderful pain mgmt doc. The CRP soared on that particular visit. Rheumy was wondering what had happened to my normal 0.1 or 0.2. I had a 5.0 or 6.0, as I recall.

Thanks for your post rumble. The wound from my now removed
pilonidal cyst is intended to heal by secondary intention so no stitches to worry about. It did get infected within the first few days but this was soon sorted out with the usual antibiotics. I now attend my local hospital which is fortunately within 10 minutes of my home. The nurses there dress my wound every day. It seems to be improving but only very slowly. It is now some 8 weeks since the surgery was done. I have been seen by the surgeon who did the job at the general hospital a couple of weeks ago as a first checkup. He thinks things are progressing but may take some weeks again. I am to see him again in 3 months for hopefully the last checkup and then discharge. I never realised there was so much to removing a pilonidal cyst. I only had it done as the rheumatologist stopped my Anti-TNF treatment because of it. So it will be some time again before I am able to restart my Anti-TNF.

I've always had the same thing. ESR and CRP are close to normal, but pain levels out of sight. These are no longer considered accurate indicators of disease activity in AS.

Hey Molly our research queen. Can you find research findings on CRP and AS. I have an appointment coming up and would like to discuss this with my Rhuemy. There was an article about this subject in my spondylitis magazine last year but I can't find it.

Hello there Manatee - Yes. Shall put in a search. See what floats up - Take care, have a good one -
Molly

Here's one - quite a biggie, good for starters -
Measuring disease activity in ankylosing spondylitis: patient and ...
https://academic.oup.com/rheumatology/article/44/6/789/2899315
Jun 1, 2005 ... The Assessment in Ankylosing Spondylitis (ASAS) International ... Elevated CRP levels and ESR are frequently absent in AS and do not ...
(snip...) "In AS their value in determining whether the disease is active or not is rather limited. Elevated CRP levels and ESR are frequently absent in AS and do not correlate well with clinical activity and radiological progression [1, 2]."

Check the references for more information. Will sift around for additional papers, but this might just do the trick - rafts of good info.