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Erythrocyte Sedimentation Rate 

  • Author: Christopher P Kellner, MD; Chief Editor: Thomas M Wheeler, MD  more...
Updated: Aug 01, 2014

Reference Range

The reference range for erthyrocyte sedimentation rate is as follows:

Adults (Westergren method)

See the list below:

  • Men under 50 years old: < 15 mm/hr
  • Men over 50 years old: < 20 mm/hr
  • Women under 50 years old: < 20 mm/hr
  • Women over 50 years old: < 30 mm/hr

Children (Westergren method)

See the list below:

  • Newborn: 0-2 mm/hr
  • Newborn to puberty: 3-13 mm/hr


Conditions that may be associated with a highly elevated ESR (>100 mm/hr) include the following:


Collection and Panels

Specifics for collection and panels are as follows:

  • Specimen type: Whole blood
  • Container: Vacutainer, lavender top or black top
  • Collection method: Venipuncture
  • Specimen volume: 4 mL

Related tests

See the list below:




The rate at which red blood cells settle out when anticoagulated whole blood is allowed to stand is known as the erythrocyte sedimentation rate. The ESR is affected by the concentrations of immunoglobulins and acute phase proteins (fibrinogen, C-reactive protein, alpha-1 antitrypsin, haptoglobin), and is a sensitive, but nonspecific, indicator of inflammation and tissue damage.[1, 2, 3]


The ESR is a nonspecific test that is often used as a screening test for patients with unexplained fevers, certain types of arthritis, muscle symptoms, or other vague symptoms of unknown origin.

Significant specific indications for ESR testing include the following:

  • Diagnosis and monitoring of giant cell arteritis
  • Diagnosis and monitoring of polymyalgia rheumatic[4]
  • Monitoring of rheumatoid arthritis


Other conditions that may be associated with an elevated ESR include the following:

Contributor Information and Disclosures

Christopher P Kellner, MD Resident Physician, Cerebrovascular Research Laboratory, Department of Neurological Surgery, Columbia University Medical Center, New York Presbyterian Hospital

Christopher P Kellner, MD is a member of the following medical societies: American Association of Neurological Surgeons, American Medical Association, Congress of Neurological Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Thomas M Wheeler, MD Chairman, Department of Pathology and Immunology, WL Moody, Jr, Professor of Pathology, Professor of Urology, Baylor College of Medicine

Thomas M Wheeler, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American Medical Association, American Society for Clinical Pathology, American Society of Cytopathology, American Thyroid Association, American Urological Association, College of American Pathologists, United States and Canadian Academy of Pathology, International Society of Urological Pathology, Harris County Medical Society

Disclosure: Received stock from PathXL for medical advisory board. for: PathXL, Inc.


Judy Lin, MD

Disclosure: Nothing to disclose.

  1. Burris CA, Ashwood ER, Burns DE. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. St. Louis: Elsevier Saunders; 2006. 1633:962-967.

  2. McPherson RA, Matthew R. Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia: Elsevier Saunders; 2011. 254-5.

  3. Wallach J. Interpretation of Diagnostic Tests. 6th ed. New York: Little, Brown; 1996. 717.

  4. McCarthy EM, MacMullan PA, Al-Mudhaffer S, Madigan A, Donnelly S, McCarthy CJ, et al. Plasma fibrinogen along with patient-reported outcome measures enhances management of polymyalgia rheumatica: a prospective study. J Rheumatol. 2014 May. 41(5):931-7. [Medline].

  5. Lin J, Yue LH, Chen WQ. Decreased plasma IL-22 levels and correlations with IL-22-producing T helper cells in patients with new-onset systemic lupus erythematosus. Scand J Immunol. 2014 Feb. 79(2):131-6. [Medline].

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