Introduction of ESR
Table of Contents
The ESR stands for erythrocyte sedimentation rate. It is the rate at which erythrocyte sediment and the ESR test is a nonspecific assay that only confirms the presence or absence of inflammatory activity in the body like infection, cancer, or an autoimmune disease. It is also clinically significant to monitor how conditions, such as those below, are progressing or responding to treatment such as rheumatoid arthritis (inflammation in the joints), temporal arteritis (a type of blood vessel inflammation), polymyalgia rheumatic (a complication of temporal arteritis), and systemic vasculitis (inflammation of the lining of the blood vessels).
ESR-Test Result, Unit, Normal Range, and Test Method
Stages of ESR
Stage of aggregation or rouleaux formation: 10 minutes
Sedimentation or setting stage: 40 minutes
Stage of packing: 10 minutes
Methods of Assaying
- Wintrobe’s -EDTA blood is used and the length of the tube is 11 cm in diameter of 2.5mm. It is graduated from 0 mm to 100 mm that contains 1 ml of blood. The normal range for males is 0 to 10 mm/hour while in females is 0 to 15 mm/hour.
- Westergreen-It is a 300mm long tube, graduated from 0 to 200 mm of diameter 2.55 mm. Trisodium citrate anticoagulated is used for this method of dilution 4:1 (1.6 ml of blood with 0.4 ml of anticoagulant having a strength of 3.2%. The normal range of this method is for males 3 to 5 mm/hour and 4 to 7 mm/hour for females.
- Micro method
- The automated sedimentation method is the most accurate and fast method of testing.
Clinical Significance
Extremely elevated results: It is an extremely high ESR value, which is one above 100 mm/hour, may indicate one of these conditions:
- Multiple myeloma (plasma cells cancer)
- Waldenstrom’s macroglobulinemia (white blood cell cancer)
- Temporal arteritis or polymyalgia rheumatica
- Hypersensitivity vasculitis (reaction to an allergen that results in blood vessel inflammation)
A moderately elevated ESR- It may not always indicate a health condition. However, it is possible that people whose ESR value is slightly high may have one of the following situations-
- Rheumatoid arthritis
- Anemia
- kidney disease
- Thyroid disease
- Red blood cell abnormalities (macrocytosis)
- Some forms of cancer like lymphoma
- Tuberculosis
- Bone infection
- Heart infection
- Systemic infection
- Pregnancy
Low levels- People with low ESR values may have in following clinical conditions-
- Sickle cell anemia, a condition that affects the shape of red blood cells
- Leukemia
- High red blood cell count
- Congestive heart failure
- Low levels of the protein fibrinogen in the blood
- Hyperviscosity, an increase in blood thickness
- Leukocytosis -a very high white blood cell count
Keynotes
- The most sensitive method is Westergreen.
- Fibrinogen, α and β globulin increases ESR while plasma albumin decreases ESR.