What is the clinical significance of erythrocyte sedimentation rate (ESR)?
Jan 15, 2022
Source: Cainiu Health
Dr. Li Qinghui
Introduction
Specifically, anticoagulated blood is placed vertically in an erythrocyte sedimentation rate (ESR) tube and allowed to stand still. Due to their higher density, red blood cells gradually settle downward. The erythrocyte sedimentation rate (ESR)—commonly referred to as “sed rate”—is typically expressed as the distance (in millimeters) that red blood cells fall in the first hour. Elevated ESR is most commonly associated with acute or chronic infections.
Erythrocyte sedimentation rate (ESR), commonly referred to as “sed rate,” is a frequently ordered clinical test. Clinically, ESR may be either elevated or decreased.
Clinical Significance of ESR
ESR elevation is observed in various conditions, including infections (both acute and chronic), acute bacterial infections, anemia, malignancies, severe trauma, post-surgical states, myocardial infarction (typically 3–4 days after onset), chronic glomerulonephritis, nephrotic syndrome, active tuberculosis, active rheumatic diseases, tissue injury, autoimmune disorders, multiple myeloma, hyperglobulinemia, systemic lupus erythematosus (SLE), liver cirrhosis, atherosclerosis, diabetes mellitus, myxedema, primary familial hypercholesterolemia, and hyperfibrinogenemia.
Certain medications—including cephalosporins, indomethacin, oral contraceptives, dopamine, procaine, aminophylline, and vitamin A—may also elevate ESR. Persistently elevated ESR following chemotherapy may predict disease recurrence. Conversely, decreased ESR may occur in polycythemia vera, extreme leukocytosis, hypofibrinogenemia, congestive heart failure, and with use of medications such as aspirin, dehydrocortisone, and quinine.
Specifically, anticoagulated blood is placed vertically in an ESR tube and allowed to stand undisturbed. Due to their relatively high density, red blood cells gradually settle downward. The ESR is conventionally expressed as the distance (in millimeters) that red blood cells fall in the first hour—hence the term “erythrocyte sedimentation rate” (ESR).
In most cases, an elevated ESR reflects acute or chronic infection, malignancy, or diseases associated with tissue degeneration or necrosis (e.g., myocardial infarction, collagen vascular diseases). These conditions often involve alterations in plasma globulins and fibrinogen levels—or the presence of abnormal proteins in circulation—leading to accelerated sedimentation. Additionally, anemia, menstruation, and pregnancy beyond the third month may also increase ESR. Therefore, ESR is a nonspecific test and cannot be used alone to diagnose any particular disease.
First, remain calm—repeat the ESR test after several days to determine whether the value remains elevated.
Second, consult a physician at a reputable local hospital. However, diagnosis must rely on comprehensive clinical evaluation and supporting laboratory/imaging findings—not solely on ESR results—to ensure timely and effective treatment.
We hope the above information is helpful. Wishing you good health and happiness!
