Medicine does not stand still – every day new diagnostic methods appear and are introduced, which make it possible to identify the causes of changes in the human body and leading to diseases.
Despite this, the definition of ESR has not lost its relevance and is actively used for diagnosis in adults and young patients. This study is mandatory and in all cases revealing, be it a visit to a doctor due to a disease or a regular medical examination and preventive examination.
This diagnostic test is interpreted by a doctor of any specialty, and therefore belongs to the group of general blood tests. And, if an ESR blood test is elevated, the doctor must determine the cause.
What is soe?
ESR is a term formed from the capital letters of the full name of the test – erythrocyte sedimentation rate. The simplicity of the name does not conceal any medical background, the test really determines the very speed of erythrocyte sedimentation. Red blood cells are red blood cells, which, when exposed to anticoagulants for a certain time, settle at the bottom of a medical tube or capillary.
The time taken to separate a blood sample into two visible layers (upper and lower) is interpreted as the erythrocyte sedimentation rate and is estimated from the height of the plasma layer obtained as a result of research in millimeters in one hour.
ESR refers to non-specific indicators, but is highly sensitive. By changing the ESR, the body may signal the development of a certain pathology (infectious, rheumatological, oncological, and other) before the appearance of a clear clinical picture,
Erythrocyte sedimentation rate in the blood helps:
- differentiate the diagnosis, for example, angina and myocardial infarction, acute appendicitis and ectopic pregnancy (signs), osteoarthritis and rheumatoid arthritis, etc.
- determine the response of the body during treatment for tuberculosis, rheumatoid arthritis, lymphogranulomatosis, disseminated lupus erythematosus and
Diseases with high ESR
The erythrocyte sedimentation rate is of important diagnostic and medical importance in the event of the suspicion of some disease. Of course, not one doctor refers to one indicator of ESR, when making a diagnosis. But together with the symptoms and results of instrumental and laboratory diagnostics, he occupies a weighty position.
The erythrocyte sedimentation rate almost always increases with the majority of bacterial infections occurring in the acute phase. The localization of the infectious process may be the most diverse, but the pattern of peripheral blood will always reflect the severity of the inflammatory response. ESR and increases with the development of viral etiology.
In general, diseases in which an increase in ESR is a typical diagnostic sign can be divided into groups:
- Diseases of the liver and biliary tract (see gallstones);
- Purulent and septic diseases of inflammatory nature;
- Diseases in the pathogenesis of which is the destruction and necrosis of tissues – heart attacks and strokes, malignant neoplasms, tuberculosis;
- Blood diseases – anisocytosis, sickle anemia, hemoglobinopathy;
- Metabolic diseases and pathological changes of the endocrine glands – diabetes mellitus, obesity, thyrotoxicosis, cystic fibrosis, and others;
- Malignant transformation of the bone marrow, in which red blood cells are inferior and enter the blood unprepared for the performance of their functions (leukemia, myeloma, lymphoma);
- Acute conditions leading to an increase in intrinsic blood viscosity – diarrhea, bleeding, intestinal obstruction, vomiting, condition after surgery;
- Autoimmune pathologies – lupus erythematosus, scleroderma, rheumatism, Sjogren’s syndrome and others.
The highest rates of ESR (more than 100 mm / h) are characteristic of infectious processes:
- SARS, influenza, sinusitis, bronchitis, pneumonia, tuberculosis, etc.
- urinary tract infections (pyelonephritis, cystitis)
- viral hepatitis and fungal infections
- for a long time, a high ESR may occur during the oncological process.
It is worth noting that during infectious processes this indicator does not grow immediately, but one or two days after the onset of the disease, and after recovery some time (up to several months) ESR will be slightly increased.
ESR – the norm and pathology
Since this indicator is normalized, there are physiological limits that are normal for different groups of the population. For children, the rate of ESR varies with age.
Separately, such a condition of a woman as pregnancy is considered, in this period increased ESR up to 45 mm / h is considered normal, while a pregnant woman does not need additional examination to detect pathology.
- In a newborn child, this indicator is in the range of 0-2 mm / h, maximum – 2.8 mm / h.
- At the age of one month the standard is 2-5 mm / h.
- At the age of 2-6 months in the physiological limits is 4-6 mm / h;
- for babies 6-12 months – 3-10 mm / h.
- In children of the age group of 1-5 years, the ESR normally ranges from 5 to 11 mm / h;
- In children from 6 to 14 years old – from 4 to 12 mm / h;
- Above 14 years old: girls – from 2 to 15 mm / h, boys – from 1 to 10 mm / h.
- For women of the age category up to 30 years, the ESR rate is 8-15 mm / h
- over 30 years old – an increase of up to 20 mm / h is allowed.
- At the age of 60 years, this figure is normal when in the range of 2-10 mm / h,
- in men older than sixty years of age, the ESR is up to 15 mm / h.
Methods for determining ESR and interpretation of results
In medical diagnostics, several different ESR methods are used, the results of which differ from each other and are not comparable with each other.
The essence of the Westergren method, widely practiced and approved by the International Committee for Standardization of Blood Research, is the study of venous blood, which in a certain ratio is mixed with sodium citrate. The erythrocyte sedimentation rate is determined by measuring the distance of the tripod — from the upper boundary of the plasma to the upper boundary of the settled red blood cells 1 hour after mixing and placing it in the tripod. If it turns out that the ESR of Westergren is elevated, the result is more indicative of diagnosis, especially in the case of accelerating the reaction.
Vintrob’s method is to study undiluted blood mixed with an anticoagulant. ESR is interpreted on the scale of the tube in which blood is placed. The disadvantage of the method is the unreliability of results at a rate higher than 60 mm / h due to clogging of the tube with settled erythrocytes.
The Panchenkov method consists in the study of capillary blood diluted with sodium citrate in a 4: 1 ratio. The blood is settled in a special capillary with 100 divisions. The result is evaluated after 1 hour.
Methods of Westergren and Panchenkov give the same results, but with increased ESR, Westergren’s method shows higher values. Comparative analysis of the indicators presented in the table (mm / h).