CRP and prednisone titration

[Middlesista]

Has anyone noted that their CRP increased when titrating prednisone? Initially mine was 24.6 and went to 16.4, to 17.5 and then 3.4. This was when I was at 40mg. I am currently titrating and am on 25mg and my CRP today was up a bit over 14. I finished my 4th Rituxin treatment on Dec 18th and not sure if the rituxin has fully kicked in although my CT scan was clear of all the nodules and cavitary lesions that were initially noted when it was done today.

Also now have increased intraocular pressure and the neuro-ophthalmologist thinks it is from the prednisone but can GPA also cause glaucoma?

[Pete]

I'll have to review my labs and medication history to see if there's a correlation between pred and CRP.

I have a family history of glaucoma. I had SLT done in 2010. My pressures are in the mid-teens to low 20s now. I've been on pred for five years.

[Birdie]

CT scan was clear of all the nodules and cavitary lesions that were initially noted

Also now have increased intraocular pressure and the neuro-ophthalmologist thinks it is from the prednisone but can GPA also cause glaucoma?

Hey Sissy, holy moley! Nodules already gone? Talk about fast healing...

Of course GPA can cause most symptoms, in this case you can bet it's pred. Watch it close, get your eye pressure tested as often as they'll do it and take it seriously. I went blind many times and lived for months on the dedication of several eye specialists. I now wear glasses and my eyesight is unstable, meaning the prescription changes constantly, daily, hourly, minute by minute sometimes. That's damage, no longer pred related. They say surgery will fix it, I doubt it. The surgery is to fix vision rather than instability. So I've got several pairs of glasses with different prescriptions...

[Middlesista]

Thanks Pete -please let me know if you get a chance and see a trend

Birdie - the neuro- optomologist wants to start me on eye gtts if the doc increases my prednisone to 30mg or more. Pleased about nodules and lesions making a disappearing act but a bit concerned about the CRP going back up- was hoping things might be turning around Still still with fatigue and no appetite, but yes - Good news with the lungs

plan on calling RA today to hear his thoughts. Hoping the Rituxin kicks in fully soon.

[MaxD]

I haven't heard of GPA causing glaucoma. But definitely prednisone will, taken over a long term - as we do. My ophthalmologist had me on some eye drops for quite some time and monitored pressure every 4-6 weeks for several months. Once the pressure was down to acceptable levels, we tapered down on the drops and now I see him every 3-4 months as my pressure is borderline.

[debra]

My stuck sista, hello there... As you know, the weg dog causes a long list of eye problems, even today, my eyes change constantly, its nuts! Mostly distance for me, so, who really needs to see far away anyway??? You'll see it when you get closer! Having said this, I do agree the pred causes glaucoma... My dad is dealing with this, he's on pred for polymalga rhumica... Spelling? Me, not phone, for a nice change of pace... So... Good luck, sista in the middle... Deb...

[Middlesista]

Max - from what I have read it sounds like the Prednisone as you mention. Eye doc told me to start eye drops if I have to increase the prednisone to 30mg. Just talked to RA he still wants me to cont to try and decrease prednisone and will check CRP in 2 weeks. How high were your pressures?

[Middlesista]

Hi Deb - you are correct if u want to see something far away walk on up to it!

With that said - because I had loss of vision when I was diagnosed I tend to be a worrywart when it comes to my eyes.

[debra]

My sista in the middle, I also have extreme loss of vision, mine were twenty twenty, now? Well, pretty bad... Ya the eyes scare the heck out of me, but since I'm still fighting for treatment, if I don't laugh, I will completely lose my mind... Some say, I'm already there! Who cares what they say... It helps with the fear, ya know? For me anyway... Good luck, my stuck sista... Debra...

[Birdie]

How high were your pressures?

After a couple months at 80 mg prednisone, I was in often in high 40's and was told 50 can pop your eye like squeezing a grape. I had serious issues for nearly a year until getting pred down to about 20 mg. I had 14 different prescription eye drops, wish I could recall the names of what worked. A few of them helped and one actually worked perfectly to reduce the pressure, the rest did nothing or had nasty side effects. The drops that helped were mostly helping with eye pain and did nothing for the pressure. The drops that worked were expensive, around $150 for a small bottle, maybe two weeks worth.

[Birdie]

if I don't laugh, I will completely lose my mind

Oh my. You couldn't post that in your thread, where I'm free to be me?

