Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Could Humira Intake Cause My ESR To Increase?
Posted on
Sun, 15 Jul 2018
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sun, 15 Jul 2018
Answered on
Fri, 2 Sep 2022
Last reviewed on
Question : Hi
I have Chrones and so far I seem to be resistant to medication. I have been on Humira since December 2017 - each fortnight - however my Calprotectin report began to escalate and so my Gastro put me on weekly. It seems that maybe the weekly is struggling to support it . However I don't feel well. I find for the first two days after injecting myself I am not well or myself on Humira - very tied and out of sorts - and fatigue is bad. It is usually two days bed after injecting. Bowel improves for a couple of days and then I become constipated and then by the end of the week during the last few days diarrhea returns. I am beginning to wonder if I could have drug induced lupus from the Humira. I get ulcers on my tongue and inside my mouth, they come and go, and I suffer sinus infections//allergy rhinitus, have sensitivity to light and sound, extreme fatigue, I get very sore lymp nodes under my arms top of breasts/chest, in groin etc etc . I suffer sweating profusely for no reason at all at the back of my neck and head as if I have had a shower and this occurs spontaneously without any given warning for no apparent reason from time to time. At night I have hot moments and my body feels very warm and although the weather outside may be minus 2 degrees C I am laying with no blankets . Then I return to normal some half an hour later. I went through an early confirmed menopause in my 30's so Dr's don't think it has anything to do with menopause. I have low Vitamin D and Zinc. Mag and Vit B
and calcium are ok. I have burning pain and tenderness at the slightess touch to my body - it comes and goes but it can be intense and very painful. I have sleep disturbances where the most I can sleep at anyone time is 4 hours. I have been diagnosed with Fibromyalgia Chronic Fatigue/ME/CFS syndrome. I find in the mornings I cannot get going - fatigue big time - bed till around 3 - 4 pm in the afternoon till around 9.30 pm I seem to improve for some unknown reason. However my energy bank is limited - if I over do it - I can be in bed for 1 - 3 days.
I have been told that before I can work on Fibromyalgia I have to fix my digestive system. As I mentioned I have Chrones and I also have GERD. My ESR blood was 104 last time and my Calprotectin Bowel was 272. I asked a Rheumatologist about the high ESR and they said it is not Rheumatic Arthritis. It is not infection, my GP thinks it is not malignancy because my first ESR blood test was 109 and then the next month it went down to 104. I am having another colonoscopy and endoscopy this week. After that my GP is having me have a MRI. But my question is could the Humira be causing my ESR to increase ? My Gastro thinks it has to be something else because whenever I have had a calprotectin report before has been into the thousands yet my ESR has only been around 48. Also my CRP has been up but this time no CRP is up - it is normal. What tests do you do for Lupus drug induced ?
I have Chrones and so far I seem to be resistant to medication. I have been on Humira since December 2017 - each fortnight - however my Calprotectin report began to escalate and so my Gastro put me on weekly. It seems that maybe the weekly is struggling to support it . However I don't feel well. I find for the first two days after injecting myself I am not well or myself on Humira - very tied and out of sorts - and fatigue is bad. It is usually two days bed after injecting. Bowel improves for a couple of days and then I become constipated and then by the end of the week during the last few days diarrhea returns. I am beginning to wonder if I could have drug induced lupus from the Humira. I get ulcers on my tongue and inside my mouth, they come and go, and I suffer sinus infections//allergy rhinitus, have sensitivity to light and sound, extreme fatigue, I get very sore lymp nodes under my arms top of breasts/chest, in groin etc etc . I suffer sweating profusely for no reason at all at the back of my neck and head as if I have had a shower and this occurs spontaneously without any given warning for no apparent reason from time to time. At night I have hot moments and my body feels very warm and although the weather outside may be minus 2 degrees C I am laying with no blankets . Then I return to normal some half an hour later. I went through an early confirmed menopause in my 30's so Dr's don't think it has anything to do with menopause. I have low Vitamin D and Zinc. Mag and Vit B
and calcium are ok. I have burning pain and tenderness at the slightess touch to my body - it comes and goes but it can be intense and very painful. I have sleep disturbances where the most I can sleep at anyone time is 4 hours. I have been diagnosed with Fibromyalgia Chronic Fatigue/ME/CFS syndrome. I find in the mornings I cannot get going - fatigue big time - bed till around 3 - 4 pm in the afternoon till around 9.30 pm I seem to improve for some unknown reason. However my energy bank is limited - if I over do it - I can be in bed for 1 - 3 days.
