Podcast 69: C-Reactive Protein and Erythrocyte Sedimentation Rate

Dear Listeners,

The C-Reactive Protein and the Erythrocyte Sedimentation Rate are both lab tests used to measure inflammation in the body. They are usually elevated during infectious, inflammatory, and malignant diseases. 

The CRP is produced by the liver shortly after the offending process so it is a direct measure of inflammation. The ESR is based on the level of fibrinogen in the blood so it is an indirect measure of inflammation. The ESR  tends to have a higher rate of both false positive and false negative results and should be used in diagnosing conditions that may not stimulate a CRP elevation such as Polymyalgia Rheumatica.

Current guidelines suggest ordering CRP for three specific reasons: 

To help with  the diagnosis of inflammatory or infectious disease where the presentation is unclear
To monitor the treatment response of inflammatory or infectious disease
To help determine the therapeutic approach in primary prevention of CVD in patients with intermediate cardiovascular risk. 

Finally, Persistently elevated levels of CRP and ESR are suggestive of a malignant process and should be considered for imaging.

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Posted on 10/10/2020 by Dr. Dimitre

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