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Test Directory - ESR

Synonyms

Erythrocyte sedimentation rate, westergren

Clinical Indications

The ESR is related to degree of red cell aggregation which occurs due to formation of rouleaux. In normal plasma, rouleaux formation is minimal and the ESR is low. An alteration of plasma proteins following tissue damage, and during inflammation and chronic pathological processes will increase ESR, providing a non-specific test of inflammation.
In acute phase response, ESR increase is slow and takes 4 to 6 days to subside after resolution of acute disease - CRP is a more sensitive early indicator.
ESR is helpful in the diagnosis and monitoring of two specific inflammatory diseases: temporal arteritis and polymyalgia rheumatica.

Request Form

Combined Pathology Blood form (Yellow/Black)

Availability

On request. May be requested urgently in suspected temporal arteritis.

Turnaround Time

Same day

Specimen

Whole blood

Volume

2 ml

Container

Black top (sodium citrate) ESR tube

Lab. Handling

Room temperature, analyse same day.

Causes for Rejection

Unlabelled sample.

Reference Range

Age and sex related ranges apply. Upper ranges are:
Male: age <60 yrs - 30mm/hr; 60-80 yrs - 40mm/hr, >80 yrs - 55mm/hr
Female: age <60 yrs - 35mm/hr; 60-80 yrs - 45mm/hr, >80 yrs - 60mm/hr

Interpretation

A normal ESR does not exclude active disease. Many apparently normal elderly subjects will have raised ESR's and therefore as a screening test, ESR is of limited value in elderly patients. ESR is raised in pregnancy.
A falsely low ESR may be seen in conditions with raised PCV or with abnormalities of cell shape (e.g. sickle cell, spherocytosis).
A falsely raised ESR may be seen in anaemia or certain inflammatory conditions associated with low albumin. 

        

 

Last edited 07/08/08