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Podcast - ESR or CRP? The inflammation debate – which test tells the best tale?
- 2025/03/19
- 再生時間： 11 分
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あらすじ・解説
The video version of this podcast can be found here: · https://youtu.be/kk5ADBP1J9MMy name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I go through guidance on inflammatory markers, ESR and CRP. For this I have reviewed a number of guidelines and publications, particularly South Tees Hospitals NHS Trust, York and Scarborough Hospitals NHS Trust and Bristol, North Somerset and South Gloucestershire ICB. A full list of the sources consulted can be found below.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The sources consulted can be found here:· BJGP article: https://bjgp.org/content/69/684/e462 · BNSSG guideline: https://remedy.bnssg.icb.nhs.uk/adults/investigations/inflammatory-marker-testing/?utm· Clinical audit: https://gps.northcentrallondon.icb.nhs.uk/cdn/serve/service-downloads/1551452026-75436315473b66e9567181d4bb9736a3.pdf?dl=1&utm· South Tees Hospitals: https://www.southtees.nhs.uk/services/pathology/tests/c-reactive-protein-crp/?utm and https://www.southtees.nhs.uk/services/pathology/tests/esr/ · York and Scarborough Hospitals: https://www.yorkhospitals.nhs.uk/seecmsfile/?id=4123 · Medcentral: https://www.medcentral.com/pain/chronic/erythrocyte-sedimentation-rate-c-reactive-protein-old-useful-biomarkers-pain-treatment?utm TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we are looking at the guidance on inflammatory markers, ESR and CRP, focusing on what is relevant in Primary Care only. For this I have reviewed a number of NHS guidelines and medical publications. A full list of the sources consulted can be found in the episode description.Right, without further ado, let’s jump into it.The most commonly used inflammatory markers are Erythrocyte Sedimentation Rate (or ESR) and C-Reactive Protein (or CRP).ESR and CRP are not only frequently ordered in Primary Care but the rate of testing also appears to be increasing. It is estimated that for every 1000 inflammatory marker tests done there are 236 false positives, which leads to 710 GP appointments, 229 blood test appointments and 24 referrals in the following six months. Furthermore, there are concerns about excessive testing because clinicians often check multiple inflammatory markers simultaneously.So, this is the reason why it is generally advised to avoid using these tests for screening or as a rule-out for patients with non-specific symptoms.But let's start with the basics.Inflammation is a fundamental response to injury, infection, or disease. It involves a complex cascade of immune mediators, which leads to the production of acute-phase reactants, that is, proteins that increase in response to inflammation. This is where ESR and CRP come into play.Let’s have a look at them individually and in a little bit more detail.And let’s start with CRP.What makes CRP clinically useful?firstly, CRP is used to assess the progression of inflammation and infection. Unlike ESR, CRP test measures the ...