Dr.Megan Ralf

is that normal crp 14

Q: Is CRP 14 mg/L a normal level if I’m having joint pain?

Question:

I’m having joint pain and the CRP test value is 14 mg/l. Is it a normal level?

Answer:

The short answer is No, CRP value of 14 mg/l is not normal but it is not high enough to tell that you have ongoing chronic inflammation, but can tell that the inflammation is fading or weak infection or just a false value that is should be higher, and details are below…

If you test high-sensitive-CRP the normal level is up to 3, hence the 14 is 4 times higher than normal
but if the CRP test is done with the latex method the normal is up to 10, hence 14 is mildly elevated.

CRP levels will rise rapidly within the first 6 to 8 hours after the onset of acute infection and inflammations and CRP reading decrease quickly about 19 hours (a half-life) after initiation of a successful treatment course, and therefore it is a better helpful tool for bacterial infections and antibiotic treatments.

Another thing is that the CRP test may go up too much if there is a tissue inflammation flare-up like in rheumatoid arthritis flare-up.

What causes CRP levels to be slightly higher than normal without inflammation?

  1. Obesity
  2. Lack of exercise
  3. Cigarette smoking
  4. Diabetes

Because CRP is not specific to RA, some people with RA may have normal CRP levels, many other tests can predict the reasons for joint pain better than the general inflammatory markers like the CRP test, such joint pain tests may include:

  1. ACCP and RF tests: which used for investigation if the joint pain is due to rheumatoid arthritis disease.
  2. Sed Rate test: is a better indicator for chronic inflammatori episodes than CRP test.
  3. Uric acid test: which indicating how high is the uric acid in the bloodm which means their are too much uric acid in the blood that can deposit in the joints and cause inflammation and painful sensation, medically called Gout.
  4. Thyroid tests: to investigate if there is Hypothyroidism (underactive thyroid) which responsible for some kind of joint inflammation.
  5. ANA test: to predict if you have any sign of abnormal immunity behaviour or not?
  6. LE cells and dsDNA tests: used for predecting the lupus erythromatosus disease.

X-ray imaging is the first step for diagnosis of joint pain, and using the blood tests comes after that to complete, approve, or exclude the etiological causes.

What causes false-negative CRP levels?

What causes a mild increase in CRP levels while it should be higher?

Certain medicines can falsely cause CRP levels in the blood to be lower than normal or become lower than they should be. These include taking antibiotics, aspirin, steroids, and nonsteroidal anti-inflammatory drugs (NSAIDs) {which are widely used for relieving pain, reduce inflammation, and bring down a high temperature}.

Types of NSAIDs include:

  • ibuprofen.
  • naproxen.
  • diclofenac.
  • celecoxib.
  • mefenamic acid.
  • etoricoxib.
  • indomethacin.
bacteria in urine testing report in absence of pus cells

Bacteria in The Urine Testing in the Absence of Pus Cells, what does that mean?

Bacteria in urine without pus cells, do I have UTI inflammation or not?

Do I have a urinary tract infection if I have no pus cells in the urine testing, or I am ok?

Such questions are sent to the official page every day, and we can conclude the reasons here, be patient…

There are many reasons behind the existence of bacteria in urine in the absence of inflammation cells called “pus cells”.

  1. Unwashed pubic area: not cleaning the pubic area well in women before dribbling the urine sample into the urine sample jar can lead to accumulation of dirt and microorganisms which falsly appear positive in the urine results.
  2. Proloned changing of women’s pants: Also, if a woman changes her underwear after long periods after wearing it, this will lead to more accumulation of dirt, secretions and microorganisms, which causes a false positive for bacteria in urine analysis in women in particular.
  3. Unsterile urine cup: If the urine sample collection cups and tools are not sterilized well in the laboratory, this may lead to a false positive appearance of bacteria and microorganisms in the result of the complete urine examination.
  4. Asymptomatic bacteriuria: If all the above reasons are well-checked, then you can exclude the poor cleaning and sanitation from the possible reasons of false bacteruria, now we can call it bacteria in urine without symptoms which does nor require a course of antibiotics, it is not false but doesn’t need treatment.

Suggestions and recommendations:

Redo urinanalysis after washing and sanitizing your pubic area and replaced your underwear pants with cleaned one.

Midstream urine is the best urine sample of testing: so you may discard the first drops of urine and collect the later urine for testing.

