Dr. Ashaq Hussain Parrey
Rheumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I had a high sedimentation rate and C-reactive protein several months ago. I saw a rheumatologist who asked me to repeat the laboratories and they are still high or slightly higher (ESR was 30 and now it is 32 and C reactive was 6.8 now it is 7.4). An autoimmune workup was done and it was negative. What do you think the next steps should be? I do have a diagnosis of oral lichenoid reaction or oral lichen planus on one spot in the corner of my mouth. In addition, I had a viral illness now (home Covid test negative) and immediately when the viral illness started getting better, I had red patches or petechiae on the roof of my mouth. I saw an ENT specialist and was advised to take an autoimmune workup which was negative aside from the sedimentation rate and C reactive. What are the next steps in the workup should be? Can oral lichenoid reaction or oral lichen cause elevated sedimentation rate and C-reactive protein to 32 and 7.41?
Hi,
Welcome to icliniq.com.
I went through your query, you need to understand that ESR (erythrocyte sedimentation rate) and CRP (C- reactive protein) are inflammatory markers and any inflammation will cause a rise in these markers. Oral lichen planus is an inflammatory condition and will result in the rise of both ESR and CRP. Your autoimmune profile is negative and I do not see a reason that this could be due to oral lichen planus.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply. I was worried about cancer because when I looked it up on the internet, it shows an elevated sedimentation rate and C-reactive protein could be due to cancer. Could a relatively small lichenoid lesion or OLP cause my sedimentation rate and C-reactive protein to rise up?
Hi,
Welcome back to icliniq.com.
Yes, the elevation is also small because a high ESR means more than 100. ESR (erythrocyte sedimentation rate) of 32 is mild elevation even simple weight gain or iron deficiency can cause this much rise in ESR. Cancers rarely cause an elevation in ESR like multiple myeloma but it is usually more than 100, so do not worry it is not cancer. I can assure you.
Thank you.
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