Tuesday, August 17, 2010

Erythrocyte Sedimentation Rate (ESR)

Erythrocyte Sedimentation Rate (ESR)

Introduction

ESR is the rate at which RBC's settle down when blood, to which anticoagulant is added, is allowed to stand in a narrow tube for one hour expressed in millimeters of clear plasma at the end of 1st hour. Sedimentation rate depends on various factors like; rouleaux formation (Rouleaux formation is directly proportional to concentration of fibrinogen and globulin in plasma. It is retarded by albumin); viscosity of plasma (ESR decreases if viscosity increases); ratio of cells to plasma (decreased ratio leads to increase Rouleaux formation); nature of anticoagulant used.

 

 

                                      Normal Range (mm in 1 hr)

        Westergren

                       Wintrobe's            

 Males

   Females

 Males

Females

 Children

Newborns

 0 –13

    0 –20

  0 –10

 0 -15

 0 – 13

0 -2

 

Increased in

Tissue damage or inflammation, anemia, any toxic or infective condition (acut or chronic), malignancies, nephrosis, physiological increase in females, pregnancy increase in temperature.

            Decreased in

Polycythemia, leukemia, hypofibrinogenemia, pernicious anemia, congestive heart failure (CHF), Protein shock (e.g. burns, severe allergic reactions), physiological decrease in newborns, decrease in temperature.

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