CRP and sed rate
 

So I have been having a flare since all the snow shoveling. I am on 20 mg of prednisone, 2000 cellcept and 660 mestinon a day. MY C reactive protein has always been high and is now back in the normal range but my sed rate is way up to 48. Do any other MGers have high CRP and sed rates or is this my other auto-immune disease (unspecified)?


thanks
kathie

Mine have always been in normal range --- and I am seroneg

I don't know about the crp, but elevated sed rate indicates inflammation somewhere in the body. Don't know that it is a Myasthenic thing or not.

From what I know with MG your sed rate and CRP should be normal.. if they are elevated it should indicate an inflammatory process of some kind.. neuromuscular wise - like a myopathy.. otherwise - it could be a million other things.. some people just run high normally maybe? Have they tested your adolase?

Adolase and creatitine kinase are normal. I was in a lot of pain - muscle, joint and tendons. My rapid bowel transit went away for 3 months when they started cellcept but returned with the pain. I also have a vascular rash on my extremities, the rheumy calls livedo reticularis. And a rash on my face constantly - looks like a butterfly to me. They did another bunch of antibody tests including ANA - all negative. But my sed rate sky rocketed, BUN is now slightly high and my urinalysis has moderate wbc, rbc and no bacteria, I am anemic again with very high RDW. I think I might have Lupus too.

They upped the prednisone to 20 mg per day. And the pain and the rapid bowel transit has subsided again. Rash looks the same.

thanks
kathie

Does anyone here have MG and Lupus? Do your symptoms and tests look like this?

tanks
kathie

Your symptoms do sound like you have lupus as well as MG, but you can't always tell. My daughter had every symptom of lupus that their is. It turned out that each of the symptoms came from a different cause.

Since both MG and Lupus are both autoimmune, I would imagine it's not uncommon to have them both.. You symptoms sound like there is something rheumatologic going on! Have they run a lupus panel in your bloodwork before? Do your rashes get worse with sun exposure?


I also have livedo riticularis, and a quite elevated ANA.. I also have bowel issues..for three years they thought maybe celiac.. but now that my sibling was diagnosed with crohns and some of my recent testing, they think crohns too... I have rapid transit with the bowels, and malabsorption (bloodwork shows vitamin deficiencies)..

The good news, if you do have something else going on, like lupus, is that MG and Lupus are usually treated in similar fashions... though it's no fun to have one problem, much less more!

They did a bunch of gastro biopsies and blood test and ruled out gluten, crohns, and celiac. Gastro thinks it definitely autoimmume, waxes and wanes with MG, wanes with prednisones and cellcept. She was thinking lupus, sjorgens or sarcoidosis and sent me back to the rheumy. Rheumy ordered a dozen different antibody test, all negative. That was 6 month ago when I was feeling pretty good. The winter and snow shoveling sent me spiralling down - the fatgue, pain everywhere constantly and the rapid bowel transit returned. The new development was all the rashes and the return of the anemia. I have gotten rashes all my lfe on sun exposure. MY hemoglobin went from 14.5 to 12 in 1 month. Every time they try to wean me off pregnisone, the anemia returns. The rheumy returns from vacation on Monday and I will give him a call. I am concerned with the tests that look like they show renal involvement

keep well
kathie.

hummm... how about B12/pernicious anemia?? If your having an absorption issue secondary to your rapid bowel transit, causing malabsorption of vitamins, including B12.. what is your MCV on your CBC profile?

I know when My GI issues are bad, that I don't even absorb my oral meds .. its awful.. and sooo frustrating!

They put me on plaquenil for the joint pains and muscle fatigue - it helps a lot.. though it does have some GI side effects initially....
Good luck!! keep us updated!

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