High CRP High platelet volume

Here is my latest blood work:

MCV: 77 (lower limit :80)
MPV : 18 (Upper limit :10.4)
Platelets: 159K (Limits 150-450 K)
Vit B12:153 (193-950)

I sometimes get tiny blood from my mouth without any reason. Both my father & brother have similar problem. That is, they get blood from nose.

Now, my problem: high MPV of even 11 or 12 is a cause for concern for stroke/MI. with 18 as my MPV, I should have been dead. How to decrease MPV? I also have GERD. Hence it may be difficult for me to use ASPRIN.

HS C-reactive protein: 4 (safe values are less than 1).  
This number is again sky high.  I have angina problems from last 18-15 yrs.  Now I know it is because of high CRP.  My total choles: 175, LDL-120,HDL-40, Trigly-85. BP 115/70.  30 Yrs back I had Rheumatic Fever with swollen joints & heart beating at 140/min.  After treating with pennicilin+asprin for 8 weeks, it went away.  But, it is possible that it may still be there in some dormant form (occational little aches & pains at joints). Now I do not have any symtom of Rheumatic Fever. Question: what tests are there to eliminate Rheumatic Fever as a possible casuse for increased CRP? what medications are there to decrease CRP??

The reason why I went to DOC: 1. Angina 2: tingling/numbess in left foot fingers from last 4 months. Doc put me on treadmill stress test. I passed in flying colors. He did ultrasonic-cardio on my heart. All are functioning OK with out any blockages. I am still having this daily (tingling/numbess )although no pain. What may be causing this?

[Cleveland Clinic]

joslin,


With your work up your overall risk of obstructive coronary disease  causing your problems is low.  If you were treated with Penicilling, the likelyhood of sequlae of rheumatic fever is low.  An phycsical exam and/or echo would also help rule out any remaining damage form it.

The MPV is not used in cardiology.  The MPV is a reflection of platelet size.  It can change in various normal and abnormal physiologic states.  Given your history of mucosal bleeding, which seems to be familial, I would want to look at a blood smear of your platelets to see if they had a normal morphology and consider various inherited bleeding disorders such as Glanzmans thrombasthenia or von willebrands disease all of which can be assoicated with abnormal platlet fucntion.

With respect to coronary disease and CRP, statins, aspirin, weight loss and an active lifestlye can lower CRP.

good luck

[joslin_joslin]

Additional details: I am in mid 40's, treadmill daily for 30 mins, had total choles of 170-180 from last 6 yrs.  Guessing that my CRP was always high (may be from last 15 yrs or so) since I had Angina ON & OFF from long time.  Thank You very much for your time.