Erythrocyte Sedimentation Rate (ESR Test): Procedure, Types & Risks

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Erythrocyte sedimentation rate or ESR is a specific blood test that measures the degree of inflammation in the body. The ESR test specifically measures how quickly the red blood cells settle at the bottom of a test tube containing the blood samples. When a blood sample is placed in a test tube, the red blood cells settle down at a slow rate, leaving clear plasma behind. A faster than normal rate settlement of erythrocytes indicates inflammation in the body. The RBC settles at a faster rate due to the presence of an increased level of proteins like C- protein, and fibrinogen. This leads to inflammation in the body.

Inflammation is a type of body’s immune response that can be acute (developing quickly after any trauma or injury) or chronic with conditions such as cancer and autoimmune diseases. The ESR is a non-specific test that may be raised in different conditions. It gives general information about the presence or absence of any possible inflammatory condition.

Other Names: ESR, Sed rate, Westergren sedimentation rate.

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WHAT ESR IS USED FOR?

An ESR Test is helpful in determining if an individual is having any a condition that may cause inflammation such as monitoring of temporal arteritis, arthritis, polymyalgia rheumatic, systemic vasculitis or inflammatory bowel disease. This test is also helpful in determining an existing condition.

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WHY DO AN INDIVIDUAL NEED AN ESR?

A health care provider or a doctor may order an ESR if a person may have symptoms of any inflammatory disease. These includes:

• Headache
• Loss of appetite
• Fever
• Weight loss
• Shoulder or neck pain
• Joint stiffness
• Anaemia

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WHAT HAPPENS DURING AN ESR (ESR TEST PROCEDURE)?

A blood sample is taken using a small needle and collected in a vial or test tube. This procedure usually takes less than five minutes. The collected blood sample is then sent to the laboratory for analysis. During this, it is monitored that how far and how quickly the RBC sinks into the tube.

Does special preparation require for an ESR?

The test requires no special preparations and precautions at all.

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WHAT ARE THE TYPES OF ESR?

There are two ways of estimating the Erythrocyte Sedimentation Rate (ESR)

1) Westergren  Method

In this method, blood is taken out into a Westergren- Katz tube until the blood level reaches at 200 millimetres. The tube is placed in a vertical position set at room temperature for about an hour.
The gap difference between the top of the blood mixture and top of the sedimentation of erythrocytes is measured. This method is most commonly used for ESR.

2) Wintrobe Method

It is same as Westergren method. The only difference in this is that the blood level reaches at 100 millimetres. It is less sensitive than Westergren method.

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WHAT DO AN ESR RESULT MEANS?

ESR result is measured in millimetre per hour (mm/h).

Below are the references considering normal ESR test results:

GENDER AND AGE	ESR RANGE (mm/h)
Women < 50 years	0- 20 mm/h
Women > 50 years	0- 30 mm/h
Men < 50 years	0- 15 mm/h
Men > 50 years	0- 20 mm/h
Children	0- 10 mm/h

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WHAT ARE THE CAUSES OF HIGH ESR?

There may be various conditions for high ESR test results. Some of them are:

• Rheumatoid arthritis
• Rheumatic fever
• Vascular disease
• Few cancers
• Inflammatory bowel disease
• Heart disease
• Kidney related diseases

Some ESR test results that are higher than normal are also associated with autoimmune disease like:

• Lupus
• Temporal arteritis
• Polymyalgia rheumatic
• Hyperfibrinogenaemia
• Allergy

Various types of infections may also lead to high ESR results such as:

• Bone infection
• Myocarditis
• Endocarditis
• Tuberculosis
• Skin infections
• Rheumatic fever

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WHAT ARE THE CAUSES OF LOW ESR?

This can be due to following reasons:

• Congestive heart failure
• Sickle cell anaemia
• Hypofibrinogenemia
• Low plasma protein
• Leucocytosis
• Polycythaemia vera

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WHAT ARE THE RISKS INVOLVED IN AN ESR TEST?

A blood test with needle has minimal or no risks. These include bleeding, infection, bruising, lightheaded feeling.

Note: Always consult your physician before any treatment.

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WHAT MIGHT AFFECTS THE RESULTS OF ESR?

• Pregnancy
• Old age
• Obesity
• Being female
• Menstrual cycle
• Certain medicines

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ANYTHING ELSE ONE SHOULD KNOW ABOUT ESR TEST?

ESR does not diagnose any particular disease. It only provides information about whether there is any inflammation in the body. If the result of ESR is abnormal, the physician or doctor may suggest various tests to diagnose the problem.

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Diagnostic and Pathology Tests Available At House of Diagnostics (HOD).

 

BOOK A TEST NOW

 

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Data Sources:

• https://medlineplus.gov/lab-tests/erythrocyte-sedimentation-rate-esr/
• https://labtestsonline.org/tests/erythrocyte-sedimentation-rate-esr
• https://www.healthline.com/health/esr#risks

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