Test Detail
Overview
Interpreting Results
FAQ's

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Written by
Dr. Betina Chandolia
BDS, MDS - Oral Pathology and Microbiology
Reviewed by
Dr. Ashish Ranjan
MBBS, MD (Pharmacology)
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Erythrocyte Sedimentation Rate

(ESR)
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Erythrocyte Sedimentation Rate
You need to provide
Blood
This test is for
Male, Female
Test Preparation
  1. No special preparation required

Overview


What is ESR?

Erythrocyte Sedimentation Rate (ESR) Test, also known as sedimentation rate test or sed rate test is a blood test which can detect inflammatory activity in the body. ESR test doesn’t diagnose one specific condition. Instead, it helps to diagnose or monitor the progress of an inflammatory disease.


Why is ESR done?

The Erythrocyte Sedimentation Rate (ESR) Test is performed:

  • To detect any inflammation in the body which may be caused due to conditions such as infections, cancers, and autoimmune diseases

  • To monitor the progress of inflammatory diseases

  • To evaluate the response to treatment of inflammatory diseases





What does ESR Measure?

The ESR test measures the rate at which red blood cells (erythrocytes) settle (sediment) at the bottom of a tube that contains a blood sample in one hour. The test result is expressed in millimeters per hour (mm/hr).

In the presence of inflammation, certain proteins mainly fibrinogen increase in blood. This high proportion of fibrinogen in the blood causes the red blood cells to form a stack (rouleaux formation) which settle quickly due to their high density.

The ESR test is a non-specific measure of inflammation. An ESR can be affected by conditions other than inflammation also. Although a high ESR can detect the presence of inflammation, it cannot provide any information regarding the cause and site of inflammation. Hence, an ESR test is done along with other tests.

Interpreting ESR results


Interpretations

The normal reference range for Erythrocyte Sedimentation Rate (ESR) is:


Men

0-15 millimetres per hour (mm/hr), or 0-20 mm/hr for men older than 50

Women

0-20 mm/hr, or 0-30 mm/hr for women older than 50

Children

0-10 mm/hr

Newborns

0-2 mm/hr


High ESR can be seen in:


  • Inflammatory disease such as Arthritis (Inflammation of joints), vasculitis (Inflammation of blood vessels)

  • Infection, such as pneumonia, pelvic inflammatory disease, appendicitis, skin infection, bone infection, heart valve infection

  • Autoimmune diseases, such as systemic lupus erythematosus or rheumatoid arthritis

  • Chronic kidney disease

  • Viral infections

  • Pregnancy

  • Cancer, such as lymphoma or multiple myeloma



Low ESR can be seen in:

  • Congestive heart failure

  • Polycythemia

  • Sickle cell disease

  • Severe liver disease

  • Hypofibrinogenemia

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about ESR


Frequently Asked Questions about Erythrocyte Sedimentation Rate

Q. How is this test performed?
This test is performed on a blood sample. A syringe with a fine needle is used to withdraw blood from a blood vessel in your arm. The healthcare provider will tie an elastic band around your arm to make the blood vessels swell with blood. This makes it easier to withdraw blood. You may be asked to tightly clench your fist. Once the veins are clearly visible, the area is cleaned with an antiseptic solution and then the needle is inserted into the blood vessel to collect the sample. You will feel a tiny pinprick during the procedure. Blood sample once collected will then be sent to the laboratory.
Q. Is there any risk associated with this test?
There is no risk associated with the test. However, since this test involves a needle prick to withdraw the blood sample, in very rare cases, a patient may experience increased bleeding, hematoma formation (blood collection under the skin), bruising or infection at the site of needle prick.
Q. What are the factors which may affect the ESR test results?
The following factors may affect the ESR test results: Pregnancy, anemia, menstrual period, certain medications such as estrogens, birth control pills, aspirin, prednisone etc.
Q. Is there any preparation required before the ESR test?
No special preparation is required for ESR test. However, you should inform the doctor about the medications you are taking as some medications such as estrogens, birth control pills, aspirin, prednisone etc. may affect the test result.
Q. Which is the other test that can be prescribed to detect inflammatory activity?
Your doctor may prescribe C - Reactive protein blood test to detect inflammation.
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