A non-specific indicator of a complete blood count, reflecting the ratio of plasma protein fractions, is called the erythrocyte sedimentation rate, abbreviated as ESR. The test for it is mandatory and is carried out in the diagnosis of pathologies, dispensary or preventive examination. When the ESR is normal, this means that the individual does not have a pronounced inflammatory process in tissues and organs. The unit of measurement of erythrocyte sedimentation rate is mm/hour. However, it should be evaluated in conjunction with other indicators.
Determination of the erythrocyte sedimentation rate in the laboratory by the Panchenkov method
The essence of this method is as follows. The taken biomaterial is mixed with sodium citrate (anticoagulant), as a result, the blood is divided into two layers. The lower one is red blood cells, i.e. erythrocytes, and the upper one is plasma. The properties of blood are associated with the subsidence of the lower layer, and this process goes through several stages:
- The first is the formation of the so-called coin column, the so-called vertical clusters of cells that form during the first ten minutes.
- Second - settling, which takes about forty minutes.
- Third, the gluing and compaction of red blood cells, as in the first stage, takes ten minutes.
In total, the entire reaction takes one hour.
For analysis, a drop of biomaterial is taken from the individual's finger and placed in a solution of sodium citrate. Diluted blood is drawn into glass capillary tubes and placed vertically using a special tripod. Exactly 60 minutes later, the results are recorded along the height of the erythrocyte column. Rules to be followed when doing this research:
- do a deep prick of the fingertip, as squeezing out blood can destroy red blood cells;
- capillary tubes must be dry and clean;
- observe the necessary ratio between blood and sodium citrate;
- air temperature to determine the ESR should not be below 18 and above 22 degrees.
Any deviation from the above rules does not guarantee an accurate result.
There is another method for determining the ESR - according to Westergren, it is considered a reference. In this case, the biomaterial for analysis is taken from a vein, mixed with an anticoagulant in a test tube and placed in a special analyzer. Next, the device calculates the erythrocyte sedimentation rate. The results obtained with different methods are comparable. However, the latter is most sensitive to an increase in ESR. In medical institutions in our country, the Panchenkov method is mainly used.
ESR norms by age
In he althy individuals, red blood cells settle slowly, respectively, and their rate will be low. In pathological conditions, the amount of protein compounds in the blood increases, whichcontribute to more rapid sedimentation of red blood cells, which as a result leads to an increase in ESR. Permissible values of this indicator depend on gender, age, physiological state. If the decoding showed an increased value, the doctor may suspect:
- inflammation;
- allergy;
- systemic disease;
- blood disease;
- neoplasm;
- tuberculosis;
- metabolic diseases and other pathologies.
In addition, an increase in the rate of ESR is associated with age, pregnancy and menstruation.
A low rate indicates damage to red blood cells, which is caused by:
- erythremia;
- large-area burns;
- congenital heart defects;
- starvation;
- dehydration;
- taking hormonal medications (corticosteroids) and other reasons.
If an increased or decreased result is detected once, it is recommended to repeat the analysis.
Under what conditions is a complete blood count prescribed?
Based on the results of this type of study, the level of ESR is also evaluated. The following are the cases in which this analysis is required:
- Pregnancy. Several times over the entire period, a woman controls the erythrocyte sedimentation rate.
- When a bacterial infection is suspected. The interpretation of the results in this case will show a high level of ESR, but this is also characteristic of an infection of viral origin. Therefore, to clarify the pathologyadditional examinations will be required.
- Rheumatological problems such as arthritis, gout, lupus erythematosus can lead to joint deformity, pain, and stiffness. These pathologies also affect connective tissues, which leads to an increase in ESR.
- Myocardial infarction. Based on the results of the analysis, it is possible to identify in advance the development of the disease, as a result of which the normal blood flow in the arteries of the heart is disrupted.
- When diagnosing oncological pathology in order to track the development of the disease and the effectiveness of therapy.
Causes of ESR deviation in women
If the erythrocyte sedimentation rate deviates from normal values, a re-analysis is prescribed. ESR returns to normal when the causes that provoked its change are eliminated. For example, after a fracture, it will take a rather long period for this indicator to fall within the acceptable range. At the same time, an excess of ESR in the blood is one of the symptoms of the following conditions:
- infectious disease;
- injuries;
- intoxication of the body;
- failure of the normal functioning of the thyroid gland;
- kidney disease;
- tuberculosis;
- violation of metabolic processes;
- anemia;
- myocardial infarction;
- new growths;
- systemic pathologies.
