ESR is higher than normal - what does this mean, and what is the norm for women by age? Increased ESR in the blood: what does it mean? When can an increase in ESR be considered safe?

Erythrocyte sedimentation rate (ESR) is an indicator that determines the speed and intensity of red blood cell gluing in certain pathological processes. This analysis is one of the mandatory values ​​of a general blood test; previously the analysis was called ROE and determined the erythrocyte sedimentation reaction.

Changes and deviations from the norm indicate inflammation and the development of the disease. That is why, in order to stabilize the ESR, the disease is initially treated, rather than trying to achieve the norm artificially with the help of drugs.

As a rule, exceeding the norm indicates a violation of the electrochemical structure of the blood, as a result of which pathological proteins (fibrinogens) attach to red blood cells. The appearance of such elements occurs against the background of bacterial, viral, infectious and fungal lesions, and inflammatory processes.

Indications

Important! ESR is a nonspecific indicator. This means that, in isolation from other data, it is impossible to make a diagnosis based on ESR alone. Deviations in erythrocyte sedimentation rate only indicate the presence of pathological changes.

Analysis of ESR is a necessary stage in diagnosing the structure of the blood, which at the earliest stages of the disease makes it possible to determine the presence of inflammatory processes in the body.

That is why ESR is prescribed for suspected pathologies of various nature:

• inflammatory diseases;
• infectious;
• benign and malignant formations.

Additionally, screening is carried out during annual medical examinations.

ESR is used in a complex of clinical (general) analysis. After this, it is necessary to additionally use other diagnostic methods.

Even minor deviations from the norm should be considered conditionally pathological, requiring additional examination.

If a pathology of the hematopoietic system is suspected, the analysis of ESR acquires the main diagnostic value.

ESR standards

The erythrocyte sedimentation rate is measured in mm per hour.

ESR according to Westergren, ESR using the micromethod - venous blood is examined

ESR according to Panchenkov - capillary blood is examined (from a finger)

Depending on the type, form of progression (acute, chronic, recurrent) and stage of development of the disease, ESR can change dramatically. To obtain a complete picture, a repeat study is carried out after 5 days.

ESR is higher than normal

Important! A physiological increase in ESR can be observed in women during menstruation, pregnancy and the postpartum period.

As a rule, the erythrocyte sedimentation rate exceeds the norm in the following diseases:

• inflammatory processes of various etiologies. The indicator increases as a result of increased production of globulins and fibrinogens during the acute phase of inflammation;
• decay, tissue death, necrotic processes in cells. As a result of breakdown, protein products enter the bloodstream, causing sepsis and purulent processes. This group includes oncological pathologies, tuberculosis, heart attacks (brain, myocardium, lungs, intestines), etc.;
• metabolic disorders - hypo- and hyperthyroidism, diabetes at all stages, etc.;
• nephrotic syndrome and hypoalbuminemia, liver pathologies, serious blood loss, exhaustion;
• anemia (anemia), hemolysis, blood loss and other pathologies of the circulatory system. As a result of the disease, the number of red blood cells in the body is reduced.;
• vasculitis, connective tissue diseases: arthritis, periarteritis, scleroderma, rheumatism, lupus and many others;
• hemoblastoses of all types (leukemia, Waldenström's disease, lymphogranulomatosis and others);
• periodic hormonal changes in the female body (menstruation, pregnancy and childbirth, the onset of menopause).

ESR is below normal

Registered in the following cases:

• disorders of the circulatory system associated with the production of red blood cells (erythremia, erythrocytosis, etc.), changes in their shape (hemoglobinopathy, spherocytosis, sickle cell anemia and others);
• prolonged fasting, dehydration;
• congenital or hereditary circulatory failure;
• nervous system disorders: epilepsy, stress, neuroses, as well as mental disorders;
• Regular use of certain medications: calcium chloride, salicylates, drugs containing mercury.

When you receive the ESR results, you need to contact a therapist, who will decipher them and refer them to a highly specialized doctor (infectious disease specialist, hematologist, oncologist, immunologist and others).

Self-medication and an attempt to artificially stabilize the ESR level will not yield results, but will blur the picture for further research and competent therapy.

How to prepare for the procedure

A general blood test (which detects ESR) is performed in the morning on an empty stomach. That is, about 8-10 hours should pass between the last snack and the blood sampling procedure.

