Do you follow patients with elevated ESR/CRP if their work-up for rheumatologic etiology is unrevealing and no other cause is identified?

The short answer is yes for most cases. That said, there are many variables. Typically, elevations in acute phase reactants (ARPs) occur in response to different initiating events and can be observed to resolve on repeat testing. Persistent elevations in ARPs in the absence of clinical signs and symptoms may indicate the development of a lymphoproliferative or myeloproliferative disorder or herald the onset of a systemic inflammatory disease. The value of follow-up allows early recognition and management of the clinical problem.

David Goddard, MD, FACP
Clinical Professor Medicine
NYU Grossman School of Medicine

Thanks for the reply, helpful to know your general approach.