If the decoding of the analysis showed that all indicators are normal, and only the ESR is overestimated, then it is necessary to control it for some time. Uncontrolled intake of vitamin A, contraceptives contributes to an increaseESR. A blood test in this case gives a false result. In addition, if a woman has anemia, high cholesterol, and has been vaccinated against hepatitis B, the erythrocyte sedimentation rate detected during the examination is unreliable. The indicator can also be false in older women, with kidney failure or a high degree of obesity.
Reduced red blood cell sedimentation rate is present in the following pathologies in women:
- epilepsy;
- circulatory failure;
- mental disorders;
- leukemia;
- heart failure and some others.
Thus, reduced or increased ESR is not a disease and does not require therapy, and treatment should be directed to the pathology that provoked the deviation from the norm.
Erythrocyte sedimentation rate in pregnant women
The norm of ESR in the blood of women in anticipation of a baby is not a constant value due to hormonal changes. However, its fluctuations should be within a limited corridor. The normal value is the level of ESR, not exceeding the value of 45. In different periods of pregnancy, it is different, for example, in the first trimester it decreases, in the second it slightly increases, in the third it is the highest. Three months after delivery, ESR returns to normal. The reasons for the deviation are inflammatory processes occurring in the respiratory, genitourinary tract or in the large intestine. In addition, the norm of ESR in women in the position above:
- for diseases of the kidneys, liver;
- infectiousprocesses;
- injuries;
- rheumatological diseases;
- diabetes.
In addition, the ESR is influenced by the level of hemoglobin, the decrease of which contributes to the growth of this indicator. The doctor prescribes an additional examination if an inflammatory process is suspected. For vegetarians, low red blood cell sedimentation rates are normal.
Erythrocyte sedimentation rate in women
Throughout life, the norm of ESR in women is different. Factors affecting her:
- puberty;
- pregnancy;
- menstruation;
- climax.
Due to some features of the organism, the permissible range of ESR in the female is from 3 to 18, i.e., the indicators are slightly higher than in men. A high level can be observed for a long time, as well as:
- in the morning hours;
- in the presence of acute inflammation;
- maximum jump in recovery.
If you suspect a disease, including cancer, the doctor recommends additional types of examinations. Consider the norms of ESR in women by age:
- Adolescence and up to 30 years - from 7 to 16. During this stage, the allowable values do not change. An increase in the indicator is observed during menstruation and during pregnancy, which is a physiologically determined process.
- From the age of 30 to 50, red blood cells settle faster, so the range andbecomes normal from 8 to 25. The increase, as in the previous age category, occurs during critical days.
- In women after 50 years, the ESR rate is quite high - up to 50. This is due to age-related changes occurring in the body against the background of the menopause. At this time, regular monitoring is necessary so as not to miss the pathology.
- At the age of 60 years, the acceptable limits are even wider, since the older the individual, the more chronic pathologies he has. At the same time, constant medication also affects the result of ESR, and its wide range just allows you to take into account all the features of this age category of citizens.
ESR in males
In men, the speed of movement of red blood cells depends on age, that is, the older, the higher this indicator. However, in old age, its level should not be higher than 35. ESR norms by age:
- 30-50 years - 1 to 10;
- 50-60 years - 5 to 14;
- over 60 years old - from 18 to 35.
Minor deviations from the norm are allowed, but they require control in order to detect pathological disorders in time. It should be remembered that it is impossible to make a diagnosis, even a preliminary one, only by this indicator. A comprehensive examination is needed.
The following degrees of ESR deviation from the norm in men are distinguished:
- Fourth. In this case, the indicator is higher than the permissible values by more than 60 units. Additional examinations are needed to establish an accurate diagnosis and prescribe therapy. This degree is typical for neoplasms of a malignant nature.
- Third. Exceeding the norm from 30 to 60 indicates a pathology of necrotic or inflammatory direction in the progression stage.
- Second. Normal numbers are overestimated by 20 or 30 units. Such values are found when some functions fail or there is an infectious process in the body. Control needed.
- First. Minor deviations from acceptable values. To determine the exact result, the study is repeated after a few days, since a false result is possible. An incorrect value leads to errors in the diagnosis. The reason for it may be violations directly during the analysis, as well as taking certain medications that affect the erythrocyte sedimentation rate.