[debra]

Birdie, hi... Ah, the golden eye drops! Pred- forte... About one hundred thirty bucks, for two weeks! Insurance didn't cover, and I'm so thankful to the pharmacist, who told me the generic, also pretty expensive is in no way the same with these drops! Good to know! Because who wants to risk their eyes! Later on, a nurse at my eye doc, who's a sweetheart, gave me a free sample, full bottle... These drops, saved my vision, so can't complain here... Though putting in the eyes every waking hour is hard! Deb...

[debra]

Birdie, Haha!!! You, rock... Deb...

[Middlesista]

After a couple months at 80 mg prednisone, I was in often in high 40's and was told 50 can pop your eye like squeezing a grape. I had serious issues for nearly a year until getting pred down to about 20 mg. I had 14 different prescription eye drops, wish I could recall the names of what worked. A few of them helped and one actually worked perfectly to reduce the pressure, the rest did nothing or had nasty side effects. The drops that helped were mostly helping with eye pain and did nothing for the pressure. The drops that worked were expensive, around $150 for a small bottle, maybe two weeks worth.

Geez - popping eyes is a scary thought! Do u still need drops on the lower dose of prednisone?

[Birdie]

Geez - popping eyes is a scary thought! Do u still need drops on the lower dose of prednisone?

Naw Sissy, the pressure dropped to 10 or 12 below 10 mg pred. That's about 3 years ago and I've had no NEW eye issues, just need glasses now and unstable vision/eye glass prescription varies.

[Pete]

Just reviewed my labs and medication history. For me, there doesn't seem to be any correllation between pred dosage and CRP. My CRP seems to fluctuate more in line with disease activity, but doesn't seem to be any direct correllation.

[Middlesista]

Naw Sissy, the pressure dropped to 10 or 12 below 10 mg pred. That's about 3 years ago and I've had no NEW eye issues, just need glasses now and unstable vision/eye glass prescription varies.

Well that is good! I have the puffy eyelid going from the prednisone - but I worry about eye issues since that is what started the dx. Saw eye doc this week and she did not think swollen was an issue and just told me to apply warm soaks and use eye gtts if prednisone dose went up.

I have heard some folks have issues with getting glasses since vision seems to not be consistent. I am with Deb with this - if I want to see something bad enough I just get closer to it

[Middlesista]

Thanks so much for checking Pete

i don't know if you recall the question I had about the granulocyte count found in the differential of the WBC - I was wondering if this had a correlation with disease activity since my level was high and then has fluctuated but is still higher than norm. I asked my RA and he thinks it is not related but I am still wondering since it makes sense to me.

[Pete]

Thanks so much for checking Pete

i don't know if you recall the question I had about the granulocyte count found in the differential of the WBC - I was wondering if this had a correlation with disease activity since my level was high and then has fluctuated but is still higher than norm. I asked my RA and he thinks it is not related but I am still wondering since it makes sense to me.

I responded to that thread. I had a significant increase in abs grans right before my first rtx. It gradually decreased to normal over the next year or so. :)

[Middlesista]

I responded to that thread. I had a significant increase in abs grans right before my first rtx. It gradually decreased to normal over the next year or so. :)

It over a year to return to norm ? Mine is still up but less than when I was first diagnosed.

I mentioned it to my RA and he said it could be related to prednisone but it makes logical sense to me that it would be elevated when there was inflammation

Just found that thread again - thanks Pete , sorry to be redundant ��

[Birdie]

thanks Pete , sorry to be redundant ��

There you go apologizing again for doing what the forum is intended to do... please keep discussing... I keep learning...

[debra]

My stuck sista, I agree with the one above me! How else do you learn? Plus learning from those going through the same, is the best way, in my opinion... I dig, you're posts, my sista... Also, keeps me less bored... Deb...

[drz]

Pred messes with your blood glucose levels. Variations in those levels affect visual acuity. That is why many people with diabetes have trouble getting effective prescriptions for their glasses. One optometrist used to take three readings over three different times and then average them to get the best correction for my lenses. Another thing that pred affects is the moisture level or film over your eyes to keep them moist which also affects your vision. Since diagnosis of Wegs my eyes are often drier which also impairs my vision too. I also found that I don't blink as much anymore as I used to which contributes to drier eyes too. I think pred also ages us more or faster and age often decreases visual acuity too.

[Middlesista]

Prednisone is bad enough but prednisone and diabetes adds yet another element to watch over Thanks

[debra]

Drz, true that! Wegeners effecting the eyes is bad enough, then add ithese, I guess its a good thing my cars gone! Once i add in the pred, can't even imagine! Yikes... People already move when they see me coming! They'll all scatter like a c.cockroach ockroach, when the lights are turned on... Oh! Ignore this, huge double typo!!! I see it, but can't fix it! You, all should not even bat an eyelash by now, though... It's me, afterall... Deb...