1-2 days before donating blood, you must give up alcohol, “heavy” foods (fried, fatty, smoked), and hot spices.

A couple of hours before the procedure, you should refrain from smoking (cigarettes, hookah, pipes, electronic cigarettes, etc.).

Severe stress, psychological stress, physical activity (running, climbing stairs, carrying heavy objects) can also affect the level of red blood cells. Immediately before the manipulations, you need to rest for 30-60 minutes.

You should also tell your doctor about all medications you take regularly or on demand. Their active substances may affect the test result.

Keep in mind that each laboratory uses different ESR testing methods and units of measurement. Therefore, it is necessary to do the analysis, undergo further (repeated) examination and treatment in the same hospital.

Erythrocyte sedimentation rate is a test used to detect inflammation in the body.

The sample is placed in an elongated thin tube, red blood cells (erythrocytes) gradually settle to the bottom, and the ESR is a measure of this settling rate.

The test can diagnose many disorders (including cancer) and is a necessary test to confirm many diagnoses.

Let's figure out what it means when the erythrocyte sedimentation rate (ESR) in the general blood test of an adult or child is increased or decreased, should we be afraid of such indicators and why does this happen in men and women?

Women have higher ESR values; pregnancy and the menstrual period can cause short-term deviations from the norm. In pediatrics, this test helps diagnose rheumatoid arthritis in children or.

Normal ranges may vary slightly depending on laboratory facilities. Abnormal results do not diagnose a specific disease.

Many factors such as age or medication use, can affect the final result. Drugs such as dextran, ovidone, silest, theophylline, vitamin A can increase ESR, and aspirin, warfarin, cortisone can reduce it. High/low readings only tell the doctor about the need for further examination.

False promotion

A number of conditions can affect the properties of blood, affecting the ESR value. Therefore, accurate information about the inflammatory process - the reason why the specialist prescribes a test - may be masked by the influence of these conditions.

In this case, the ESR values ​​will be falsely elevated. These complicating factors include:

• Anemia (low red blood cell count, decreased hemoglobin in serum);
• Pregnancy (in the third trimester, ESR increases approximately 3 times);
• Increased concentration of cholesterol (LDL, HDL, triglycerides);
• Kidney problems (including acute kidney failure).

The specialist will take into account all possible internal factors when interpreting the results of the analysis.

Interpretation of results and possible reasons

What does it mean if the erythrocyte sedimentation rate (ESR) in the blood test of an adult or child is increased or decreased, should we be afraid of indicators that are higher than normal or lower?

High levels in blood test

Inflammation in the body provokes red blood cells to stick together (the weight of the molecule increases), which significantly increases their rate of settling to the bottom of the test tube. Increased sedimentation levels may be caused by the following:

• Autoimmune diseases – Libman-Sachs disease, giant cell disease, polymyalgia rheumatica, necrotizing vasculitis, rheumatoid arthritis (the immune system is the body’s defense against foreign substances. Against the background of an autoimmune process, it mistakenly attacks healthy cells and destroys body tissue);
• 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, such as pneumonia, pelvic inflammatory disease, or appendicitis;
• Inflammation of joints (polymyalgia rheumatica) and blood vessels (arteritis, diabetic angiopathy of the lower extremities, retinopathy, encephalopathy);
• Inflammation of the thyroid gland (diffuse toxic goiter, nodular goiter);
• infections of the joints, bones, skin, or heart valves;
• Too high serum fibrinogen concentrations or hypofibrinogenemia;
• Pregnancy and toxicosis;
• Viral infections (HIV, tuberculosis, syphilis).

Because the ESR is a nonspecific marker of inflammation foci and correlates with other causes, the results of the analysis should be taken into account together with the patient’s health history and the results of other examinations (complete blood count - extended profile, urinalysis, lipid profile).

If the sedimentation rate and the results of other tests coincide, the specialist can confirm or, conversely, exclude the suspected diagnosis.

If the only elevated indicator in the analysis is ESR (against the background of a complete absence of symptoms), the specialist cannot give an accurate answer and make a diagnosis. Besides, a normal result does not exclude disease. Moderately elevated levels may be caused by aging.

