Erythrocyte Sedimentation Rate (ESR), Sodium Citrate Whole Blood

Erythrocyte sedimentation rate (ESR) is a useful but non-specific marker of underlying inflammation. ESR is elevated in inflammation, infections, cancers and/or autoimmune diseases. It is non-specific test, as increased ESR indicates that there is an inflammation but does not detect what is causing it. Hence it is advised to do ESR along with other test like C-reactive proteins. ESR is elevated in: Rheumatoid arthritis, chronic infection, collagen disease, polyclonal hyperglobulinemia and hyper fibrinogenemia, temporal arteritis, septic arthritis, pelvic inflammatory disease, and appendicitis, Osteomyelitis, Neoplastic disease (Myeloma, Macroglobulinemia, Prostate cancer, Hodgkins disease, Renal cell carcinoma), Stroke, coronary artery disease, Pregnancy (increase at the 10th to the 12th week, and returns to normal about 1 month post partum) ESR is decreased in: Polycythemia, hyperviscosity, sickle cell anemia, leukemia, low plasma protein (liver, kidney disease) and congestive heart failure.

1. Is ESR done as a routine screening test?

No. ESR is not a specific test and it does not indicate a single or specific condition or disease. ESR test is affected by many factors other than inflammation and hence it is not recommended as a routine screening test.

2. What other tests are useful besides ESR?

Depending on the symptoms, C-reactive protein, complete blood picture, antinuclear antibody (ANA), rheumatoid factor (RF), fibrinogen or serum protein electrophoresis may be useful investigations besides ESR.

3. What does elevated ESR mean?

Elevated ESR indicate presence of infection or inflammation. In cases of chronic inflammatory disease, the results of ESR fluctuate with the degree of severity of the disease.