Also, treating asymptomatic bacteriuria can promote antibiotic-resistant organisms, however, pregnant women may need treatment with antibiotics in asymptomatic bacteriuria after doctor consultation.

skin atrophy and red spots

Q: I and My Daughter have Red Patches on my Skin although the Tests PT, aPTT, and FDP are normal in Blood Test Results, what could be the actual reason?

Question:

So I was sent off for some testing because of how my legs look… these are the results and I know they are in range but they are close to the bottom or top of the ranges could these be why I’m the way I am with my legs… I’ve had 2 lots of tests this week Monday and Thursday so waiting to see those results…

Well I’ve Multiple sclerosis (ms) and Ehlers-Danlos syndrome (EDS), and many other things but unsure on why I get these and my daughter is the same

Nothing can stop it…I don’t mind it just part of life so have to forget it

Answer:

Ehlers-Danlos syndrome (EDS) and MS have clinical aspects that include skin fragility and easy bruising, and bruise-like aspects, and other skin changes and skin-accelerated aged appearance that accompany that two diseases. Just to take that into your account.

Also, if you find your daughter’s skin is translucent don’t be surprised, because it’s from MS and EDs.

We recommend covering all furniture to make homes safe and prevent falls, avoid contact sports and wear protective wear, stop smoking, avoid the sun, and take some vitamins and collagen to compensate.

Unfortunately, there’s no blood test to diagnose the MS disease, instead, we do other tests that rule out the autoimmune diseases that share the same symptoms such as Lupus erythematosus, Sjogren’s, vitamin and mineral deficiencies, some infections, and rare hereditary diseases.

according to these medical facts, red patches on the skin is one of many skin changes that occur to a person who has such autoimmune abnormalities as MS and EDs, that is why PT test, PTT, and FDP tests are normal in the MS/EDs patient’s blood. red patches and scars on the skin of multiple sclerosis patients are not due to abnormal blood coagulation factors or lack of platelets and not due to blood clots under the skin, it’s due to abnormalities and defects of the skin itself.

What Do high platelets and High Lymphocyte WBC count mean in the CBC test?

If the results show: high white blood cells count and high Platelets count, both are mildly elevated. The most common causes are Infection or inflammation.

In all ages of children and adults, the most common cause of an elevated platelet count and high white cell count is the infection somewhere in the body.

The type of white blood cell that elevated in these results is the lymphocyte cells.

Lymphocytes are kinds of white blood cells that circulate in the human blood and responsible for counter-attack invadors like viruses, bacteria, and toxins, thus lymohocytes are important memeber of human ummune system.

If your complete blood count test shows that your lymphocyte count is high, the test result might indicate an Infection (bacterial, viral, other).

Even the shown lymphocytes numbers are mildly elevated, it can be used as an early marker of cancer of the blood or lymphatic system.

However, An autoimmune disorder such as SLE, and MCTD may causing chronic inflammation and causes high white blood cells.

high white blood cells count and high Platelets count
a question image sent to the official Fb group

Possible infections that elevate PLT and Lymphocyte counts may include:

  1. viral infections, including measles, mumps, and mononucleosis.
  2. adenovirus.
  3. hepatitis.
  4. influenza.
  5. tuberculosis.
  6. toxoplasmosis.
  7. cytomegalovirus.
  8. brucellosis.

Blood tests that may be required after elevated WBC and platelets count

  1. MMR antibody screening test: it is a developed test to detect if there are antibodies against measles, mumps, and rubella viruses, hence its name MMR.
  2. EBV IgM, IgG tests: are two tests used for the detection of Epstein-Barr virus infection that causes Mononucleosis”the kissing disease”.
  3. adenovirus antibodies and antigen test: that used for investigation of infection by adenovirus.
  4. TB Zn test for investigation of tuberculosis.
  5. TORCH antibodies tests: that used to investigate infection by (Toxoplasma, Rubella, CMV virus, Herpes respectively)
  6. Sed Rate test: to follow-up the course of inflammation and the effect after treatment.
  7. CRP test: to detect acute phase inflammations, and may be used for distinguishing bacteria infection from other viral infections.

However, some viruses cause decreased lymphocyte count instead of elevation, the most common virus is COVID-19.

For proper medicine, you must revise a specialized doctor, follow for more answers.