CRP Level

[Jandersen20]

Does anyone know if having a cold could increase CRP? My son has a little cold and just had lab work done. His CRP was quite a bit higher than last time.
He’s on Humira. Could having a cold play any role at all in a higher CRP level? Or is it more than likely attributed to him being in a flare and the Humira not doing its job?

 

[Jandersen20]

Also, his ESR (Sed rate) actually slightly decreased. So his CRP jumped way up, but ESR slightly dropped. Could the jump in CRP be from a little cold he has? Because, if it was truly from inflammation and the Humira not being effective, wouldn’t the ESR increase along with the CRP?

 

[Jandersen20]

Also, his ESR (Sed rate) actually slightly decreased. So his CRP jumped way up, but ESR slightly dropped. Could the jump in CRP be from a little cold he has? Because, if it was truly from inflammation and the Humira not being effective, wouldn’t the ESR increase along with the CRP?

@my little penguin, What are your thoughts on this?

 

[xmdmom]

CRP can increase with upper respiratory infections. If the CRP elevation persists (when repeated in a few weeks), you can probably attribute it to gi inflammation. If it comes down, the elevation may have been due to his cold.

CRP go up and down faster than ESR.

Every test has some degree of error so small changes may not mean anything about what’s going on inside one’s body.

What were your son’s CRPs and ESR values?

 

[Jandersen20]

Thank you.
9/30/21:
CRP was 9.7
ESR was 8

11/19/21:
CRP jumped up to 19
ESR went down to 7

Diagnosed with Crohn’s with severe colonic ulceration in July. Only symptom at the time was bleeding. Started with a round of Prednisone while we waiting to start Humira. Been on Humira now for 4 months. Symptoms now include bleeding (slightly better), frequency, and urgency.

Waiting for test results for Humira trough levels/antibodies. I just don’t understand the significant increase in CRP. I wonder if Humira just isn’t doing its job.

Just started Uceris Foam 2 nights ago so hoping that will at least help with bleeding, frequency, and urgency while we figure out what’s going on with Humira.

 

[crohnsinct]

Yeah CRP is not that reliable to predict Crohn’s inflammation. My daughter once had hers go up to 40 with no rhyme or reason and two weeks later back down.

For this reason most GI’s will use fecal calpro rectum to understand more about what us going on with IBD inflammation. But at this point, it is clear to your GI that he is inflamed so the more important test is the levels/antibodies.

I know waiting stinks but that’s the name of the game with this disease. We wait for diagnosis, wait for drugs to kick in, wait for labs, wait for appointments. Just stinks.

Has the foam helped at all? Is he only taking it once a day? My daughter did twice. Once am and once before bed. Also wanted to say the many people find that one or the other topical rectal therapy works better for them over the others. FWIW our doc says the suppositories seem to work better for sigmoid/rectal disease and that is our experience. So don’t give up if foam doesn’t work you could try the enemas or suppositories.

Goid luck! I hope the foam kicks in soon.

 

[xmdmom]

Just wanted to add that ESR 8 and 7 are really the same.

 

[Jandersen20]

Yeah CRP is not that reliable to predict Crohn’s inflammation. My daughter once had hers go up to 40 with no rhyme or reason and two weeks later back down.

For this reason most GI’s will use fecal calpro rectum to understand more about what us going on with IBD inflammation. But at this point, it is clear to your GI that he is inflamed so the more important test is the levels/antibodies.

I know waiting stinks but that’s the name of the game with this disease. We wait for diagnosis, wait for drugs to kick in, wait for labs, wait for appointments. Just stinks.

Has the foam helped at all? Is he only taking it once a day? My daughter did twice. Once am and once before bed. Also wanted to say the many people find that one or the other topical rectal therapy works better for them over the others. FWIW our doc says the suppositories seem to work better for sigmoid/rectal disease and that is our experience. So don’t give up if foam doesn’t work you could try the enemas or suppositories.

Goid luck! I hope the foam kicks in soon.

Thank you. Makes sense. He is doing the foam twice a day for 2 weeks and then will go to once a day for 4 weeks. I’ll have to ask about suppositories if needed.

 

[Jandersen20]

Thank you. Makes sense. He is doing the foam twice a day for 2 weeks and then will go to once a day for 4 weeks. I’ll have to ask about suppositories if needed.
If he needs a steroid as bridge therapy, do you have any experience with oral Prednisone vs Uceris (Budesonide)? I’ve been reading that Budesonide is a little bit milder with side effects, but it may not be as effective. I don’t know. Do you know if he can take Uceris oral pills and Uceris Foam at the same time?

 

[Scipio]

CRP is sometimes kind of shaky in telling you what is going on in IBD. For active intestinal IBD my CRP has always been low: <3.0. Didn't matter whether the disease was getting better or worse, CRP just didn't respond. But then when I came down with pericaditis as a bad extra-intestinal manifestation of Crohn's, suddenly the CRP shot up to over 200. And it came back down after surgery to remove the inflamed pericardium and treatment with Stelara to knock down the Crohn's. And it has stayed down ever since.

So for me CRP has been a useful monitor only for extraintestinal manifestation, not for the main line intestinal Crohn's. Your mileage may vary.

 

[Jandersen20]

Good information. Thanks for sharing.

 

[my little penguin]

Crp is useless for my kiddo with crohns
Only went up with mastoiditis (ear infection that spread )
Rest of the time normal
Esr was a better indicator but even then …..
He has to be really bad for it to move

 

[Jandersen20]

Thank you. Other than doing scopes, is fecal calpro one of the best ways to check for IBD inflammation?

So for my son’s CRP to jump from 9 to 19 in 6 weeks, it could be something other than his Crohn’s inflammation? He started Uceris Foam the day before his blood work, but that wouldn’t raise CRP would it? Just trying to understand why it would raise.

 

[crohnsinct]

Not likely the foam raised his CRP.

In general, calpro is a much better indicator of intestinal inflammation but since your son is actively bleeding that actually indicates he is inflamed. The jump could be something else but since he is actively inflamed it could be his Crohns also.

See? Clear as mud.

 

[Jandersen20]

Lol, yep. Got it. Thank you for your response.

 

[Maya142]

CRP could definitely go up with any illness. It does tend to go up and down much faster than ESR. For what it's worth, my daughter's doctors all say that CRP is more useful than ESR - they rarely check her ESR now, but do follow her CRP and of course, Fecal Calprotectin.
This is an extreme example but a couple of weeks ago, my daughter was hospitalized because her blood work was all over the place - her liver labs were very elevated, her WBC was elevated and her CRP was hugely elevated.

In the course of 6 days, her CRP went from roughly 130 (!!!!!!) to 60 to 20 some to 11 (range was 0-3). Her WBC went from high to normal and a serious infection was ruled out. ESR was 44 at its lowest (range was 0-20). She asked both her rheumatologist and GI why her CRP was so high and they both said they honestly did not know and it's possible she had a virus, but also that we may never know. Her arthritis is severe and hard to control so her CRP has been high for 5 years now - it only comes down on steroids.

CRP should not go up with a steroid, especially a foam. My guess is just that Humira hasn't fully controlled the disease.

I can't remember - have they done Humira levels? And/or antibodies to Humira?

 

[Jandersen20]

They did blood work to check levels so we’re just waiting for the results.

Thank you for your response.