Erythrocyte Sedimentation Rate esr00.htm

ERYTHROCYTE SEDIMENTATION RATE
Clinical Pathology

HEMATOLOGY

PAGE EXPIRES: June 2000

SYNONYMS:  ESR; Sed Rate

COMPONENT TESTS:  none

SCHEDULE:  Routine turnaround time:

SPECIMEN AND COLLECTION REQUIREMENTS:  Specimen should be handled gently to prevent damage to collected red cells.

CAUSES FOR REJECTION:  Improperly labeled; specimen to old (see STORGAGE); specimen hemolyzed; specimen clotted; diluted with IV fluid; collection tube not filled to minimum volume.

STORAGE:  Maintain specimen at room temperature if testing can be completed within two hours; specimen may be refrigerated at 4 C for maximum of six hours and allowed to warm to room temperature before testing.

USES:  General health indicator; monitor inflammatory or malignant disease; aid detection and diagnosis of occult disease, such as tuberculosis, necrosis, and connective tissue disease.

NORMAL VALUES:

METHOD:  The natural (by gravity) rate of settling (sedimentation) of erythrocytes in their native, anitcoagulated plasma is measured and reported.

DESCRIPTION AND COMMENTS:  Sedimentation occurs in three stages: (1) rouleaux formation, (2) sinking of rouleaux at a constant speed, and (3) slowing of sedimentation as cells begin to pack.

The ESR is elevated in pregnancy, in the puerperium, and in a low percentage of apparently normal children. Also increased in:

Conditions which increase immunoglbulins and acute-phase reactants (fibrinogen, haptoglbins, transferrin, etc.), e.g., infections, tuberculosis, pelvic inflammatory disease, systemic lupus erythematosus, and some arthritis.

Conditions which produce relative increase of globulins (as occurs with loss of albumin), e.g., kidney disease, chronic liver disease, and enteritis.

Conditions which cause an absolute increase of globulins, e.g., multiple myeloma, cryoglobulinemia, macroglobulinemia, and lymphomas.

Conditions producing extensive tissue necrosis, such as malignant tumors and myocardial infarction.