What is ESR in a blood test?
The content of the article:
- What does ESR mean in a blood test?
- Normal ESR values
- Decoding ESR
- Causes of increased ESR in children
- How to normalize ESR?
What is ESR in a blood test? The erythrocyte sedimentation rate, or ESR for short, is a non-specific laboratory test that may indicate an inflammatory, allergic or other pathological process in the body.
Blood reacts to almost any change in the functioning of the human body. That is why a general (clinical) blood test is prescribed for patients with almost any disease, as well as during a dispensary examination. This analysis examines a number of indicators, including ESR.
What does ESR mean in a blood test?
Plasma density is less than the density of red blood cells. Therefore, the erythrocytes in the test tube under the influence of gravity settle to the bottom, and after a while the blood is divided into two parts: transparent plasma and red sediment. The speed of this process also depends on the rate of adhesion of red blood cells to each other (the process of aggregation of erythrocytes). The adhered cells are heavier and therefore sink to the bottom faster.
The aggregation of erythrocytes is influenced by many substances that make up the blood, for example, fibrinogen, albumin, globulins. They change the charge of the erythrocyte membrane, thereby increasing their ability to adhere and, as a result, increase the ESR.
With many pathologies and some physiological conditions, the ESR increases
The use of ESR in a blood test was proposed in 1918 by the Swedish scientist Faro. It was he who found that in women during pregnancy, the erythrocyte sedimentation rate increases. Subsequently, he found that ESR reacts with an increase to other conditions and diseases. Nevertheless, this laboratory test entered widespread clinical practice much later. This happened in 1926, when another Swedish doctor, Westergren, proposed his own method for determining ESR, which is still widely used today.
In medical and diagnostic institutions in the USSR, ESR was determined according to the Panchenkov method, which is still used today in many clinics in the CIS countries. The results of determining the ESR by these two methods, lying in the area of the norm, coincide with each other. However, the Westergren study is more sensitive to an increase in the erythrocyte sedimentation rate, therefore, in the zone of increased values, it gives a more accurate result.
ESR cannot be considered as a specific symptom of any disease. However, if this indicator is increased, this is a kind of signal for the doctor about the need for further, more in-depth examination of the patient (biochemical analysis, detailed clinical analysis with a leukocyte formula, ultrasound, radiography, etc.).
The erythrocyte sedimentation rate in modern test forms is designated "ESR" and is measured in mm / h.
Normal ESR values
The rate of erythrocyte sedimentation rate depends on the age and gender of the patient.
| Age | Floor | ESR, mm / h |
| Newborn | Girls and boys | 0 to 3 |
| 1 month | Girls and boys | 2 to 5 |
| 2-6 months | Girls and boys | 4 to 6 |
| 6-12 months | Girls and boys | 3 to 10 |
| 1-5 years | Girls and boys | 5 to 11 |
| 6-14 years old | Girls and boys | 4 to 12 |
| 15-18 years old | Young men | 1 to 10 |
| 15-18 years old | Girls | 2 to 15 |
| 19-30 years old | Women | 8 to 15 |
| 31 and older | Women | 2 to 25 |
| 19-60 years old | Men | 2 to 10 |
| 61 and older | Men | Up to 15 |
In some laboratories, to determine the ESR rate in patients from 50 years of age and older, they use the data not presented in the table, but a formula according to which the upper limit of the ESR rate in men is their age, divided by two. For women, the formula is different: B / 2 + 10, where “B” means age. However, this method is not widespread, since it often interprets a high ESR, which requires further additional examination of the patient, as normal.
In pregnant women, the erythrocyte sedimentation rate can reach 40-50 mm / h, which is not a pathology and does not require any treatment.
Decoding ESR
A variety of diseases and conditions can cause an increase in ESR. That is why the decoding of ESR is carried out taking into account other laboratory tests, as well as data from instrumental examination and clinical signs of the disease.
Most often, an increase in ESR is caused by:
- anemia;
- stroke;
- heart attack;
- obesity;
- cystic fibrosis;
- diseases of the biliary tract and liver;
- diabetes;
- tuberculosis;
- leukemia;
- malignant tumors;
- almost all infectious and inflammatory diseases.
According to medical statistics, in 40% of cases, high ESR indicates an infectious process. In 23% of cases, malignant neoplasms lead to an increase in the indicator, and in 17% - rheumatic diseases. Anemia, trauma, diabetes mellitus, inflammatory diseases of the upper respiratory tract, as well as the pelvic organs and the gastrointestinal tract are the cause of increased ESR in 8% of cases. In less than 3% of cases, an increased erythrocyte sedimentation rate was observed with kidney disease.
Despite the available statistics, it is impossible to make a diagnosis based on an increase in ESR alone. In addition to pathological ones, there are also physiological reasons that affect ESR (pregnancy, type of diet, exercise, allergic reactions, taking certain medications).
In most cases, ESR begins to increase not from the first hours of the disease, but only after 2-3 days. After recovery, this figure returns to normal only after a few weeks.
Cases of decreased ESR in clinical practice are rare. The reasons can be:
- violations of water and electrolyte balance with symptoms of overhydration;
- acute and chronic liver failure;
- muscle dystrophy;
- high-dose corticosteroid therapy;
- smoking;
- early pregnancy;
- prolonged fasting;
- vegetarianism.
Causes of increased ESR in children
The body of children, due to the immaturity of the immune system, reacts violently to any diseases and other altered conditions.
Most often, infectious and non-infectious somatic diseases lead to an increase in ESR in them:
- bronchial asthma;
- anemia and other blood diseases;
- extrapulmonary and pulmonary tuberculosis;
- trauma;
- endocrine diseases;
- hypovitaminosis conditions;
- helminthic invasions.
In children of the first year of life, an increase in ESR can also be caused by teething, as well as taking non-steroidal anti-inflammatory drugs (Paracetamol, Ibuklin, Ibufen). Therefore, in pediatric practice, without additional examination, it is impossible to say what exactly is the cause of the increase in ESR.
During pregnancy, the ESR increases several times, but this is not a pathology
How to normalize ESR?
It should be understood that a high ESR value is not an independent pathology. It can be due to both pathological and physiological reasons, the elimination of which leads to the normalization of the indicator. For example, in pregnant women after childbirth, ESR independently returns to normal limits. If the cause of the increase in ESR was an infectious disease, then the normalization of the indicator occurs some time after anti-infective therapy. With iron deficiency anemia, patients are prescribed iron supplements and multivitamins, and with diabetes mellitus - insulin or sugar-reducing drugs.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
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