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CRP Test vs ESR Test: Understanding the Differences and Significance

By Dr. Nayana Shetty +2 more

Key Highlights: 

  • Importance of understanding the differences between CRP and ESR tests. 
  • Roles and procedures of both CRP and ESR tests. 
  • Interpretation of results and factors affecting CRP and ESR levels. 
  • Comparison between the two tests for sensitivity, specificity, and diagnostic applications. 
  • Use of CRP and ESR tests in various medical scenarios. 
     

Introduction 

When we are dealing with infections, inflammation, and different diseases, laboratory tests are of great help. They aid in correctly diagnosing health concerns. Two frequently used tests, the C-reactive protein (CRP) test, and the erythrocyte sedimentation rate (ESR) test can detect inflammation. Each of them plays a unique role in detecting inflammation and monitoring a disease.  On the contrary, there are distinct differences between them.  

In this article, we will understand the roles and procedures of both CRP and ESR tests. We will glean insight into how they differ, their impact on medical diagnosis and management, and the typical medical situations in which they are used. 

crp test vs esr test

Did you know?

  • ESR tests alone cannot diagnose the specific condition causing inflammation; further testing is usually required. source: MedlinePlus
  • ESR blood tests are non-specific and are usually used along with other tests to determine the cause or location of inflammation. source: healthdirect.gov.au
  • Patients with metabolic syndrome and high CRP have a significantly higher vascular risk. Source: ncbi
  • Exercise, weight loss, and dietary control are effective in lowering CRP levels and reducing vascular risk. Source: ncbi

C-reactive protein (CRP) test 

An important inflammation marker is the C-reactive protein or CRP. It is produced by your liver and increases during times of inflammation. A simple blood test is the usual course to measure it. 

1. Understanding CRP and its role 

Essentially, CRP is an acute phase reactant. Its levels rise when the body is dealing with inflammation. This response is caused by specific proteins termed cytokines, which are produced by white blood cells in times of inflammation. 

  • Production of CRP 

The liver plays a central role in producing CRP.  The production of cytokines in response to inflammation stimulates the synthesis of CRP. This results in an increase in CRP levels in your bloodstream. 

  • When do CRP levels increase? 

CRP usually spikes during bouts of inflammation. This inflammation could be triggered by an infection, injury, or any chronic inflammatory disease. 

2. CRP test procedure 

Measuring CRP levels requires a blood sample, which is then tested in a laboratory. 

  • Blood sample collection 

Blood is usually drawn from a vein. The vein is searched for on the inner side of your elbow or the back of your hand. A needle is pricked into the vein, and the blood is then collected either in an air-tight vial or a syringe. 

  • CRP test analysis 

Once your blood sample is collected, it is sent to a laboratory. The laboratory technicians determine CRP concentrations. This gives a clearer picture of the level of inflammation in your body. 

3. Interpretation of CRP test results 

The way to interpret CRP test results is described below.  

  • Normal CRP levels 

CRP levels depend on age, gender, and even ethnic background. In healthy grown-ups, CRP mainly stays below 0.3 mg/dL. Low CRP doesn’t always mean no inflammation. Some people with conditions like rheumatoid arthritis might show normal CRP. 

  • High CRP levels and associated conditions 

An upsurge in CRP may suggest different conditions like cancer, heart attack, infection, IBD, and autoimmune illnesses such as rheumatoid arthritis and lupus. It’s worth noting that high CRP itself can’t pin down the exact cause of inflammation. 

4. Factors affecting CRP levels 

Several factors can sway CRP levels. Some of them are pregnancy, birth control pills, and certain medications. Therefore, it’s crucial that you talk about any personal conditions with your healthcare provider when reading CRP test results. 

Erythrocyte sedimentation rate (ESR) test 

The erythrocyte sedimentation rate (ESR) is another inflammation marker. This test checks how fast red blood cells (erythrocytes) settle at the bottom of a tube.  