Very large numbers usually have good reasons, such as multiple myeloma or giant cell arteritis. People with Waldenström's macroglobulinemia (the presence of abnormal globulins in the serum) have extremely high ESR levels, although there is no inflammation.

This video describes in more detail the norms and deviations of this indicator in the blood:

Low performance

Low sedimentation rates are generally not a problem. But may be associated with such deviations as:

• A disease or condition that increases red blood cell production;
• A disease or condition that increases white blood cell production;
• If a patient is being treated for an inflammatory disease, the degree of sedimentation going down is a good sign and means that the patient is responding to treatment.

Low values ​​can be caused by the following reasons:

• Elevated glucose levels (in diabetics);
• Polycythemia (characterized by an increased number of red blood cells);
• Sickle cell anemia (a genetic disease associated with pathological changes in cell shape);
• Severe liver diseases.

The reasons for the decline could be any number of factors., For example:

• Pregnancy (in the 1st and 2nd trimester, ESR levels drop);
• Anemia;
• Menstrual period;
• Medicines. Many medications can falsely lower test results, such as diuretics and medications that contain high calcium levels.

Increased data for diagnosing cardiovascular diseases

In patients with cardiac or myocardial disease, ESR is used as an additional potential indicator of coronary heart disease.

ESR used for diagnostics– (inner layer of the heart). Endocarditis develops due to the migration of bacteria or viruses from any part of the body through the blood to the heart.

If symptoms are ignored, endocarditis destroys the heart valves and leads to life-threatening complications.

To make a diagnosis of endocarditis, a specialist must prescribe a blood test. Along with high levels of sedimentation rates, endocarditis is characterized by a decrease in platelets(lack of healthy red blood cells), the patient is often also diagnosed with anemia.

Against the background of acute bacterial endocarditis, the degree of sedimentation may increase to extreme values(about 75 mm/hour) is an acute inflammatory process characterized by severe infection of the heart valves.

When diagnosing congestive heart failure ESR levels are taken into account. This is a chronic, progressive disease that affects the power of the heart muscles. Unlike regular “heart failure,” congestive heart failure refers to the stage in which excess fluid accumulates around the heart.

To diagnose the disease, in addition to physical tests (echocardiogram, MRI, stress tests), the results of a blood test are taken into account. In this case, analysis for an extended profile may indicate the presence of abnormal cells and infections(sedimentation rate will be higher than 65 mm/hour).

At myocardial infarction An increase in ESR is always provoked. The coronary arteries deliver oxygen in the blood to the heart muscle. If one of these arteries becomes blocked, part of the heart is deprived of oxygen, causing a condition called myocardial ischemia.

Against the background of a heart attack, ESR reaches peak values(70 mm/hour and above) for a week. Along with increased sedimentation rates, the lipid profile will show elevated levels of triglycerides, LDL, HDL and cholesterol in the serum.

A significant increase in erythrocyte sedimentation rate is observed against the background acute pericarditis. This, which begins suddenly, causes blood components such as fibrin, red blood cells and white blood cells to enter the pericardial space.

Often the causes of pericarditis are obvious, such as a recent heart attack. Along with elevated ESR levels (above 70 mm/hour), an increase in urea concentration in the blood was noted as a result of renal failure.

Erythrocyte sedimentation rate increases significantly against the background of the presence of an aortic aneurysm or . Together with high ESR values ​​(above 70 mm/hour), blood pressure will be elevated; 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 painful conditions characterized by tissue necrosis and inflammation, and is also a sign of blood viscosity.

Elevated levels directly correlate with the risk of myocardial infarction and coronary heart disease. For high subsidence levels and suspected cardiovascular disease the patient is referred for further diagnostics, including an echocardiogram, MRI, electrocardiogram to confirm the diagnosis.

Experts use erythrocyte sedimentation rate to determine foci of inflammation in the body; measuring ESR is a convenient method of monitoring the progress of treatment of diseases accompanied by inflammation.

Accordingly, high sedimentation rates 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 development and its regression.

Although sometimes even low levels correlate with the development of some diseases, for example, polycythemia or anemia. In any case, consultation with a specialist is necessary for a correct diagnosis.

Quick page navigation

General and clinical characteristics of blood are the most common and familiar analysis to everyone. Combined with its ease of execution and professional informativeness, it is indispensable for any diagnostic search.

