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Erythrocyte Sedimentation Rate
Overview
What is ESR?
An erythrocyte sedimentation rate (ESR) test indicates the presence of an inflammation but does not locate the cause. Any inflammation in the body could be a sign of chronic disease, an immune disorder, or other medical conditions. It also helps to determine whether you have an active disease or not.
There are multiple causes of a high ESR such as advanced age, kidney disease, autoimmune disease, and certain types of cancers. An abnormally high ESR could also indicate the presence of cancerous tumors.
Why is ESR done?
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

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