ESR (Erythrocyte Sedimentation Rate)
Understanding ESR (Erythrocyte Sedimentation Rate)
What is ESR (Erythrocyte Sedimentation Rate)?
An ESR (Erythrocyte Sedimentation Rate) test measures the rate at which red blood cells (also known as erythrocytes) settle in a test tube over a specified period of time. This test is a marker of inflammation and helps detect or monitor various inflammatory diseases, such as infections, autoimmune disorders, certain cancers, and tissue damage.
Inflammation is the body’s normal response to an injury or infection. It usually occurs when the body releases chemicals that trigger an immune response to fight off a disease or heal damaged tissue. Once the injury or infection is healed, the inflammatory process subsides. An ESR (Erythrocyte Sedimentation Rate) test helps assess the presence and degree of inflammation in the body. It may also be used to monitor the progression of certain chronic inflammatory diseases such as rheumatoid arthritis.
An ESR (Erythrocyte Sedimentation Rate) test may be done if you experience signs and symptoms like fever, joint stiffness, body pain, abdominal pain, or blood in the stool. It is a non-specific test; it cannot diagnose a specific disease or determine the cause of inflammation. It is usually done along with other tests to identify the underlying condition. Higher ESR values generally indicate a higher degree of inflammation or disease activity.
Elevated ESR values may be seen in infections such as bacterial, viral, or fungal infections, autoimmune conditions such as rheumatoid arthritis, systemic lupus erythematosus, and vasculitis, after a heart attack, trauma, or surgery, or in some cancers, including lymphoma and multiple myeloma. Conditions other than inflammation that may cause an increase in ESR levels include anemia, pregnancy, aging, and certain medications. A decrease in ESR values may indicate a positive response to therapy.
Usually, overnight fasting (8-12 hours) is preferred for this test; however, it is not mandatory. It would be best to inform your doctor about your medications, as some may affect your test results.
Test result ranges are approximate and may differ slightly between labs depending on the methodology and laboratory guidelines. Talk to your doctor about your specific test results. Narrate your complete medical history to help the doctor correlate your clinical and laboratory findings. The test results will help them determine your medical condition and formulate your treatment plan.
What is ESR (Erythrocyte Sedimentation Rate) used for?
An ESR test is done:
- As part of routine checkups to monitor your overall health.
- To detect any inflammation in the body which may be caused due to conditions such as infections, cancers, and autoimmune diseases.
- To monitor the progress of inflammatory diseases.
- To evaluate the treatment response of inflammatory diseases.
What does ESR (Erythrocyte Sedimentation Rate) measure?
An ESR test measures the rate at which red blood cells (erythrocytes) settle (sediment) in one hour at the bottom of a tube that contains a blood sample.
When there is inflammation in the body, certain proteins, mainly fibrinogen, increase in the blood. This increased amount of fibrinogen causes the red blood cells to form a stack (rouleaux formation) that settles quickly due to its high density, leading to an increase in the ESR.
An ESR test is a non-specific measure of inflammation and can be affected by conditions other than inflammation. This test cannot identify the exact location of the inflammation in your body or what is causing it. Hence, an ESR test is usually performed along with a few other tests to identify or treat possible health concerns.
Interpreting ESR (Erythrocyte Sedimentation Rate) results
Interpretations
The normal reference range for Erythrocyte Sedimentation Rate (ESR) is:
Men |
0-15 millimeters per hour (mm/hr), or 0-20 mm/hr for men older than 50 |
Women |
0-20 mm/hr, or 0-30 mm/hr for women older than 50 |
Children |
0-10 mm/hr |
Newborns |
0-2 mm/hr |
High ESR can be seen in:
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Inflammatory diseases such as Arthritis (Inflammation of joints), vasculitis (Inflammation of blood vessels)
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Infections, such as pneumonia, pelvic inflammatory disease, appendicitis, skin infection, bone infection, heart valve infection
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Autoimmune diseases, such as systemic lupus erythematosus or rheumatoid arthritis
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Chronic kidney disease
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Viral infections
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Pregnancy
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Cancer, such as lymphoma or multiple myeloma
Low ESR can be seen in:
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Congestive heart failure
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Polycythemia
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Sickle cell disease
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Severe liver disease
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Hypofibrinogenemia