One of the component characteristics is ESR, or ROE (an indicator of the presence of inflammatory processes in the body based on the rate or reaction of erythrocyte sedimentation and sediment formation in a test tube).

Increased ESR in the blood - what does it mean? ESR is an indicator of the sedimentation rate of erythrocytes (red blood cells) under the force of gravity to the bottom of a special test tube.

At the same time, the second part of the blood (plasma), which contains suspensions of formed elements, is deprived of all hemostasis (clotting) factors. This is necessary to exclude the influence of hemostasis on the formation of erythrocyte clots.

Thus, the ESR indicator reflects the connection of plasma proteins with formed cellular elements circulating in the blood. The diagnostic indicator of ESR in the blood is affected by increased protein and the plasma component of the blood.

In a healthy body, the membranes of red blood cells, circulating in the bloodstream, carry an electrical negative charge, allowing them to repel each other and not stick to each other.

If, for certain reasons, the charge potential is disrupted, red blood cells stick together (agglutination process). Naturally, their weight causes rapid subsidence. This process is facilitated by changes in protein components in the plasma and inflammatory pathologies in the body.

• The ESR indicators recorded in this case will be higher than normal.

Normal ESR in the blood of women, men and children

The normal ESR levels in the blood depend on the patient’s gender and age. There are certain boundaries, the violation of which indicates the presence of pathological processes.

Norm of ESR in the blood of women and men by age - table

In healthy women ESR norms (average) vary within 12 mm of sedimentation per hour with a ceiling limit of up to 18 mm. At 50 years of age and above, the rate increases slightly and is: lower limit 14, upper limit 25 mm per hour.

Norm of ESR in men due to the rate of agglutination (gluing) and erythrocyte sedimentation. In a healthy body, their level ranges from 8 to 10 mm per hour. But in old age (over 60), the average value of the parameter increases to 20 mm per hour, and values ​​exceeding 30 mm per hour, for this age category, are considered a deviation.

Although in women this figure is considered overestimated, it is quite acceptable and is not considered a pathological sign.

Indicators of normal ESR in children differ significantly by age. If the sedimentation rate at birth is up to 2 mm per hour, then by two months it doubles and can reach up to 5 mm per hour.

By six months, this figure is 6 mm, and by two years – 7 mm per hour. The normal rate of precipitation from 2 to 8 years is considered to be up to 8 mm per hour, although 10 mm in three-year-old children is considered the normal limit.

During puberty, ESR increases and in girls it can be 15 mm, and in boys from 10 to 12 mm per hour. After adulthood, the erythrocyte sedimentation rate norms are compared with the norms of adults.

For any person, ESR norms can vary upward due to individual characteristics and are not considered a pathology, just as the syndrome of increased sediment acceleration can also be a hereditary factor.

An increase in ESR in the blood in adults should be alarmed by concomitant symptoms with an increase in ESR up to 40 mm per hour. This is an indicator for additional diagnosis and appropriate treatment.

By itself, the level of ESR in tests cannot be a sign of any pathology, it is only a reflection of inflammatory processes, and the reason for its manifestation can be provoked by many factors of a physiological and pathological nature.

Among the physiological causes of increased ESR, the following dominate:

• Poor nutrition with a predominance of fatty and spicy diets and a lack of vitamins;
• Stressful situations and allergic processes;
• Overstrain and emotional stress;
• The presence of inflammatory processes with boils, scratches, boils, or splinters;
• Taking certain medications.

In women, increased ESR in the blood is observed during menstrual cycles or after taking oral contraceptives. This syndrome is typical, with different fluctuations in the level of sedimentation rate at certain hours - in the morning, in the evening or at night.

During pregnancy, against the background of hormonal changes, the ESR rate changes significantly. At the beginning of pregnancy, its levels are usually reduced. But sometimes, a woman’s immune system perceives the fetus as a foreign object and triggers the process of phagocytic defense, thereby changing the protein component of the blood. This entails an increase in the level of ESR in the blood during pregnancy.

The norm for pregnant women is 45 mm per hour, but during the entire period of bearing a child it can increase three times and persist for a long time after childbirth.

The increase in the level of erythrocyte sediment during pregnancy and after childbirth is influenced by the level of hemoglobin concentration. Its loss during childbirth may be reflected by an increased rate of sedimentation.

