Measurement of ESR as a diagnostic method was identified by the Swedish researcher Faro at the beginning of the last century. First, it was possible to find out that the erythrocyte sedimentation rate is increased in pregnant women compared to non-pregnant women, then - that an increase indicates some diseases.
This analysis entered the mandatory medical research protocols only decades later. Westergren in 1925 and Winthrop in 1935 developed universal methods for determining the erythrocyte sedimentation rate, which are actively used in modern medical practice.
Laboratory characteristic
Erythrocyte sedimentation rate (ESR) shows the ratio of plasma proteins. The density of blood cells is higher than the density of plasma, so due to gravity they gradually settle to the bottom. The faster blood cells stick together, the lower their resistance to friction and the higher the speed. As a result, a burgundy precipitate is formed at the bottom of the erythrocytes, and in the upper part of the tube remainsplasma is a translucent liquid.
ESR (except for red blood cells) is affected by chemicals that make up the blood. Albumins, fibrinogen and globulins can change the charge of red blood cells, thereby increasing their tendency to stick together. This will increase the erythrocyte sedimentation rate. ESR is a non-specific indicator, so it is impossible to accurately determine the cause of the deviation from the norm. But the high sensitivity of the indicator gives the doctors a reason to refer the patient for further examination.
Blood test methods
In addition to the methods developed by Westergren and Winthrop, the Panchenkov method is used in modern medicine. The methods are slightly different, but the results show approximately the same. The Westergren method is the most common in the world, it is approved by the standardization committee. It is supposed to take blood from a vein, which is connected to sodium citrate (4 to 1). The material is placed in a test tube (15 cm) with a measuring scale. Sixty minutes later, the distance between the settled erythrocytes and the plasma is measured. The Westergren method is the most objective.
According to the Winthrop method, blood is combined with an anticoagulant that inhibits the ability to coagulate, placed in a thin tube with a scale that determines the erythrocyte sedimentation rate. The technique is not indicative for high ESR, since the tube in this case is clogged with settled blood cells. At the same time, the results according to the methods of Panchenkov and Westergren are the same fornormal, and with an increased erythrocyte sedimentation rate, the second method determines indicators above the norm. In modern medical practice, it is the Westergren technique that is considered more accurate.
Settling rate norms
The normal indicator differs significantly depending on the age and gender of the person. For newborns, the norm is 0-2.8 mm / h, at one month - 2-5 mm / h, at two to six months - 4-6 mm / h, at six to twelve months - 3-10 mm / h. From one to five years, the norm is 5-11 mm / h, from six to fourteen years - 4-12 mm / h. At fourteen to eighteen years old, for girls, the norm is 2-15 mm / h, for boys - 1-10 mm / h. From nineteen to thirty years in women, the norm is 2-15 mm / h, after thirty - up to 25 mm / h. For males from nineteen to thirty years old, the normal rate is 2-10 mm / h, over thirty - up to 15 mm / h.
Relatively normal performance
Erythrocyte sedimentation rate for people over sixty is sometimes determined not by a specific indicator, but by a formula. In this case, for women, the upper limit of the norm is: (age + 10) 2, and for men: age / 2. The maximum values \u200b\u200bfor this technique can reach 36-44 mm / h and even higher, which for most doctors is already a signal about the development of pathology and the need for additional medical research.
In pregnant women, an increased erythrocyte sedimentation rate is considered the norm. The indicators can be very different from normal, which does not indicate the development of pathology. During pregnancy, the speed can be 40-50 mm / h, which is not a prerequisite for additional diagnostics.
Reasons for increased ESR
What does "increased erythrocyte sedimentation rate" mean in test results? This usually indicates the development of pathology, therefore it is used in combination with other studies. At the same time, there is a specific list of diseases in which ESR is increased:
- strokes and heart attacks;
- various blood diseases;
- autoimmune diseases;
- metabolic disorders (obesity, diabetes);
- tuberculosis;
- myeloma, leukemia, lymphoma, etc.;
- oncological diseases.
