ESR Blood Test, High ESR, Normal and Low ESR


ESR blood test stands for erythrocyte sedimentation rate.  It is also known as Biernacki Reaction, Westergen sedimentation rate or simply sedimentation rate.  This blood test determines the rate of sedimentation of red blood cells within a one hour period.  The unit used is in millimeter per hour (mm/hr); a reflection of how fast red blood cells fall.

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What is ESR blood test used for?

This is a nonspecific test to determine the presence of inflammation, whether acute or chronic.    It should be noted though, that the test is nonspecific.  This means that even though the results are high, the test cannot specify where the inflammation is or the cause for the inflammation.  Besides, ESR is easily affected by many factors aside from swelling.  Hence, to be able to make the right diagnosis, ESR is performed in combination with other evaluations.

That being said, still, ESR has been found to be valuable in diagnosing temporal arteritis, multiple myeloma, polymyalgia rheumatica, systemic lupus erythematosus, a range of auto-immune diseases, rheumatoid arthritis, and chronic kidney diseases.  ESR test could also be employed for diagnosing Kawasaki’s disease, endocarditis and tuberculosis.

ESR is also useful as a means to monitor the body’s response to treatment for some ailments such as rheumatoid arthritis, polymyalgia rheumatica and temporal arteritis.

It is best to keep in mind, however, that a high ESR, without the existence of other findings, does not warrant a wide-ranging workup to find a disease.  In fact, doctors would want to repeat the test to make sure of the result.

What do high ESR and low ESR mean?

The following are the normal range for ESR:

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v  Newborn: 0-2 mm/hr

v  Infancy to puberty:  3-13 mm/hr, max: 20 mm/hr

v  Men: 20 years old = 12 mm/hr; 55 years old = 14 mm/hr; 90 years old = 19 mm/hr

v  Women: 20 years old = 18 mm/hr; 55 years old = 21 mm/hr; 90 years old = 23 mm/hr

ESR result should be interpreted alongside other results of laboratory evaluations, clinical findings and the patient’s medical history.  To be able to make a proper diagnosis, the ESR result and clinical findings should concur.  A high ESR or low ESR, alone, will not provide a conclusive finding.  On the other hand, a value within the normal range for ESR, could not discount a disease or swelling.

• Low ESR: Low ESR values are typically not a cause for alarm. Although, it may be indicative of health conditions that hinder normal red blood cell sedimentation. These conditions include protein abnormalities, leukocytosis and polycythemia. Crescent shape red blood cell as in sickle cell anemia also reduces the ESR.

• Moderately high ESR: this may mean inflammation, or anemia, pregnancy, infection or old age.

• Very high ESR: This implies severe infection and requires further tests like blood cultures. Individuals with polymyalgia rheumatica, temporal arteritis, multiple myeloma or Waldenstrom’s macroglobulinemia will reflect very high ESR.

• Rising ESR: When monitoring treatment effectiveness, a rising ESR may mean unsuccessful response to therapy or the presence of inflammation.

• Decreasing ESR: This, on the other hand, means the body is responding well to treatment.

ESR blood test is affordable and quick. However, one must let the doctor do the interpretation to avoid confusion and unnecessary worry.

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3 Comments

  1. i had fever it came down after 4 days but i still have 99;2 99;4 for last 15 days my esr was 52 leukocyte 52 other result were normal no typhoid xray normal urine normal but still low grade fever advice me

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