As long as you're looking at lupus because of the sun rash, you could look at the porphyrias as well (you wouldn't even want to know how many case reports there are of people who have been diagnosed with both lupus and a porphyria -- it seems as if they'll diagnose both when in doubt ).

I doubt a porphyria would give you a higher sed rate but you could get diarrhea, a lot of pain, trouble breathing, a sun rash, anemia, high blood pressure, tachycardia, some kidney problems, and difficulty walking (+ a lot of other neurological symptoms) with it.

Kathie, Get yourself in to see a nephrologist pronto. If you have lupus and if you have kidney involvement, that is something to urgently address.

I'm not trying to scare you, but it's nothing to mess with.

The ESR could indicate an acute inflammatory response in your kidneys—or elsewhere. It's interesting that your chronically elevated CRP is better after AI drugs.

The kidneys might also be having trouble filtering out the drugs you're on. Again, an expert (nephrologist) needs to address all of this, not only a rheumatologist!

ESR and CRP are very nonspecific tests. For example, my ESR was 104 when I had C diff. It's often the change in numbers that is important. Although, anything over 80 is something to be checked out, and anything over 100 means you need help right away. So a change for you is significant.

Those tests can indicate inflammation, infection, or cancer.

Bottom line is that you need to see someone. I hope they can figure all of this out!!!

Annie