ESR and CRP measure different responses

ESR depends partly on red-cell and plasma-protein properties; some conditions raise it without a parallel CRP rise.

Anemia or altered red-cell propertiesSome blood-count changes accelerate erythrocyte settling independently of acute inflammation.
Monoclonal proteins or immunoglobulin changesHigh circulating proteins can influence ESR even with relatively low CRP.
Chronic inflammatory or autoimmune diseaseCertain inflammatory conditions may produce a discordant marker pattern.
Recent or resolving infectionESR may fall more slowly than CRP after some illnesses.
Kidney or other systemic diseaseRenal and protein-balance disorders can alter inflammatory-marker interpretation.

A one-time mismatch may reflect timing

ESR can remain elevated longer than CRP as an inflammatory episode resolves, so dates matter.

Monoclonal proteins or immunoglobulin changesHigh circulating proteins can influence ESR even with relatively low CRP.
Chronic inflammatory or autoimmune diseaseCertain inflammatory conditions may produce a discordant marker pattern.
Recent or resolving infectionESR may fall more slowly than CRP after some illnesses.
Kidney or other systemic diseaseRenal and protein-balance disorders can alter inflammatory-marker interpretation.
Anemia or altered red-cell propertiesSome blood-count changes accelerate erythrocyte settling independently of acute inflammation.

High ESR with symptoms may merit targeted examination, but the number is not a disease diagnosis.

Chronic inflammatory or autoimmune diseaseCertain inflammatory conditions may produce a discordant marker pattern.
Recent or resolving infectionESR may fall more slowly than CRP after some illnesses.
Kidney or other systemic diseaseRenal and protein-balance disorders can alter inflammatory-marker interpretation.
Anemia or altered red-cell propertiesSome blood-count changes accelerate erythrocyte settling independently of acute inflammation.
Monoclonal proteins or immunoglobulin changesHigh circulating proteins can influence ESR even with relatively low CRP.

Comparing units, reference ranges and sampling dates is the first step before interpreting the apparent contradiction.

Recent or resolving infectionESR may fall more slowly than CRP after some illnesses.
Kidney or other systemic diseaseRenal and protein-balance disorders can alter inflammatory-marker interpretation.
Anemia or altered red-cell propertiesSome blood-count changes accelerate erythrocyte settling independently of acute inflammation.
Monoclonal proteins or immunoglobulin changesHigh circulating proteins can influence ESR even with relatively low CRP.
Chronic inflammatory or autoimmune diseaseCertain inflammatory conditions may produce a discordant marker pattern.