Normal values for the erthyrocyte sedimentation rate (ESR), as derived using the Westergren method, are as follows[1] :
Conditions that may be associated with a highly elevated ESR (>100 mm/hr) include the following:
Hypersensitivity vasculitis
Giant cell arteritis
Waldenström macroglobulinemia
Polymyalgia rheumatica
Metastatic cancer
Chronic infection
Hyperfibrogenemia
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
See the list below:
C-reactive protein (CRP)
Antinuclear antibody (ANA)
Rheumatoid factor (RF)
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.[2, 3, 4]
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[5]
Monitoring of rheumatoid arthritis
Monitoring of systemic lupus erythematosus[6]
Other conditions that may be associated with an elevated ESR include the following:
Anemia
Other arthritides
Other autoimmune disorders
Infective endocarditis
Inflammatory disease
Malignancy (eg, lymphoma, leukemia)
Osteomyelitis
Pregnancy
Renal disease
Severe skin infection (eg, erysipelas)
Systemic infection
Rheumatic fever
Thyroid disease
Tissue death
Tuberculosis