Most often, an increase in ESR is caused by infectious diseases. More than 40 percent of cases of growth in the indicator are due to infections. In 23% of cases, the cause is oncological diseases, in 17% - rheumatism. Eight percent of patients with elevated ESR suffer from anemia, diabetes mellitus, inflammatory processes in the organs of the digestive system and small pelvis, and diseases of the upper respiratory tract. In 3% of cases, an increased erythrocyte sedimentation rate in women and men is caused by kidney disease.
Blood Diagnosis
Only a doctor can accurately diagnose a blood test. Additionally, several analyzes are used. The ESR indicator can increase very strongly (up to 90-100 mm / h) depending on the typepathology. In addition, there are cases in which an increase in ESR does not indicate the development of the disease. A sharp increase is observed in pregnant women, and a gradual increase in the indicator is possible with an allergic reaction, during a diet or during fasting. In medical practice, this group of reasons is called the causes of a false positive analysis. The doctor will try to exclude such factors even before the examination.
What does it mean - the erythrocyte sedimentation rate is increased? In some cases, even in-depth studies do not show specific reasons for the increase in the rate of sedimentation of blood cells. Rarely, overestimated indicators are the norm for the body, a feature that has neither prerequisites nor consequences. This is typical for 5% of people. But even knowing about such a feature, it is worth being examined by a doctor from time to time so as not to miss the development of the pathology.
False results
In most diseases, the indicator does not increase immediately, but a day after the onset of the inflammatory process. After recovery, the recovery of the indicator can last up to four weeks. This should be remembered by the doctor so as not to subject the patient to additional tests and studies due to a residual increase from the norm. But there is usually no need for additional tests.
Increased ESR in children
A child's body differs significantly from an adult's according to laboratory results, ESR is no exception, but an increase in a child's performance is provoked by another listpossible reasons. What does "increased erythrocyte sedimentation rate" mean if such a record was found in the results of the child's tests? In most cases, this indicates the presence of an infectious-inflammatory process in the body.
Often, the results of a general analysis and an increased ESR form a clear clinical picture. At the same time, the growth of the indicator is accompanied by a deterioration in the child's well-being: apathy, drowsiness, weakness, lack of appetite. This is a classic clinical picture of an infectious disease with an accompanying inflammatory process. Among non-communicable diseases that can provoke an increase in a child’s indicator, one can single out bronchial asthma, anemia and blood diseases, injuries, metabolic disorders.
In some cases, an increased ESR in a child may not indicate a pathology. Going beyond the norm can be triggered by taking paracetamol and some other drugs. Paracetamol is a commonly used medication for fever and other conditions. These factors are referred to as false positives. Such reasons must be taken into account when preparing for the delivery of a laboratory analysis. Usually the doctor asks about the presence of factors that can give an incorrect result.
Reason for the low rate
Low erythrocyte sedimentation rate is rarely diagnosed. In the vast majority of cases, this result of the analysis is provoked by violations of the water-s alt balance, muscle dystrophy or hepaticinsufficiency. Non-pathological causes include smoking and other bad habits, taking corticosteroids and certain other drugs, vegetarianism (especially strict), prolonged fasting (hard diets), early pregnancy in women.
General information about ESR
Erythrocyte sedimentation rate is not considered a specific indicator, which means that it is impossible to accurately identify any disease only by test results. In addition, this is one of the few studies that is based not on the evaluation of a chemical reaction, but on a mechanical one. If the erythrocyte sedimentation rate is increased, what does this mean? Overestimated figures are only a reason for in-depth analysis and additional research. The reasons may vary.
Until recently, false results were caused by laboratory errors. Recently, automatic systems for measuring the rate of erythrocyte sedimentation rate have appeared. In current medical practice, ESR is almost the most demanded study. High sensitivity allows you to accurately determine the presence of problems in the patient and send him for further examination. The only drawback of the analysis is the dependence of the result on the actions of the laboratory assistant, but (as mentioned above) the current level of development of medicine has eliminated the human factor.
