Erythrocyte Sedimentation Rate (ESR)
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Latest Edit: Iva Lloyd, ND 2021-08-24 (EDT)
| See Also | Lab Tests |
|---|
Erythrocyte Sedimentation Rate or ESR refers to the rate at which erythrocytes or red blood cells settle out of anti-coagulated blood in 1 hour. This test is useful for determining the level of tissue destruction, inflammation, and is indicative of an ongoing disease process that should be investigated.[1],[2]
Discussion
- This test is based on the alteration of certain blood proteins in inflammatory conditions, causing aggregation of the red blood cells
- Aggregation causes the cells to become heavier and fall more rapidly when placed in a vertical test tube
- The faster the sedimentation, the higher the ESR
- Increased albumin levels in the blood can lead to decreased ESR
- Since albumin is produced in teh liver, liver dysfunction can cause decreased albumin productions and therefore increase the ESR
Patient Preparation
- Hold medications that may affect test results, if indicated
- Factors which can cause increased levels
- presence of fibrinogen, globulins, and cholesterol, pregnancy after 12 weeks until 4th week postpartum, young children, menstruation, high hemoglobin values.
- Drugs: dextran, methyldopa (Aldomet), oral contraceptives, penicillamine, procainamide, theophylline, heparin, and vitamin A
- Falsely decreased levels
- having blood samples stand for more than 24 hours, high blood sugar, high albumin levels, high phospholipid levels
- Drugs: steroids, high dose aspirin, cortisone, quinine
Clinical Implications
Ranges: The following are the reference ranges for this lab. However, lab ranges can vary by laboratory and country. [2]
| Standard U.S. Units | Standard International Units | |
|---|---|---|
| Conventional Laboratory Range | Males: 0-15 mm/hour Females: 0-20 mm/hour | Males: 0-15 mm/hour Females: 0-20 mm/hour |
| Optimal Range | Males: <5 mm/hour Females: <10 mm/hour | Males: <5 mm/hour Females: <10 mm/hour |
| Alarm Ranges | Males: >45 mm/hour Females: >45 mm/hour | Males: >45 mm/hour Females: >45 mm/hour |
High levels indicate:
- Tissue inflammation
- Tissue destruction
- Musculoskeletal conditions
- Cardiovascular conditions
- Malignant diseases
- Other conditions: Uncomplicated viral disease, Active renal failure with heart failure, Active allergy, Peptic ulcer, Infectious mononucleosis
Low levels indicate:
- Not significant
Associated Tests
- C-Reactive Protein (CRP), protein electrophoresis, WBC with differential, RBC and indices, albumin, total protein, ALP and the isoenzymes of ALP (liver, bone and intestine), ANA, Rheumatoid Factor, fibrinogen
References
- ↑ Pagana Kathleen D, Pagana Timothy J, (1998) Mosby's Manual of Diagnostic and Laboratory Tests, Mosby, Inc
- ↑ 2.0 2.1 Weatherby Dicken, Ferguson Scott (2002) Blood Chemistry and CBC Analysis: Clinical Laboratory Testing from a Functional Perspective, Bear Mountain
