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Erythrocyte Sedimentation Rate (ESR) – Serum Blood Test

The erythrocytes have a slightly higher specific weight compared to the blood plasma, which leads to a sedimentation of the erythrocytes in a non-moving blood column. The alteration of the plasma by an inflammatory reaction leads to an increase in the erythrocyte sedimentation rate.

Standard value:

1–20 mm/h (women), 1–13 mm/h (men); for the elderly the upper normal value applies.

Laboratory test method:

1.6 ml of whole blood are mixed with 0.4 ml of 3.8% sodium citrate and mounted in a vertical 200 mm long plastic tube. After one hour, the cell-free supernatant is measured (in mm).

Indications:

Diagnosis and treatment monitoring of inflammatory diseases, after operations, tumor prognosis parameter (see CRP). Compared to the CRP, ESR measurement is cheaper. Disadvantageously is the slow reaction of the ESR to changes of the disease intensity.

Differential Diagnosis of Elevated ESR

• Moderately increased: malign tumors, infections, pregnancy, postoperative, trauma, anemia, leukemia, age.
• Marked increase: plasmocytoma, macroglobulinemia, rheumatic fever, temporal arteritis, nephrotic syndrome, urosepsis, sepsis, collagenosis, chronic polyarthritis.

Differential Diagnosis of Low ESR

Polycythemia.

References

  Deutsche Version: BSG: Blutsenkungsgeschwindigkeit