The sedimentation rate( sedimentation) of erythrocytes is an analysis used to detect inflammation in the body.
The sample is placed in an elongated thin tube, the red blood cells( erythrocytes) gradually settle on its bottom, and the ESR is a measure of this settling rate.
Analysis allows you to diagnose many disorders( including cancer) and is a necessary test to confirm many diagnoses.
Let's figure out what this means when the rate of erythrocyte sedimentation( ESR) in a general analysis of adult or child blood is increased or decreased, is it worth fearing such indicators and why does it occur in men and women?
NormESR in men, women and children - age table
| Age group and gender | ESR value, mm / hour |
| Women under 50 | 20 or below |
| Women over 50 years old | 30 or below |
| Maleup to 50 years old | 15 or below |
| Men over 50 years old | 20 or below |
| Newborns and infants | 0-2 |
| Children under the age of 18 years | 3-13 |
Normal ranges of values may vary slightly depending on the equipment of the laboratories. Abnormal results do not diagnose a particular disease.
Many factors, such as the age or the use of medicines, can affect the end result. Such drugs as dextran, ovidon, silest, theophylline, vitamin A can increase ESR, and aspirin, warfarin, cortisone can reduce it. High / low rates only tell the doctor about the need for further examination.
False enhancement of
A number of conditions may affect blood properties, affecting the value of ESR.Therefore, accurate information about the inflammatory process - the reason that a specialist assigns the surrender of the analysis - can be masked under the influence of these conditions.
In this case, the values of ESR will be falsely elevated. These complicating factors include :
- Anemia( reduced number of red blood cells, reduced hemoglobin in serum);
- Pregnancy( in the third trimester ESR increases approximately 3 times);
- Increased cholesterol concentration( LDL, HDL, triglycerides);
- Kidney problems( including acute kidney failure).
Interpretation of results and possible causes of
What does this mean if the erythrocyte sedimentation rate( ESR) in an adult or child's blood test is elevated or decreased, is it worthwhile to fear indicators above or below normal?
High levels in blood analysis
Inflammation in the body provokes gluing of erythrocytes( the weight of the molecule increases), which significantly increases their sedimentation rate to the bottom of the tube. Elevated levels of sedimentation can be caused by the following reasons:
- Autoimmune diseases - Liebman-Sachs disease, giant cell arteritis, rheumatic polymyalgia, necrotic vasculitis, rheumatoid arthritis( the immune system is the body's defense against foreign substances.) On the background of an autoimmune process, it accidentally attackshealthy cells and destroys the tissues of the body);
- Cancer( this can be any form of cancer, from lymphoma or multiple myeloma to bowel and liver cancer);
- Chronic kidney disease( polycystic kidney disease and nephropathy);
- Infection, for example, pneumonia, pelvic inflammatory disease or appendicitis;
- Inflammation of the joints( rheumatic polymyalgia) and vessels( arteritis, diabetic angiopathy of the lower extremities, retinopathy, encephalopathy);
- Inflammation of the thyroid gland( diffuse toxic goiter, nodular goiter);
- Infections of joints, bones, skin or valvular heart;
- Too large concentrations of fibrinogen in serum or hypofibrinogenemia;
- Pregnancy and Toxicosis;
- Viral infections( HIV, tuberculosis, syphilis).
Because ESR is a nonspecific marker of inflammatory foci of and correlates with other causes, the results of the analysis should be taken into account along with the patient's health history and the results of other examinations( general blood analysis - extended profile, urinalysis, lipid profile).
If the only elevated index in the analysis is ESR( on the background of a complete absence of symptoms), a specialist can not give an exact answer and make a diagnosis. In addition, the normal result does not exclude disease. Moderately elevated levels can be caused by aging.
Very large indicators usually have serious causes of , for example, multiple myeloma or giant cell arteritis. People with Waldenstrom macroglobulinemia( presence of pathological globulins in the serum) have extremely high levels of ESR, although there is no inflammation.
