sazz9

7+ Year Member
Oct 1, 2009
49
5
Status
Pre-Medical
Hey all.
Getting pimped out on this right now by my attending and for the life of me I can not figure out what he is looking for.

Pt is 70yo WF with DM2. CAme in feeling "horrible" (very vague with explanation), review of systems normal, PE normal. Labs showed elevated CRP at 15, normal ESR, normal CBC/CMP.

He is asking me why he chose to do both the CRP and ESR for this patient, why the CRP was high and ESR was not, and what is the next step.... (PS. we are in an Outpatient IM clinic)

ANy help!!??
 

jdh71

Grim Optimist.
10+ Year Member
Dec 14, 2006
68,169
48,153
Last House on the Block, USA
Status
Attending Physician
It's aids.

Clearly.

Tell him that patient has aids and you want a stat viral load.
 

obiwan

Junior Member
10+ Year Member
Mar 26, 2006
693
50
Texas
Status
Attending Physician
so does he always check esr/crp for all patients who feel like s**t?
 
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drfunktacular

ANA ≠ SLE
10+ Year Member
Oct 5, 2004
555
176
Status
Attending Physician
Tell your attending he is over-relying on very non-specific tests if he thinks that one or the other being high is indicative of anything at all absent other, more specific clinical findings (GCA symptoms, for example: headache, jaw claudication, polymyalgia rheumatica, etc)

He is probably thinking something along the lines of what qwaszx69 mentioned... ESR is "supposed" to reflect more chronic inflammation while CRP is "supposed" to reflect more acute inflammation. But in general I find this distinction to be completely bogus and without any clinical applicability... and I order and interpret a LOT of ESR/CRP's every week.