Proper understanding of ESR (blood sedimentation) and CRP (C-reactive protein) in rheumatic diseases

  Clinically, many rheumatic patients are very concerned about ESR (blood sedimentation) and CRP (C-reactive protein), and get very nervous when they hear that the blood sedimentation is high; in fact, they are not very clear about the meaning of ESR and CRP. ESR and CRP sometimes do have great significance for the diagnosis, activity, and efficacy of the disease. However, in rheumatic diseases, in many cases, the performance of different diseases is not the same.  1, CRP and ESR are both non-specific indicators and have important clinical reference value for assessing general inflammatory status.  2, There are more factors affecting ESR measurement, so sometimes its results are not accurate; while CRP is an acute temporal reaction substance, its measurement results are not affected by age, gender, anemia, pregnancy, hyperglobulinemia and other factors; CRP elevation and recovery are faster than hematocrit, in addition, CRP elevation is larger. In short, CRP is more sensitive than blood sedimentation, which is more helpful for early diagnosis and dynamic observation in general.  3, ESR and CRP can be high in the active phase of many rheumatic diseases, such as rheumatoid arthritis can have high ESR and CRP in the active phase, while the stable phase is generally normal; but there are also some rheumatic diseases, CRP is not high, such as in systemic lupus erythematosus ESR can be high, but if there is no co-infection, CRP should generally be normal.