ESR-ERYTHROCYTE SEDIMENTATION RATE

Wintrobe method

Males:

• 0-9 mm/hr

Females:

• 0-20 mm/hr

Westergen method

Males:

• 3-5 mm/hr

Females:

• 5-12 mm/hr

• Estimation of the red cells occurs when anti-coagulated blood is allowed to settle. The rate at which the red cells fall is known as the ESR. The test actually measures the rate of fall (sedimentation) of RBCs in a sample of blood that has been placed into a tall, thin, vertical tube.
• Sedimentation of red cells occurs due to rouleau formation. Sedimentation is faster when the size and number of rouleau are large. Therefore, any factor that facilitates rouleaux formation increase ESR and any factor that inhibits it decrease ESR.
• ESR is a non-specific test to detect inflammation. ESR increases in inflammatory conditions, be it infective or non-infective.
• A rise in plasma fibrinogen as it occurs in acute infections, or a rise in plasma globulin as seen in chronic infections, or a rise in phase reactant as seen in non-infective inflammations increases ESR. It also increases in malignant diseases like carcinoma and leukemia.
• It increases with an increase in the rate of inflammation and decreases with a decline in inflammatory activity. Thus ESR gives a clue to the physician regarding the progress of the disease and the response of the disease to treatment. Sometimes, ESR remains elevated long after the clinical manifestations have disappeared, indicating that the defence mechanism of the body continues to be more active than normal.
• ESR test is typically indicated for the diagnosis and monitoring of Temporal Arteritis, Systemic vasculitis, and polymyalgia rheumatica

• When a condition or disease is suspected of causing inflammation in the body
• When Arthritis is suspected of causing inflammation and pain in the joints or when digestive symptoms are suspected to be caused by inflammatory bowel disease.
• When there are s/s that suggest polymyalgia rheumatica, systemic vasculitis, temporal arteritis such as headaches, neck and shoulder pain, pelvic pain , unexplained weight loss and joint stiffness

Physiological

• Pregnancy (due to increased fibrinogen and globulin)
• After a meal

Pathological

• Acute infection e.g. pneumonia
• Chronic infection e.g. TB
• Acute non-infective inflammation e.g. gout
• Collagen vascular disease (RA, SLE etc.)
• Malignant disease e.g. CA breast, leukemia , Multiple myeloma
• Anemia

• Polycythemia
• Afibrogenemia
• Sickle cell anemia
• Hereditary spherocytosis