An increased ESR is a kind of landmark in the treatment of many inflammatory diseases. But such an indicator may not be observed immediately after the formation of pathology, but can remain at a certain elevated level for a long time. This is due to the inability of red blood cells with a destroyed structure to quickly recover.

The genesis of the acceleration of red blood cells to sedimentation is based on any processes, including inflammatory ones, as a result of which cellular immunity reactions occur with the release of tissue mediators with the formation of inflammatory processes.

The most common reasons are due to:

1. Viral, bacterial and intestinal infections in the acute, latent or recovery phase of the course.
2. Diseases of any organs and systems with any localization of inflammatory processes.
3. Purulent infections - boils, abscesses, phlegmons, lymphadenitis, purulent cavities in internal organs.
4. Systemic autoimmune and reactive-allergic pathologies - rheumatism, arthritis of any origin, allergic skin pathologies.
5. Malignant neoplasms, even at the stage of preclinical development.
6. Any manifestation of a feverish state.
7. Blood diseases - anemia, leukemia, leukopenia.
8. Traumatic and shock conditions - large burn injuries.
9. Post-infarction condition, poisoning and intoxication.

Sometimes tests reveal platelets in the blood and an increased ESR. This combination may result from:

• large blood loss during surgical interventions;
• ulcerative colitis, acute rheumatism or tuberculosis;
• hemolytic anemia;
• treatment with corticosteroid drugs;
• the presence of other rare pathologies.

In a child, the increased rate of erythrocyte sedimentation is due to the same reasons as in adults. The main reasons can be supplemented by the factor of breastfeeding, when the mother violates the nutritional regime. The presence of helminthiasis. The period of teething or fear of taking blood for analysis.

Despite the many reasons that cause accelerated sedimentation of red blood cells, to clarify the diagnosis, the doctor’s attention is focused on the patient’s existing medical history. If there is none, the possibility of developing oncological pathologies and indolent infections is excluded.

Increased ESR - is treatment necessary?

The manifestation of the syndrome itself in a blood test is not a reliable sign of disease or pathological manifestations in the body. But extensive diagnostics for identifying and early treatment of life-threatening diseases are based on its indicators.

So, without identifying the underlying cause, treatment is inappropriate.

The measurement of erythrocyte sedimentation rate (ESR) and the use of this indicator as a method of medical diagnosis was proposed by the Swedish researcher Faro back in 1918. First, he was able to establish that the ESR rate in pregnant women is significantly higher than in non-pregnant women, and then he discovered that an increase in ESR indicates many diseases.

But this indicator was included in medical protocols for blood testing only decades later. First, Westergren in 1926, and then Winthrop in 1935, developed methods for measuring erythrocyte sedimentation rate, which are widely used in medicine today.

Laboratory characteristics of ESR

The erythrocyte sedimentation rate shows the ratio of plasma protein fractions. Due to the fact that the density of red blood cells is higher than the density of plasma, they slowly settle to the bottom under the influence of gravity in a test tube. Moreover, the very speed of this process is determined by the degree of aggregation of red blood cells: the higher the level of blood cell aggregation, the lower their frictional resistance and the higher the sedimentation rate. As a result, a thick burgundy sediment of red blood cells appears at the bottom of the test tube or capillary, and a translucent liquid remains in the upper part.

Interestingly, the erythrocyte sedimentation rate, in addition to the red blood cells themselves, is also affected by other chemicals that make up the blood. In particular, globulins, albumins and fibrinogen are able to change the surface charge of red blood cells, increasing their tendency to “stick together”, thereby increasing ESR.

At the same time, ESR is a nonspecific laboratory indicator, which cannot be used to clearly judge the reasons for its change relative to the norm. At the same time, its high sensitivity is valued by doctors, who, when the erythrocyte sedimentation rate changes, have a clear signal for further examination of the patient.
The ESR is measured in millimeters per hour.

In addition to the methods of measuring the erythrocyte sedimentation rate of Westergren and Winthrop, the Panchenkov method is also used in modern medicine. Despite some differences in these methods, they show approximately the same results. Let's consider all three methods of studying ESR in more detail.