I have been told that before I can work on Fibromyalgia I have to fix my digestive system. As I mentioned I have Chrones and I also have GERD. My ESR blood was 104 last time and my Calprotectin Bowel was 272. I asked a Rheumatologist about the high ESR and they said it is not Rheumatic Arthritis. It is not infection, my GP thinks it is not malignancy because my first ESR blood test was 109 and then the next month it went down to 104. I am having another colonoscopy and endoscopy this week. After that my GP is having me have a MRI. But my question is could the Humira be causing my ESR to increase ? My Gastro thinks it has to be something else because whenever I have had a calprotectin report before has been into the thousands yet my ESR has only been around 48. Also my CRP has been up but this time no CRP is up - it is normal. What tests do you do for Lupus drug induced ?
Brief Answer:
ESR and CRP are indicator of inflammation.
Detailed Answer:
Hi,
1) CRP and ESR are old and non-specific test indicating inflammation any where in the body. They would be high in any condition which causes inflammation. As per the history given by you. You are a diagnosed case of Crohn's disease which is a inflammatory bowel condition. So your ESR would be high it has nothing to do with Humira.
In short ESR and CRP are value which would always be higher in any of the condition causing inflammation in body ranging from arthritis to inflammatory bowel disease.
2) Antibody assay test is done-In drug-induced lupus anti-ssDNA and anti-dsDNA are measured the quantity of anti-ssDNA is higher.
Hope I was helpful. Feel free to follow up.
Thank you!
ESR and CRP are indicator of inflammation.
Detailed Answer:
Hi,
1) CRP and ESR are old and non-specific test indicating inflammation any where in the body. They would be high in any condition which causes inflammation. As per the history given by you. You are a diagnosed case of Crohn's disease which is a inflammatory bowel condition. So your ESR would be high it has nothing to do with Humira.
In short ESR and CRP are value which would always be higher in any of the condition causing inflammation in body ranging from arthritis to inflammatory bowel disease.
2) Antibody assay test is done-In drug-induced lupus anti-ssDNA and anti-dsDNA are measured the quantity of anti-ssDNA is higher.
Hope I was helpful. Feel free to follow up.
Thank you!
Above answer was peer-reviewed by :
Dr. Remy Koshy
I don't have arthritis. Also what my Gastro mentioned to me is the rise in ESR is disproportionate to the Calprotectin report for the bowel. ie when my bowel has been inflamed before into the thousands ( when it should be <50 - <100) my ESR was sitting at 36 - 48 and my CRP 10 - 11. This time CRP is normal. It is only the ESR that is extremely high.
Brief Answer:
Follow up.
Detailed Answer:
Hello,
Firstly, as I said earlier ESR and CRP etc., are old school tests and are not very sensitive nor specific. For e.g., you can assume some one using swords to win a war against battle tanks in 21st era(example).
Calprotectin is also a screening test and sensitivity is again around 60% which means that out of 100 patients in only 60 calprotectin would indicate that there is a disease while in 40/100 the values would be normal or fluctuating.
Suggestion:
As you are a diagnosed case of Inflammatory bowel disease you must have undergone colonoscopy and biopsy. Colonoscopy is the gold standard test for diagnosis of any inflammatory condition related to bowel. These tests like ESR CRP Calprotectin has no value if colonoscopy is positive.
Thanks.
Follow up.
Detailed Answer:
Hello,
Firstly, as I said earlier ESR and CRP etc., are old school tests and are not very sensitive nor specific. For e.g., you can assume some one using swords to win a war against battle tanks in 21st era(example).
Calprotectin is also a screening test and sensitivity is again around 60% which means that out of 100 patients in only 60 calprotectin would indicate that there is a disease while in 40/100 the values would be normal or fluctuating.
Suggestion:
As you are a diagnosed case of Inflammatory bowel disease you must have undergone colonoscopy and biopsy. Colonoscopy is the gold standard test for diagnosis of any inflammatory condition related to bowel. These tests like ESR CRP Calprotectin has no value if colonoscopy is positive.
Thanks.
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