Causes of increased and decreased erythrocyte sedimentation rate in men
Red corpuscles (erythrocytes), which are examined during a blood test in a practically he althy individual, do not hold together in a collision due to a negative charge, but repel each other. When the ESR is above the norm, they stick together and form into groups. The main provocative factor in detecting an increased rate of their settling is the inflammatory process. The indicator increases under the following conditions:
- infection;
- rheumatism;
- arthritis;
- tuberculosis;
- inflammatory, septic, purulent manifestations;
- autoimmune pathologies;
- diseases of the kidneys, liver;
- tissue necrosis;
- failure of endocrine functionssystem;
- heart valve pathology;
- neoplasms of a malignant nature.
If deviations below the normal ESR are found, then the cause may be the presence of the following pathological conditions:
- erythremia;
- hepatitis;
- blood disease;
- cholecystitis;
- epilepsy;
- jaundice;
- neurosis.
In addition, a low rate of movement of red blood cells is observed in violation of the functions of the circulatory, endocrine and nervous systems.
Erythrocyte sedimentation rate in children
The norm of ESR in children is different depending on the age category. The physiological difference between this indicator in boys and girls manifests itself as they grow up. The female sex has fewer red blood cells, and they settle faster, therefore, the ESR level is higher than in men. In children, the indicator should not be higher than 20, that is, the maximum allowable value. A low red blood cell sedimentation rate is rare and is caused by the following conditions:
- tumors;
- dehydration;
- prolonged diarrhea;
- viral hepatitis;
- metabolic failure;
- chronic blood flow insufficiency;
- regular vomiting;
- heart disease.
Perfectly he althy babies from birth to two weeks of age have a low level of ESR, which is not a pathology.
If a child's ESR is higher than normal, what does it mean? The reason is the inflammatory process and, as a result, a violation of the ratio of proteins in the blood, which accelerate the process of gluing erythrocytes and contribute to their faster sedimentation. The following phenomenon is observed:
- with SARS;
- injuries;
- allergies;
- flu;
- angina;
- poisoning;
- stress conditions;
- anemia;
- oncology;
- tuberculosis;
- intestinal infections;
- sepsis;
- helminthiasis;
- thyroid diseases;
- autoimmune diseases and some other pathologies.
The causes of high ESR in infants are:
- teething;
- an individual feature of the organism;
- eating fatty foods for breastfeeding women;
- taking certain medications on the eve of biomaterial delivery.
A particularly high deviation of the ESR from the norm is observed when diagnosing a child:
- fungal infection;
- pyelonephritis;
- cystitis;
- ARVI;
- pneumonia;
- flu;
- bronchitis;
- sinusitis.
Some conditions in children give a false result. These include:
- menstruation in girls;
- overweight;
- allergy;
- kidney failure;
- anemia, in which hemoglobin and the total number of red blood cells in the blood are reduced;
- diet or solid food on the eve of the test;
- vaccination;
- receptionvitamin complexes containing vitamin A;
- technical errors in the study.
In these cases, a high level of ESR is not considered the cause of inflammation in the child's body. In children, as in adults, this indicator must be considered in conjunction with others. The norm of ESR in the blood after an illness is restored after a certain period of time. Sometimes this period can take several months.
Preparing for a CBC
Following simple activities will help you to have no doubts about the results and will minimize the risk of errors. For this you need:
- Take biomaterial on an empty stomach. A minimum of eight hours must have elapsed since the last meal.
- On the day of the test, do not brush your teeth, do not eat.
- For a day, refuse to eat heavy and indigestible food. Reduce the amount of s alt. Limit any load, both physical and psychological. Avoid alcohol-containing drinks.
- Do not smoke the night before.
- As agreed with the doctor, stop taking medication for a while, as some medications affect the results of the study.
- It is advisable for women not to take an analysis on critical days. In cases of pregnancy, the doctor must be informed.
- Before entering the laboratory, sit quietly, calm down and only then go in.
Ready analysis can be received the next day. In case of emergency, it will be ready in two hours.
Conclusion
In medical institutions all over the world, an erythrocyte sedimentation rate test is considered mandatory when performing a general blood test. It is prescribed for the diagnosis of pathology, dispensary, mandatory and preventive examination. ESR is not a unique indicator, and its interpretation is acceptable in combination with other equally important analysis parameters.
The doctor finds out the exact reason for the ESR deviation from the norm by examining and analyzing the results of additional types of examinations. Having identified the source, all efforts are directed to its elimination, i.e., the appropriate therapy is recommended to the individual. In some situations, no additional measures are required, for example, during pregnancy. ESR in this case normalizes after delivery.