The Westergren method is the most common in the world and is approved by the International Committee for Standardization of Blood Research. This method involves collecting venous blood, which is combined for analysis in a 4 to 1 ratio with sodium citrate. The diluted blood is placed in a capillary 15 centimeters long with a measuring scale on its walls, and after an hour the distance from the upper limit of the settled red blood cells to the upper limit of the plasma is measured. The results of ESR studies using the Westergren method are considered as objective as possible.

The Winthrop method of studying ESR differs in that blood is combined with an anticoagulant (it inhibits the blood's ability to clot) and placed in a tube with a scale on which ESR is measured. However, this technique is considered not indicative for high erythrocyte sedimentation rates (more than 60 mm/h), since in this case the tube becomes clogged with settled blood cells.

According to Panchenkov, the study of ESR is as similar as possible to Westergren’s methodology. Blood diluted with sodium citrate is placed to settle in a capillary, divided into 100 units. An hour later, the ESR is measured.

At the same time, the results according to the methods of Westergren and Panchenkov are the same only in the normal state, and with an increase in ESR, the first method records higher indicators. In modern medicine, when the ESR increases, it is the Westergren method that is considered more accurate. Recently, automatic instruments for measuring ESR have also appeared in modern laboratories, the operation of which actually does not require human intervention. The function of a laboratory employee is only to decipher the results obtained.

Norms of erythrocyte sedimentation rate

The normal ESR indicator varies quite seriously depending on the gender and age of the person. The gradations of this standard for a healthy person are specifically designated and for clarity, we present them in the form of a table:

In some gradations of ESR norms for people aged 60 years and over, not a specific indicator is used, but a formula. In this case, for older men the upper limit of normal is equal to age divided by two, and for women it is age plus “10” divided by two. This technique is used quite rarely and only by certain laboratories. The values ​​of the maximum ESR norm can reach 36-44 mm/h and even higher values, which is already considered by most doctors to be a signal of the presence of pathology and the need for medical research.

It is worth noting once again that the ESR norm in a pregnant woman may differ significantly from the indicators given in the table above. While expecting a child, the erythrocyte sedimentation rate can reach 40-50 mm/h, which in no way indicates a disease or pathology and is not a prerequisite for any further research.

Reasons for the increase in ESR

An increase in ESR can indicate dozens of different diseases and abnormalities in the body, so it is always used in conjunction with other laboratory tests. But at the same time, in medicine there is a certain list of groups of diseases in which the erythrocyte sedimentation rate invariably increases:

• blood diseases (in particular, with sickle cell anemia, the irregular shape of red blood cells provokes an increase in the erythrocyte sedimentation rate, which differs significantly from standard values);
• heart attacks and (in this case, acute-phase inflammatory proteins are adsorbed on the surface of blood cells, reducing their electrical charge);
• diseases associated with metabolic disorders (diabetes mellitus, cystic fibrosis, obesity);
• diseases of the liver and biliary tract;
• leukemia, lymphoma, myeloma (with myeloma, the erythrocyte sedimentation rate in almost all cases exceeds 90 mm/h and can reach 150 mm/h);
• malignant neoplasms.

In addition, an increase in ESR is observed with most inflammatory processes in the body, with anemia and with various infections.
Modern statistics of laboratory studies have collected enough data on the reasons for the increase in ESR, which made it possible to create a kind of “rating”. The absolute leader causing an increase in ESR are infectious diseases. They account for 40 percent of detections of ESR exceeding the norm. The second and third places on this list with results of 23 and 17 percent were taken by cancer and rheumatism. In eight percent of cases where a high erythrocyte sedimentation rate was recorded, this was caused by anemia, inflammatory processes in the gastrointestinal tract and pelvic area, diabetes mellitus, injuries and diseases of the ENT organs, and in three percent of cases, an increased ESR was a signal of kidney disease.

Despite the fact that the collected statistics are quite eloquent, you should not independently diagnose yourself using the ESR indicator. Only a doctor can do this, using several laboratory tests in combination. The ESR indicator can increase very seriously, up to 90-100 mm/h, regardless of the type of disease, but in terms of the result of the study, the erythrocyte sedimentation rate cannot serve as a marker of a specific cause.

