hsCRP

[miachic]

Dr. Fett, what are the "good" numbers for hsCRP? I can't remember. :D

[JAMESFETT]

CRP,normals under 5 mg/L; in PPCM we are looking for evidence of an inflammatory process, and finding a " cut-off" somewhere in the range of 10 to 20 mg/liter. Of course, in inflammatory cardiomyopathy, including PPCM, the numbers can and often do go considerably above that, into the 100's. CRP plasma elevations have been found in PPCM, lymphocytic myocarditis, viral myocarditis, inflammatory cardiomyopathy, post-viral cardiomyopathy, and non-viral idiopathic dilated cardiomyopathy with inflammation.

JD

[JAMESFETT]

P.S. In the USA, I have plasma CRP records on only 2 PPCM patients at diagnosis, and for those two the levels were 59 mg/L and 73 mg/L. I would like to see the levels for every PPCM patient at diagnosis.

JDF

[JAMESFETT]

PPS, a non-PPCM healthy mother will have a plasma CRP in the range of 5 to 10 mg/L at term pregnancy, and then it quickly settles back to under 5 following delivery.

JDF

[Elliesmom]

my most recent numbers are 8.8 for my hscrp one month ago it was at 4. something....my cardiologist wasn't concerned. he didn't think it should even be monitored?? i am at 26 weeks along and no other signs or symptoms...i'll let you know what the next hscrp is.

[JAMESFETT]

Good for you for monitoring! That may well be a normal limit at 26 weeks pregnancy; it will be good to see what it is around 32 weeks or so. Thanks for letting me know.

JD

[miachic]

I got it drawn yesterday so hopefully this week they'll call with the results. I'm glad he told me I needed to get my blood studies updated yesterday. I will get them all updated again at 28 weeks when I get everything taken for my glucose test. My doc is really on it...thank God. I think we'll redo everything again at 36 weeks. When would be the most likely time my BNP and/or hsCRP would increase? More like 36 weeks range or would it be later?

I get my next echo at 28-29 weeks and even if my cardio says he doesn't want another I'm going to push really hard for one at 36 weeks so we have an idea of how things are looking going into delivery. :D I think I get on my doctors' nerves, hahaha.

So I have another question...what do we do if it goes up above that "normal" pregnancy range? Is there anything we can do other than watch and monitor more closely? Just curious. Me, being the ever constant planner, want to have an idea of what happens next, hehehe. :D

[JAMESFETT]

That's a good schedule of testing. At term is a good time, because that is a higher risk time for relapse. If it's not up to or over 10, it will rapidly decline after delivery unless there is a problem. I like to pair the CRP test, if elevated, with a BNP, and if that is rising, then an echo to be sure there is no decrease. Of course all the while one must pay attention to any new symptoms, but you are an expert at that, having experienced PPCM once. Good luck.

JD

[miachic]

Thanks! He's drawing BNP and hsCRP together as well as all my electrolytes every time I get a blood draw. :D