CRP Levels determine treatment?

Just got off the phone w/ the new gi and he said it looks like severe inflammation as he reviewed the slides.  I was dx 3 wks ago.  He said the CRP was normal and wants me to find out if that was the case from diagnosis as well.  If the CRP and sed rates were normal than remicade might not be the way to go and he would use 5asa's and antibiotics.  He said it was ileal disease mostly.  I am trying to find some info on CRP and outcome or course of treatment using these predictors but haven't been able to come across this.  Anyone have any info on this???

Thx

Chris (newbie trying to find her way through this Crohn's maze)

CRP = C-Reactive Protein. Unreliable as the only method of determining disease activity. As is the Sed rate (ESR) blood test. They are just two of the tools doctors use to monitor disease activity.


You can read about these two tests and others at:

http://my.webmd.com/hw/health_guide_atoz/hw43353.asp

or

http://labtestsonline.org/

Here in the US many gastros are real excited about the potential of the biologics to treat IBD and are changing from the step-up approach to treating early IBD aggressively.

My CRP and ESR are very seldom elevated either. It's frustrating when you feel crummy and the doctor says "Well, your sed rate is fine so the Crohn's appears to be mostly under control". We had quite a discussion about that at my last appointment. After looking back at my blood test results from when I was first diagnosed, he realized that my levels did't go up much then and conceded that it probably isn't the best measure of disease activity for me. Duh!

Jen

It sounds like you're on the right track looking for answers. Shortly after diagnosis I went into denial for about a year--and my disease progressed. I am one of the "lucky" ones who produces CRP. (If I understand my dr. correctly, some CD'ers produce it, some don't. And I am "lucky" becuase we can use it as a marker. Even when I am mild, my CRP and ESR are elevated. So it was a HUGE deal when my labs came back normal--for the first time since I was diagnosed.

You asked about the difference in disease when the location is different.... That's the thing about CD. It affects everyone differently. Mine is in the ilium and I have chronic consitpation--not D. The statistic is that only 30% of patients have joint pain--I am one of those lucky ones too.

Be sure to write down all the questions you think of before going back to the doctor. And don't leave the office until you've had the opportunity to ask all of them.

Good luck!