1. Understanding ESR and its role 

When our bodies fight inflammation, red blood cells may clump together. They get heavier and settle faster in a tube. The farther these cells sink within the hour, the higher the inflammatory response. 

  • Factors affecting ESR 

ESR can be influenced by factors like age, anaemia, pregnancy, kidney problems, thyroid disease, certain cancers, infections, and injuries. 

2. ESR test procedure 

ESR test also needs a regular blood sample for laboratory testing, much like the CRP test. 

  • Blood sample collection for ESR 

For this test, blood is drawn from a vein, usually inside the elbow or back of your hand. This sample is placed in a tall, thin tube for the ESR analysis. 

  • ESR test analysis 

This test gauges how far red blood cells fall in the tube within an hour. The greater the distance they cover, the higher the inflammation. 

3. Interpretation of ESR test results 

ESR interpretation is similar to CRP where several factors need to be considered. Different conditions can play with ESR values, making it essential to keep them in mind while interpreting the results. 

  • Normal ESR levels 

Like CRP, ESR also depends on factors like age and gender. Usually, men show ESR up to 15 mm/hr, while women may have up to 20 mm/hr. 

  • High ESR levels and associated conditions 

Raised ESR levels are often found in people suffering from giant cell arteritis, polymyalgia rheumatica, rheumatoid arthritis, and infections. 

4. Factors affecting ESR levels 

ESR might be swayed by factors such as anaemia, pregnancy, kidney problems, thyroid disease, certain cancers, and infections. 

CRP test vs ESR test  

It’s critical to note the differences and similarities between CRP and ESR tests. Both help in  detecting inflammation. Understanding the nuances aid in wise medical decisions. 

Similarities between CRP and ESR tests 

Both detect inflammation in our bodies. They provide an overall status of inflammation but can’t point out the exact cause or location. 

Differences between CRP and ESR tests 

Despite measuring inflammation, CRP and ESR tests aren’t the same. 

  • Sensitivity and specificity 

CRP is generally more sensitive than ESR. It responds faster to changes in inflammation. In contrast, after inflammation resolves, ESR may stay elevated for a longer time. 

  • Conditions diagnosed with CRP and ESR tests 

Both tests assist in diagnosing different conditions. CRP is good at detecting short-term inflammation and infections. On the other hand, ESR is better at monitoring chronic inflammatory diseases like rheumatoid arthritis. 

  • Responding to therapy 

When it comes to checking therapy effectiveness, CRP can give quicker feedback. ESR, along with other evaluations, helps monitor management effects on chronic conditions. 

  • Procedure and blood sample requirements 

Both tests demand a blood sample, mostly drawn from the inner elbow or back of the hand. Yet, they use different methods and aspects in measuring inflammation. 

Also Read: CRP Blood Test Cancer: Understanding its Significance in Diagnosis and Treatment

Applications of CRP and ESR tests in medical practice 

These tests come in handy in many medical situations, helping diagnose and monitor various health conditions. 

1. Rheumatoid arthritis diagnosis and monitoring 

CRP and ESR tests help in the diagnosis and tracking of rheumatoid arthritis, a chronic inflammatory autoimmune disease. They work together with other tests to gauge disease activity and track the progress of management plans. 

2. Inflammatory bowel disease management 

Inflammatory bowel disease (IBD) is a long-term inflammation of the gut. Both tests play a vital role in observing disease trends and checking if therapies are working. 

3. Assessing the risk of cardiovascular disease 

High-sensitivity CRP has gained importance in predicting a person’s risk for heart issues like heart attack or stroke. High CRP implies higher risk. It helps healthcare professionals decide possible management and steps to reduce risk. 

4. Infections and detecting inflammation 

Unexpected inflammation or potential infections can be detected by both tests. They provide valuable data for guiding therapy decisions and ensuring suitable care. 

