I had all sorts of joint pain and my Rheumatoid Factor was high. My doctor prescribed Plaquenil, which I took for four months prior to seeing a rheumatologist. The rheumatologist had me tested for ESR, CRP, and CCP IGG, which were all negative. I had also taken a weeks worth of corticosteroid 20 days prior to the lab tests. I am thinking these may have lowered inflammation and, therefore, my tests would not be accurate. I don't want to have Rheumatoid Arthritis, but if I do I want to catch it and treat it before I have joint damage. Does anyone who has taken Plaquenil know if it would have an effect on the lab tests? Would steroids also have an effect on lab tests? I would appreciate any input because I have been unable to find any answers. Thanks.
Brenda
It would not be surprising if your ESR (sed rate) came down, especially if you notice you're feeling better. CRP also is an indication of inflammation. I don't personally know how fast it would respond to medication. anti-CCP test would tell if you're more at risk for erosive arthritis, but you can have RA without a positive anti-CCP test. Just about any of the RA drugs would lower inflammation, that's why we take them. But the markers are a little different - they can stay around. I have not had my RF or anti-CCP antibodies tested since I began medication so I can't say personally. I have heard of people being tested years afterward and their RF titer or number went down. The rheumatologist should be the expert on all of that ... IGG refers to a whole set of immunoglobulins (gamma globulins to be specific). Certain ones tend to be elevated in RA. There is also the possibility of 'reactive' or 'infectious arthritis' in which case sometimes the doc can find signs of infection in the joint fluid, if they aspirate it from your joint. (I know, sounds scary. They were going to check mine, but the blood tests for me were enough...) But the 'clinical picture' (i.e., exam & symptoms) are a big part of the RA diagnosis. I think you need to work with the rheumatologist to sort things out. He or she should be aware of how the drugs can affect your condition. If worse came to worse, he/she might have you go off the Plaquenil to see the result, or do some additional tests. Good luck, let us know how things go ...
I think the rheumatologist I went to is a qwack! I went off the Plaquenil and we'll see how I do. I just hope he knows what he's doing. If I don't have rheumatoid arthritis, I figured it must be osteoarthritis. I asked him (through his office staff) if there were any other tests he would like to run before the end of the year (because my deductible was in for the year). He came back with a sleep apnea test because I had mentioned difficulty sleeping due to pain. I then went back to my primary care physcian and asked him to at least x-ray my shoulders to see if there was osteoarthritis. He came back and said he saw calcium, and believes I have tendonitis. I began looking into tendonitis for the pain I experience in the shouders, hips, and feet and found it could be tendonitis. I also read tendonitis is often found with rheumatoid arthritis. From comments I've been reading from others it takes forever to get a diagnosis and treatment is often hit or miss. I just found this site and it does seem to be helpful for sharing information and experiences.