Erythrocytes
in plasma usually settle slowly. However, if they aggregate for any reason
(usually because of plasma proteins called acute phase reactants, eg, fibrinogen),
they settle rapidly. Sedimentation of RBCs occurs because of their greater
density than plasma. ESR measures the distance in mm that erythrocytes fall
during 1 hour.
Normal Range: Male: < 10 Female: < 15
increased
in: Infections (osteomyelitis, pelvic inflammatory disease [75%]), inflammatory
disease (temporal arteritis, polymyalgia rheumatica, rheumatic fever), malignant
neoplasms, paraproteinemias, anemia, pregnancy, chronic renal failure, GI
disease (ulcerative colitis, regional ileitis).
Decreased in: Polycythemia,
sickle cell anemia, spherocytosis, anisocytosis, hypofibrinogenemia, hypogammaglobulinemia,
congestive heart failure, microcytosis, drugs (high dose corticosteroids).
Low value of no diagnostic significance.
Additional: There
is a good correlation between ESR and C-reactive protein, but ESR is less
expensive. Test is useful and indicated only for diagnosis and monitoring
of temporal arteritis and polymyalgia rheumatica. The test is not sensitive
or specific for other conditions. ESR is higher in women and older persons.
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