Conclusion 

Knowing how CRP and ESR tests differ and match, and understanding their role in medical practice is a must for healthcare professionals. They are potent tools in detecting inflammation, guiding diagnoses, tracking diseases, and assessing the success of therapy. 

As you explore medical testing, it’s key to appreciate the unique role of each test. They work hand-in-hand to deliver the best patient care. 

Also Read: CRP Test Report: Interpreting Results and Their Medical Implication

Frequently Asked Questions (FAQs) 

Can CRP and ESR tests be used interchangeably? 

While both tests detect inflammation, they’re not the same. They focus on different facets and have varying sensitivity and specificity. They are usually used together to provide a well-rounded picture of a person’s inflammation status and help with management decisions. 

What can cause false-positive or false-negative results in CRP and ESR tests? 

Both CRP and ESR test results can be affected by various factors including age, gender, ethnic background, pregnancy, medications, and other health conditions. Hence, it’s important to discuss your specific conditions with your healthcare provider to avoid any or misinterpretation of results. 

How often should CRP and ESR tests be repeated? 

How frequently CRP and ESR tests should be done depends on the disease being tracked and other personal factors. The best schedule will be determined by your healthcare provider, keeping in mind your case and targets of therapy. 

Are there any risks associated with CRP or ESR tests? 

While drawing blood for both CRP and ESR tests, there might be minor risks. These include bruising, swelling, feeling dizzy, or infection. But, these risks are small, and most people undergo the tests without any problems. 

How can I prepare for a CRP or ESR test? 

For a CRP or ESR test, you don’t need any special preparation. Do inform your healthcare provider about any medications you’re on as some can impact the results. If you wear a short-sleeved shirt to the test, it will be easier to access your veins for the blood draw. 

References: 

  1. PubMed. It’s time to redefine inflammation [Internet]. [cited 2024 Apr 2]. Available from: https://pubmed.ncbi.nlm.nih.gov/28179421 
  1. PubMed. Erythrocyte Sedimentation Rate and C-reactive Protein Measurements and Their Relevance in Clinical Medicine [Internet]. [cited 2024 Apr 2]. Available from: https://pubmed.ncbi.nlm.nih.gov/29094869 
  1. PubMed. Erythrocyte sedimentation rate and C-reactive protein: how best to use them in clinical practice [Internet]. [cited 2024 Apr 2]. Available from: https://pubmed.ncbi.nlm.nih.gov/25290132 
  1. PubMed. Inflammation and cancer [Internet]. [cited 2024 Apr 2]. Available from: https://pubmed.ncbi.nlm.nih.gov/12490959 
  1. PubMed. A history of the term “DMARD” [Internet]. [cited 2024 Apr 2]. Available from: https://pubmed.ncbi.nlm.nih.gov/26002695 
  1. PubMed. Getting under the skin: Social isolation and biological markers in the National Health and Aging Trends Study [Internet]. [cited 2024 Apr 2]. Available from: https://pubmed.ncbi.nlm.nih.gov/34698366 
  1. JAMA Network. Social Isolation and Loneliness in Older Adults—A Mental Health/Public Health Challenge [Internet]. [cited 2024 Apr 2]. Available from: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2766710 
  1. National Center for Biotechnology Information (NCBI). C Reactive Protein [Internet]. [cited 2024 Apr 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441843 
  1. National Center for Biotechnology Information (NCBI). Causes and outcomes of markedly elevated C-reactive protein levels – PMC [Internet]. [cited 2024 Apr 2]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5471098 
  1. PubMed. [Etiology and prognosis of highly elevated C-reactive protein levels (≥500 mg/L): a retrospective study about 168 measures in a series of 113 patients] [Internet]. [cited 2024 Apr 2]. Available from: https://pubmed.ncbi.nlm.nih.gov/21592631 
  1. Centers for Disease Control and Prevention (CDC). Rheumatoid Arthritis [Internet]. [cited 2024 Apr 2]. Available from: https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html 

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