There are also prerequisites under which an increase in ESR does not reflect the development of any disease. In particular, a sharp increase in the indicator is observed in pregnant women, and a slight increase in ESR is possible due to allergic reactions and even depending on the type of diet: diet or fasting lead to changes in blood tests and to one degree or another affect the ESR. In medicine, this group of factors is called the causes of a false-positive ESR analysis, and they try to exclude them even before the examination.
In a separate paragraph, it is worth mentioning cases where even in-depth studies do not show the reasons for the increase in ESR. Very rarely, a constant overestimation of this indicator may be a feature of the body that has neither prerequisites nor consequences. This feature is typical for every twentieth inhabitant of the planet. But even in this case, it is recommended to be regularly examined by a doctor so as not to miss the development of any pathology.

It is also important that in most diseases, the increase in ESR does not begin immediately, but after a day, and after recovery, the restoration of this indicator to normal can last up to four weeks. Every doctor should remember this fact so that after completing the course of treatment, he does not subject the person to additional studies due to a residual increase in ESR.

Reasons for an increase in ESR in a child

The body of children traditionally differs from that of an adult in terms of laboratory test results. The erythrocyte sedimentation rate is no exception, the growth of which in a child is provoked by a slightly modified list of prerequisites.

In most cases, an increased ESR in the blood of a child indicates the presence of an infectious-inflammatory process in the body. This is often confirmed by other results in a general blood test, which, together with ESR, almost immediately form a picture of the child’s condition. Moreover, in a small patient, an increase in this indicator is often accompanied by a visual deterioration of the condition: weakness, apathy, lack of appetite - a classic picture of an infectious disease with the presence of an inflammatory process.

Of the non-infectious diseases that most often provoke increased ESR in a child, the following should be highlighted:

• pulmonary and extrapulmonary forms of tuberculosis;
• anemia and blood diseases;
• diseases associated with metabolic disorders;
• injuries.

However, if an increased ESR is detected in a child, the reasons may be quite harmless. In particular, going beyond the normal range of this indicator can be triggered by taking paracetamol - one of the most popular antipyretics, teething in infants, the presence of worms (helminth infections), and a deficiency of vitamins in the body. All these factors are also false positives and should be taken into account at the stage of preparation for a laboratory blood test.

Reasons for low ESR

A low relative to normal erythrocyte sedimentation rate is quite rare. In most cases, this situation is provoked by disorders of hyperhydration (water-salt metabolism) in the body. In addition, low ESR may be a consequence of developing muscle dystrophy and liver failure. Among the non-pathological causes of low ESR are the use of corticosteroids, smoking, vegetarianism, prolonged fasting and early pregnancy, but there is practically no systematicity in these prerequisites.
Finally, let’s summarize all the information about ESR:

• this is a non-specific indicator. It is impossible to diagnose the disease using it alone;
• an increase in ESR is not a reason to panic, but is a reason for in-depth analysis. The reasons can be both very harmless and quite serious;
• ESR is one of the few laboratory tests that is based on a mechanical action rather than a chemical reaction;
• Automatic systems for measuring ESR that were not available until recently made laboratory technician error the most common cause of a false erythrocyte sedimentation rate test result.

In modern medicine, erythrocyte sedimentation rate continues to be perhaps the most popular laboratory blood test. The high sensitivity of the analysis allows doctors to clearly determine whether the patient has problems and prescribe further examination. The only serious drawback of this study is the strong dependence of the result on the correct actions of the laboratory assistant, but with the advent of automatic systems for determining ESR, the human factor can be eliminated.

What is ESR in a blood test? Erythrocyte sedimentation rate, or ESR for short, is a nonspecific laboratory test that may indicate the occurrence of an inflammatory, allergic or other pathological process in the body.

Blood reacts to almost any change in the functioning of the human body. That is why a general (clinical) blood test is prescribed to patients for almost any disease, as well as during a clinical examination. This analysis examines a number of indicators, including ESR.

In children of the first year of life, an increase in ESR can be caused by teething, as well as taking non-steroidal anti-inflammatory drugs.

What does ESR mean in a blood test?

The density of plasma is less than that of red blood cells. Therefore, red blood cells in a test tube, under the influence of gravity, settle to the bottom, and after some time the blood is divided into two parts: transparent plasma and a red precipitate. The speed of this process also depends on the speed of red blood cells sticking together (the process of red blood cell aggregation). Clumped cells are heavier and therefore sink to the bottom faster.

