Seronegative and Normal CRP & ESR

[snoweye]

Hi,
Does anyone know if it possible to have Sjogren's while all inflammatory markers are normal? Not only am I negative for ANA and RF, CRP and ESR are also within normal ranges.

My GP concedes these blood tests are not always conclusive but thinks there is very little chance of something autoimmune going on while all inflammatory markers are normal.

Thanks.

[Carolina]

Dear Snoweye,

Welcome!

I have a severe Immune Disorder that does NOT use autoantibodies to attack my organs/systems.  So I have never tested positive for any Autoimmune condition.  And yet, I have all the damage of autoimmune conditions.

My Duke Immunologist says "We use the tests we HAVE, not the tests we NEED". 

So, stay focused.  Your body knows what is going on, even if it can't be defined clearly.

Treat the symptoms with the medications that are effective, that is the key.  If it works, keep it.  If it doesn't work, move along to something else.

We live with a lot of uncertainty and trial and error.

I did not get confirmation that I have a serious Immune Disorder until I was over 70, and yet I had serious illnesses from birth.

Tell us what is going on, we will understand.

Hugs,  Elaine

[JoanElizabeth]

Definitely possible, I am negative for SSa, SSb, RF, and my ESR and CRP are always within normal range. My only positives are ANA and my lip biopsy and I have pretty severe issues

[irish]

I had all the symptoms of Sjogrens for years and had no positive markers at all. ANA was repeatedly negative as was sed rate, etc. It was after 40 years of illness that I had a positive lip biopsy but not positive SSA<SSB, nor was sed rate ever positive.

Several years after lip biopsy the SSa and SSb turned positive and the ANA turned positive. The sed rate has never been positive nor has my CRP. It should be noted that I had body aches and pains, horrible fatigue, swollen joints off and on, reflux and other ailments too numerous to list over these years. I also had horrible problems with cavities and root canals, abscesses, etc. Ended up have most of my teeth pulled prior to having a positive lip biopsy.

I doctored and doctored and just kept pestering the good docs. When I finally got diagnosed they were all totally surprised. Goes to show you that blood work doesn't mean beans. I am now 73 years old and diagnosed with 5 autoimmune diseases and 2 immune deficiencies and still kicking, but not very hard. Good luck with this. Irish

[trc1962]

My labs are usually "within normal" but that doesn't mean much when you feel so sick. I have a firend who got severe polymiositis and while in the hospital everything just kept coming back "normal." A really good ER dr. had her test again a week after starting her IV treatments and it was then the inflammation showed up in the tests. For her flares don't show disease activity, but it does after the inflammation is receding. The body is crazy and hopefully your dr. can think "out of the box" - most don't do well at that though. Wishing you well.

[snoweye]

Thanks for the replies. So it seems possible to have completely normal blood results and still suffer from an autoimmune disease.

I also found:

In a large study of RA patients from Finland and US, between 45-47% of patients had a normal ESR, 44-58% had normal CRP at presentation. BOTH were normal in 33% and 42% of patients**. When a rheumatoid factor test was included, 14-15% of patients had no abnormalities in all 3 tests.

http://www.jrheum.org/content/36/7/1387.abstract