This video details the norms and deviations of this indicator in the blood:
Low values of
Low sedimentation rate, as a rule, is not a problem. But can be associated with such abnormalities as:
- Disease or condition that increases the production of red blood cells;
- Disease or condition that increases the production of leukocytes;
- If a patient undergoes treatment for an inflammatory disease, the degree of sedimentation going down is a good sign and means that the patient responds to treatment.
Low values can be caused by the following reasons:
- Elevated glucose level( in diabetics);
- Polycythemia( characterized by an increased number of erythrocytes);
- Sickle cell anemia( genetic disease associated with pathological changes in the shape of cells);
- Severe liver disease.
Any factors of can be the cause of the decline, for example:
- Pregnancy( in the 1st and 2nd trimester the levels of ESR are lowered);
- Anemia;
- Menstrual period;
- Medicinal products. Many drugs can falsely reduce test results, for example, diuretics( diuretics), taking drugs with a high calcium content.
Elevated data for diagnosis of cardiovascular diseases
In patients with angina or myocardial infarction, ESR is used as an additional potential indicator of coronary heart disease.
ESR is used for the diagnosis of endocarditis - endocardial infection( inner layer of the heart).Endocarditis develops against the background of the migration of bacteria or viruses from any part of the body through the blood in the heart.
For the diagnosis of "endocarditis", a specialist necessarily prescribes the surrender of a blood test. Along with high levels of sedimentation rate, endocarditis is characterized by a decrease in platelets ( a lack of healthy red blood cells), often the patient is also diagnosed with anemia.
On the background of acute bacterial endocarditis, the degree of sedimentation of may increase to the extreme values of ( about 75 mm / hr) - this is an acute inflammatory process characterized by a severe infection of the heart valves.
When diagnosing for congestive heart failure, , the levels of ESR are taken into account. This is a chronic progressive disease that affects the cardiac muscle power. In contrast to the usual "heart failure", stagnant refers to the stage in which excess fluid accumulates around the heart.
For the diagnosis of the disease in addition to physical tests( electrocardiograms, echocardiograms, MRI, stress tests), the results of a blood test are taken into account. In this case, the analysis on the extended profile of may indicate the presence of abnormal cells and infections of ( sedimentation rate will be higher than 65 mm / hour).
With myocardial infarction is always provoked by an increase in ESR.Coronary arteries deliver oxygen from the blood to the heart muscle. If one of these arteries is blocked, part of the heart is deprived of oxygen, a condition called "myocardial ischemia" begins.
On a background of myocardial infarction, the ESR reaches peak values of ( 70 mm / h and above) during the week. Along with the increase in sedimentation rate, the lipid profile will show elevated levels of triglycerides, LDL, HDL cholesterol and serum cholesterol.
A significant increase in the rate of erythrocyte sedimentation is noted against the background of acute pericarditis .This acute inflammation of the pericardium, which begins suddenly, and causes blood components, such as fibrin, red blood cells and white blood cells, to penetrate the pericardial space.
Often the causes of pericarditis are evident, for example, a recent heart attack. Along with increased levels of ESR( above 70 mm / hr), showed an increase in urea concentration in the blood of as a result of renal failure.
The erythrocyte sedimentation rate significantly rises in the presence of an aortic aneurysm of the thoracic or abdominal cavity. Along with high values of ESR( above 70 mm / h), blood pressure will be increased, in patients with an aneurysm, a condition called "thick blood" is often diagnosed.
Conclusions
ESR plays an important role in the diagnosis of cardiovascular diseases .The indicator appears to be elevated against the background of many acute and chronic disease states characterized by tissue necrosis and inflammation, and is also a sign of blood viscosity.
Elevated levels directly correlate with the risk of developing myocardial infarction and ischemic heart disease. At high levels of subsidence and suspected cardiovascular disease , the patient is referred for further diagnosis of , including an echocardiogram, an MRI, an electrocardiogram to confirm the diagnosis.
Accordingly, a high sedimentation rate will correlate with greater disease activity and indicate the presence of possible conditions such as chronic kidney disease, infections, thyroid inflammation and even cancer, while low values indicate less active disease progression and regression.
Although sometimes even low levels correlate with the development of some diseases of , for example, polycythemia or anemia. In any case, a specialist's consultation is necessary for the correct diagnosis.