The aggregation of erythrocytes is influenced by many substances that make up the blood, for example, fibrinogen, albumin, globulins. They change the charge of the red blood cell membrane, which helps to increase their ability to stick together and, as a result, increases the ESR.

The use of ESR in blood tests was proposed in 1918 by the Swedish scientist Faro. It was he who discovered that the erythrocyte sedimentation rate increases in women during pregnancy. Subsequently, he discovered that ESR also responds to other conditions and diseases by increasing. However, this laboratory test entered widespread clinical practice much later. This happened in 1926, when another Swedish doctor, Westergren, proposed his method for determining ESR, which is widely used today.

In diagnostic and treatment institutions of the USSR, ESR was determined using the Panchenkov method, which is still used today in many clinics in the CIS countries. The results of determining ESR using these two methods, which are within the normal range, coincide with each other. However, the Westergren test is more sensitive to an increase in erythrocyte sedimentation rate, therefore, in the zone of increased values ​​it gives a more accurate result.

ESR can be due to both pathological and physiological reasons, the elimination of which leads to normalization of the indicator.

ESR cannot be considered a specific symptom of any disease. However, if this indicator is elevated, this is a kind of signal for the doctor about the need for further, more in-depth examination of the patient (biochemical analysis, detailed clinical analysis with leukocyte formula, ultrasound, radiography, etc.).

The erythrocyte sedimentation rate in modern test forms is designated “ESR” and is measured in mm/h.

Normal ESR values

The normal erythrocyte sedimentation rate depends on the age and gender of the patient.

In some laboratories, to determine the ESR norm in patients aged 50 years and older, they do not use the data presented in the table, but a formula according to which the upper limit of the ESR norm in men is their age divided by two. For women, the formula is different: B/2+10, where “B” means age. However, this method is not widely used, since it often interprets a high ESR, which requires further examination of the patient, as normal.

In pregnant women, the erythrocyte sedimentation rate can reach 40-50 mm/h, which is not a pathology and does not require any treatment.

Decoding ESR

The cause of an increase in ESR can be a variety of diseases and conditions. That is why ESR is deciphered taking into account other laboratory tests, as well as instrumental examination data and clinical signs of the disease.

In most cases, ESR begins to increase not from the first hours of the disease, but only after 2-3 days. After recovery, this indicator returns to normal only after a few weeks.

The most common causes of increased ESR are:

• cystic fibrosis;
• diseases of the biliary tract and liver;
• almost all infectious and inflammatory diseases.

According to medical statistics, in 40% of cases, a high ESR indicates an infectious process. In 23% of cases, an increase in the rate is caused by malignant neoplasms, and in 17% by rheumatic diseases. Anemia, trauma, diabetes mellitus, inflammatory diseases of the ENT organs, as well as the pelvic and gastrointestinal tract are the cause of increased ESR in 8% of cases. In less than 3% of cases, an increased erythrocyte sedimentation rate was observed in kidney disease.

Despite the available statistics, it is impossible to make a diagnosis based on an increase in ESR alone. In addition to pathological ones, there are also physiological reasons that affect ESR (pregnancy, type of diet, physical activity, allergic reactions, taking certain medications).

In most cases, ESR begins to increase not from the first hours of the disease, but only after 2-3 days. After recovery, this indicator returns to normal only after a few weeks.

Cases of low ESR are rarely observed in clinical practice. The reasons may be:

• disturbances of water-electrolyte balance with symptoms of overhydration;
• acute and chronic liver failure;
• high-dose corticosteroid therapy;
• smoking;
• early pregnancy;
• prolonged fasting;
• vegetarianism.

Reasons for increased ESR in children

Due to the immaturity of the immune system, the body of children reacts violently to any diseases and other altered conditions.

How to normalize ESR?

It should be understood that a high ESR value is not an independent pathology. It can be caused by both pathological and physiological reasons, the elimination of which leads to normalization of the indicator. For example, in pregnant women after childbirth, the ESR returns to normal levels on its own. If the cause of the increase in ESR is an infectious disease, then normalization of the indicator occurs some time after anti-infective therapy. For iron deficiency anemia, patients are prescribed iron supplements and multivitamins, and for diabetes mellitus, insulin or hypoglycemic drugs are prescribed.

Video from YouTube on the topic of the article: