ESR according to Westergren (capillary blood) (capillary blood) in Kachkanar

Indications for testing

Blood is one of the most informative resources of the human body. By sending it for laboratory testing, the vast majority of diseases can be diagnosed with high accuracy. Clinical analysis contains many indicators, each of which reflects a specific process and function and serves as an important diagnostic criterion. However, despite the abundance of examinations, the most common and in demand at the MedArt clinic is a general blood test (ESR).

Erythrocyte sedimentation rate is the most important indicator, often confirming the presence of inflammation or other pathology (in the acute and latent stages). The mechanism of this analysis is quite simple, so you don’t need to spend several days to get the result. Red blood cells are much heavier than plasma and other cellular elements, and therefore, by placing blood in a vertically placed test tube, after a certain period of time a specific sediment will form at the bottom of the container, and a translucent liquid will appear at the top.

This is a completely natural phenomenon that occurs as a result of gravity. Red blood cells can stick together, forming entire colonies that settle to the bottom much faster than individual elements. This is due to the larger mass, which may indicate a problem.

What does a low erythrocyte sedimentation rate indicate?

This indicator may be below normal due to:

• Following a strict vegetarian diet;
• Violations of water-salt balance;
• Diseases of the nervous system;
• Fasting;
• Excessive physical activity;
• Taking certain steroid hormones;
• Congenital disorder of the hemoglobin protein structure;
• Pregnancy in the second and third trimesters.

Decreased values ​​are much less common than increased values. Often they do not mean any serious violations. Yet sometimes it is a low erythrocyte sedimentation rate that helps the doctor identify the problem. Or at least understand in which direction to look for it, what studies to prescribe for the patient.

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How to prepare for the test

ESR is included in the list of standard indicators that are displayed in all blood tests (general and clinical). However, special attention is paid to it in the following situations:

• Diagnosis confirmation
• Preventive examination
• Evaluation of the effectiveness of prescribed treatment
• Infectious and inflammatory pathologies
• Autoimmune disorders
• Tumors (malignant and benign) of any location

Many pathologies of internal organs are asymptomatic, and often identifying an ESR deviation from the norm becomes a reason to begin a more detailed diagnosis, thanks to which it is possible to identify the problem in the early stages and begin effective treatment. Most often, after any abnormalities are found, an additional biochemical analysis is prescribed, which allows a more detailed study of the bloodstream.

Important Notes

Material for research Capillary blood.

Children under 7 years of age: venous blood/capillary blood (for special indications). Children over 7 years of age and adults: venous blood. Capillary blood collection for research is carried out only for children under 7 years of age (for special indications)! According to GOST R 53079.4-2008, indications for taking capillary blood are possible: in newborns, in patients with very small or hard-to-reach veins, with large-area burns, and in severely obese patients.

How the research is carried out

The accuracy of this diagnostic method depends on many nuances: proper preparation for the test, the professionalism of the laboratory worker and the quality of the reagents. Subject to these conditions, you can guarantee the most reliable result. And if the person donating blood cannot influence the last 2 points, then the preparatory stage completely depends on him. Despite the fact that in this case no special and complex preparation is required, there are a number of mandatory general rules that are strongly recommended to be followed.

First of all, 1 day before the test, you must stop drinking alcoholic beverages, and also refrain from eating for 4-5 hours. Only drinking plain water is allowed. It is also recommended to quit smoking an hour before the test. Secondly, if the patient takes (on an ongoing basis or only at the moment) any medications, then the doctor must be informed about this in advance. Some medications can distort the results, which is why their use may be stopped and reinstated after donating blood. Thirdly, on the eve of the procedure you should not visit sports or gyms. You should also refrain from intense physical activity and avoid emotional stress.

If you doubt anything, just call us at this number +375(29) 666-30-96 or make an appointment with a doctor using our online form.

How to reduce ESR in the blood?

The doctor will tell you in detail about ways to reduce this indicator with the help of medications after the study. He will prescribe a treatment regimen once the diagnosis has been made. It is strictly not recommended to take medications on your own. You can try to reduce it with folk remedies, which are mainly aimed at restoring normal function of the immune system , as well as cleansing the blood. Effective folk remedies can be considered herbal decoctions, teas with raspberries and lemon, beet juice, etc. How many times a day to take these remedies, how much you need to drink, you should find out from a specialist.

How to prepare

The duration of the analysis does not exceed 5-10 minutes. As a rule, the procedure is accompanied by slight pain and discomfort in the puncture area, but the discomfort passes very quickly. If capillary blood is needed, then before piercing the third or fourth finger of the left hand, the skin in this place is treated with an alcohol cotton ball. After this, using a special medical blade, a small incision is made on the fingertip (its depth does not exceed 3 millimeters). The resulting drop of blood is disposed of with a sterile napkin, after which the laboratory assistant proceeds to collect the biomaterial. Having collected the required amount, the wound surface is lubricated with an antiseptic, and a cotton swab with alcohol is applied to the puncture site.

If the analysis involves taking biomaterial from a vein, then the patient’s forearm is tightened with a medical tourniquet or strap, after which he must work a little with his fist (clench and unclench) for better vascular filling. The site of the intended puncture is treated with an alcohol wipe, after which a needle is inserted into the selected vessel, to which a test tube is connected to collect the released blood. Having collected a sufficient amount of biomaterial, the needle is removed, and a cotton swab with alcohol is applied to the wound.

To calculate ESR, an anticoagulant is placed in the biological material to prevent clotting. Then it is sent to a vertical container for 60 minutes. Since the specific gravity of red blood cells exceeds the weight of plasma, gravity forces them down to the bottom of the container. Because of this, 2 visible layers are formed in the test tube: the upper (colorless plasma) and the lower (erythrocyte accumulations). Then the laboratory assistant takes measurements of the top layer. The indicator corresponding to the mark between the red blood cells and the plasma zone on the test tube scale is ESR (indicated in mm/h).

Today there are 2 main ways to detect ESR:

• Panchenkov's method. The capillary is divided into exactly one hundred compartments, and later 5% sodium citrate is added to it to the “P” level. Then the capillary is filled with biomaterial up to the letter “K”. The resulting mixture is mixed and installed vertically. The assessment takes place after 60 minutes.
• Westergren method. Here, venous blood is used, mixed with sodium citrate 3.8% in a ratio of 4:1. It can be mixed with Trilot B followed by the addition of sodium citrate or saline solution in an amount of 4:1. The study is carried out in test tubes equipped with a 200 mm scale. The result is assessed after 60 minutes. This technique is used everywhere, and its main distinguishing feature is the type of test tubes and measuring scale used.

Despite the coincidence of the results of these methods, the Westergren method is famous for its greater sensitivity to exceeding the ESR indicator, and therefore it is considered highly accurate and informative.

An increase in erythrocyte sedimentation rate (ESR) in women under 50 years of age is observed when the value is more than 15 mm/h, in women over 50 years of age - more than 30 mm/h; in men under 50 years old - more than 10 mm/h, over 50 years old - more than 20 mm/h.

Mechanism of occurrence

ESR depends on the intensity of the formation of erythrocyte agents, which is associated with the properties of the plasma and the charge of the erythrocyte membrane. The most important property of blood plasma that affects this indicator is its viscosity. It increases as the protein spectrum shifts towards coarsely dispersed proteins. This occurs primarily with an increase in the amount of fibrinogen, the main stabilizer of red blood cell suspension. An increase in other globulins in the plasma (γ-globulins, α2-globulins) also leads to a drop in the electrical charge of erythrocytes and promotes their aggregation. ESR also depends on the number, size, volume of red blood cells, and the concentration of hemoglobin in them. The fewer these cells, the faster they settle in the capillary.

On average, men have more red blood cells than women, so the ESR is higher in the latter. It also increases at low temperatures. As for physiological conditions, pregnancy is accompanied by a significant acceleration of ESR (up to 30–40 mm/h). In 1984, L. Wilson and co-authors found that in healthy elderly people this figure can reach 50–60 mm/h.

When the level of bile acids in the blood increases, the ESR slows down. Severe hypofibrinogenemia, for example in severe liver damage, can prevent an increase in ESR even with significant dysproteinemia. Its slowdown is facilitated by an increase in the partial tension of CO2 in the blood, as well as erythrocytosis.

When is accelerated ESR observed?

1. Inflammatory diseases:

• bacterial infections,
• immune inflammation,
• aseptic inflammation,
• viral infections.

2. Blood diseases:

• anemia,
• paraproteinemic hemoblastoses,
• other forms of hemoblastosis.

3. Malignant tumors.

4. Metabolic diseases:

• amyloidosis,
• diseases occurring with impaired fat metabolism.

Inflammatory diseases

An increase in ESR is associated with the development of dysproteinemia, the appearance in the bloodstream of tissue breakdown products, C-reactive protein, immune complexes and other components that change blood viscosity and the potential of the erythrocyte membrane. In bacterial infections, the severity of this process is often determined by the severity of the pathology.

With purulent inflammations and abscesses of various organs, the ESR is significantly accelerated. Sometimes its indications lag behind the clinical development of the disease, which is especially evident in acute inflammatory conditions. At the same time, there is no direct connection between the indicators of ESR, body temperature and leukocytosis. ESR increases relatively more slowly and also decreases to normal compared to the number of leukocytes and the clinical manifestations of the disease.

For example, in acute tonsillitis, the maximum acceleration of ESR is most often observed during the period of decreased body temperature and the reverse development of the inflammatory process in the tonsils. Nevertheless, the majority of such common inflammatory diseases as acute appendicitis, cholecystitis, pyelonephritis, pneumonia are characterized by a degree of ESR acceleration that correlates with the severity of the pathological process, although it occurs later than leukocytosis and fever appear.

In chronic inflammatory conditions, an increase in ESR is more often and more consistently recorded than fever and leukocytosis.

Sometimes chronic indolent infections of the biliary tract, urinary system, oral cavity and other localizations occur latently, and acceleration of ESR is one of the few or even the only symptom that allows one to suspect the presence of a chronic focus of infection. Encapsulation of an inflammatory focus, in which decay products do not enter the blood, is not always accompanied by an increase in ESR, in contrast to the rapid entry of necrosis products into the bloodstream. For active tuberculosis, an acceleration of ESR is typical, usually combined with moderate leukocytosis and lymphopenia.

Most specific bacterial infections are associated with an acceleration of ESR. Difficulties in diagnosis arise with latent infections that are not accompanied by a clear clinical picture. It is necessary to identify a latent infection that affects the teeth, tonsils, paranasal sinuses, bile ducts, kidneys, and female genital organs. In addition to a persistent acceleration of ESR, moderate leukocytosis can be detected, sometimes with a shift in the leukocyte formula to the left. C-reactive protein appears in the blood serum, the amount of sialic acids increases, dysproteinemia is possible, mainly due to a moderate increase in globulins of various fractions. Sometimes functional disorders are detected on the part of the organs involved in the inflammatory process. Immune inflammation covers a large group of various diseases with primary or secondary immunopathological reactions. In some cases, exposure to an infectious agent that initially causes infectious inflammation subsequently triggers a chain of immunological phenomena.

A common cause of increased ESR is rheumatism. The level of this indicator correlates with the activity of the rheumatic process and the severity of the exudative phase of inflammation. A significant acceleration of ESR is typical for all systemic connective tissue diseases and is often consistent with the activity of the disease. With these diseases, cryoglobulins sometimes appear in the blood, which sharply increase blood viscosity and reduce ESR. Immune kidney diseases also lead to an increase in it. This is typical for nephrotic syndrome of various origins due to pronounced dysproteinemia and hypercholesterolemia, often hyperfibrinogenemia.

Significant acceleration of ESR has been described in sarcoidosis. Aseptic inflammation also leads to this. It occurs under the influence of various exogenous physical and chemical factors (irradiation, burns, injuries, exposure to acids and alkalis, etc.). In such cases, infection can quickly set in.

A typical example of aseptic inflammation is the so-called resorption-necrotic syndrome during acute myocardial infarction, in which, in particular, ESR increases 1–2 days after the onset of leukocytosis and fever. Moreover, the acceleration remains until the heart attack is completely healed.

The dynamics of ESR, as well as leukocytosis and fever, have a certain diagnostic and prognostic significance. Sometimes this suggests the addition of various complications.

Viral infections, unlike bacterial ones, are rarely accompanied by a significant increase in ESR. In acute viral infections of the respiratory tract, primarily with influenza, a moderate acceleration of ESR is delayed and is often recorded for the first time against the background of already decreasing body temperature and the reverse development of clinical manifestations of the disease. Viral pneumonia often occurs without acceleration of ESR.

Viral hepatitis is characterized by a moderate acceleration of ESR in the pre-icteric period, a decrease in ESR to normal and even lower as jaundice appears, and an increase again with the disappearance of jaundice with a gradual return to normal during recovery. Long-term persistence of a moderately accelerated ESR indicates the persistence of the virus or the addition of a bacterial infection of the biliary tract.

Infectious mononucleosis is accompanied by normal or slightly accelerated ESR in combination with leukocytosis and the presence of polymorphic cells with a large nucleus in the blood.

The bulk of acute viral infections occur with normal or even reduced ESR in combination with moderate leukopenia and relative or absolute lymphocytosis.

Blood diseases

An increase in ESR in anemia is a typical symptom associated primarily with a decrease in the number of red blood cells, although dysproteinemia that is often present also plays a role. There are calculations and nomograms that determine the proper ESR values ​​depending on the number of red blood cells.

It is believed that if the ESR is increased compared to the calculated value, then this may be associated with other severe pathologies that cause anemia (infectious disease, tumor, collagenosis, kidney pathology, etc.). On the contrary, if the ESR is accelerated to a lesser extent, then some authors attribute this to favorable signs of the regenerative nature of anemia (for example, this situation is sometimes observed during reticulocyte crisis in patients with B12-deficiency anemia).

With microspherocytic anemia, there may not be a significant increase in ESR, since the morphological characteristics of erythrocytes in this condition prevent their agglomeration. To diagnose the type of anemia, it is necessary to take into account the medical history, clinical picture, changes in blood tests, bone marrow, and instrumental data (ultrasound, endoscopic examination of the gastrointestinal tract).

Acceleration of ESR is observed in 85% of patients with multiple myeloma due to hyperviscosity syndrome. This diagnosis is made when more than 10% of plasma cells are found in the bone marrow and the paraprotein is present in the serum and/or urine. In Bence-Jones myeloma, when only light chains are secreted, the ESR may remain within normal limits unless severe anemia is present. The second most common, but very rare paraproteinemic hemoblastosis is Waldenström's macroglobulinemia, for which, unlike multiple myeloma, osteolytic processes are uncharacteristic. But hepatosplenomegaly, lymphadenopathy and pronounced hyperviscosity syndrome are typical. The latter appears:

• bleeding of mucous membranes,

• hemorrhagic retinopathy,

• dilatation of retinal veins,

• Raynaud's syndrome,

• ulceration and gangrene of the distal limbs,

• paraproteinemic coma,

• macroglobulinemic retinopathy.

The criteria for the diagnosis of Waldenström's macroglobulinemia are the presence of a mixed cellular substrate in the bone marrow (plasma cells and lymphocytes), detection of monoclonal macroglobulinemia, fibrosis in the trephine.

Heavy chain diseases (HCDs) are B-cell lymphatic tumors. There are options: BTC-γ, BTC-α, BTC-δ, BTC-μ.

With BTC-γ, the average age of patients is 60 years, but can also occur in children. The clinical picture includes: fever, night sweats, weakness, weight loss, lymphadenopathy, splenomegaly, hepatomegaly, damage to the pharyngeal lymphoid ring, recurrent infections, damage to the thyroid gland, salivary glands, skin, subcutaneous tissue, autoimmune processes (25%) with the clinic rheumatoid arthritis, systemic lupus erythematosus, autoimmune hemolytic anemia, thrombocytopenia, thyroiditis, Sjogren's syndrome and others. The bone marrow is affected in 50% of cases. This nosological form does not have a specific histological picture. In the immunochemical diagnosis of BTC-γ, the secretion of fragments of heavy chains of the PIgG subclasses is determined, serum PIg is present in the urine (overload proteinuria), Bence Jones protein is usually absent.

BTC-α is more common in children and young patients under 30 years of age. There are 2 options: abdominal and pulmonary. In the first case, malabsorption syndrome (chronic diarrhea, steatorrhea, exhaustion, edema, hypocalcemia, hypokalemia, baldness, amenorrhea), fever, and attacks of abdominal pain are noted. The pulmonary form is accompanied by bronchopulmonary lesions and mediastinal lymphadenopathy. In the immunochemical diagnosis of BTC-α, fragments of α-chains are determined in blood serum and urine, in the contents of the duodenum and small intestine, and in saliva. Bence Jones protein is never detected in BTC-α. Benign monoclonal gammopathies have been described, which manifest themselves only as a syndrome of increased ESR and are determined biochemically. Sometimes it is possible for such gammopathy to exist throughout the patient’s life. But in some cases, the clinical picture of myeloma or another malignant process gradually develops, sometimes after decades.

As for other forms of hematological malignancies, an increase in ESR is typical for all acute and chronic leukemias, malignant lymphomas, including Hodgkin lymphoma. For diagnosis, in addition to examining the hemogram, sternal puncture and/or trepanobiopsy are necessary. To determine the various forms of lymphomas, it is necessary to conduct histological, enzyme-linked immunosorbent examination of biopsy material, and genetic studies. To clarify the localization of damage to the lymph nodes and internal organs, ultrasound of the abdominal cavity and CT scan of the chest are used.

Malignant tumors

The increase in ESR in this case is associated not only and not so much with the severity of anemia, but with dysproteinemia, an increase in the amount of fibrinogen and a change in the charge of the erythrocyte membrane. More often, persistent and significantly accelerated ESR is observed in cancer of the bronchus, bones, ovary, hypernephroma, sarcomas, and less often in gastrointestinal tumors. Although with cancer of the stomach, colon, pancreas, and liver, a significant increase in ESR is also sometimes encountered. Its magnitude depends on the histological structure of the tumor, but is largely determined by the size of the tumor and the presence of complications. In some cases, an increase in ESR is at the first stage the only manifestation of malignant growth, ahead of clinical symptoms.

With the development of the tumor, other peripheral blood parameters may also change: anemia is often observed (less commonly secondary erythrocytosis), in some cases neutrophilic leukocytosis, lymphopenia, monocytosis, and hyperthrombocytosis are observed. If a neoplasm is suspected and there are no clear clinical manifestations, a thorough and systematic examination is necessary: ​​sternal puncture (detection of signs of hemoblastosis or anemia as the cause of an increase in ESR), ultrasound of the abdominal organs, CT and X-ray examination of the lungs, bronchoscopy, FGDS, FCS. You should consult an obstetrician-gynecologist and urologist.

Metabolic disorders

Most often, an increase in ESR is observed with tissue dysproteinoses. This process may be associated with some forms of hyperlipidemia and widespread atherosclerosis. The main reasons for an increase in ESR in metabolic diseases are dysproteinemia and hypercholesterolemia.

Amyloidosis leads to its acceleration due to severe dysproteinemia. The most common is secondary amyloidosis, which complicates the course of chronic suppurative lung diseases, tuberculosis, chronic osteomyelitis, ulcerative colitis, Crohn's disease, and systemic connective tissue diseases. Paraproteinemic hemoblastoses can lead to the occurrence of this lesion. Amyloid deposition is possible in all organs and tissues. Most often, parenchymal organs are affected: kidneys, liver, spleen, adrenal glands, less often - the gastrointestinal tract, cardiovascular system, lungs, thyroid gland, etc.

There are 4 stages of renal amyloidosis: latent, proteinuric, nephrotic and azotemic. In the first case, the symptoms of the underlying disease, potentially dangerous in relation to amyloidosis, dominate. Sometimes a slight proteinuria appears and a persistent, significantly increased ESR is recorded, which is often not explained by the activity of the underlying pathology. Already at this stage, an enlarged liver and spleen can be palpated, amyloid deposition in which is most common in secondary amyloidosis.

The advanced stage is manifested by complete nephrotic syndrome (proteinuria more than 3 g per day, hypoproteinemia, hyperlipidemia, edema). Symptoms of chronic renal failure subsequently arise and progress. In some patients, amyloid is deposited primarily in the liver. This is characterized by moderate pain in the right hypochondrium, flatulence, and sometimes jaundice. The liver can be enlarged very significantly and descend into the pelvis. In rare cases, a predominant deposition of amyloid in the adrenal glands is possible with a gradual development of the clinical picture of hypocortisolism up to the full-blown symptoms of chronic adrenal insufficiency: increasing weakness, adynamia, persistent decrease in blood pressure, nausea, vomiting, diarrhea, hyperpigmentation of the mucous membranes of the lips and skin on exposed parts of the body and in the area of ​​folds, loss of sexual function. Any impact (intercurrent infection, trauma, etc.) can trigger an adrenal crisis. At the same time, all the listed symptoms increase. Abdominal pain, uncontrollable vomiting appear, dehydration rapidly progresses, convulsive syndrome, oliguria and acute renal failure occur. As a result, a coma develops and the patient dies. Even more rarely, predominant amyloid deposition is observed in the intestine. Clinically, this is manifested by pain, intestinal atony, and persistent diarrhea. Sometimes bleeding is possible.

A persistent and significant increase in ESR as an early symptom is characteristic of primary (idiopathic) amyloidosis.

The most typical lesions are the skin (itching, petechiae, pigment spots, urticaria, sometimes dense swelling that makes the face amicable), muscle and nervous systems (muscle pain, stiffness, muscle tightening, sometimes their atrophy, paresthesia, less often - polyneuropathic syndrome, epileptiform seizures , psychotic reactions). In contrast to secondary amyloidosis, damage to parenchymal organs is less common in primary amyloidosis. Selective deposition of amyloid in any organ is possible. Various forms of hereditary amyloidosis, caused by genetics, have also been described.

A persistent increase in ESR is typical for senile amyloidosis , which is manifested by a triad of Schwartz symptoms: damage to the heart (progressing heart failure), brain (various types of dementia) and amyloid deposition in the islets of Langerhans of the pancreas with the development of symptoms of diabetes. All forms of amyloidosis are characterized by hypercholesterolemia and hyper-β-lipoproteinemia, which occur in the nephrotic stage of renal amyloidosis. When the latter are affected, occasional small proteinuria is observed at an early stage, then it increases and usually exceeds 3 g per day. Proof of amyloidosis is possible by biopsy of various organs and tissues, followed by histological and histochemical examination of the biopsy.

Diseases that occur with impaired fat metabolism, in particular, widespread atherosclerosis, with hypercholesterolemia, can cause a persistent, often moderate, sometimes significant increase in ESR.

In patients with severe atherosclerosis, weight loss, accelerated ESR, sometimes predominant signs of atherosclerotic damage to the cerebral vessels are found (headache, noise in the head or ears, dizziness, syncope, sleep disorders, memory disorders, changes in the emotional sphere, mental disorders; cerebral disorders may occasionally occur vascular crises), and symptoms of damage to the coronary arteries, aorta, and arteries of the lower extremities can be moderately expressed.

Hypercholesterolemia accompanies a variety of diseases, especially common in some forms of liver cirrhosis and nephrotic syndrome of any nature. The increase in ESR in these cases is associated not only with it, but also with severe dysproteinemia. Hypercholesterolemia is typical of hypothyroidism, in which the ESR may increase. It is also typical for some hereditary forms of hyperlipidemia, which contribute to the development of atherosclerosis, for some lipidosis and glycogenosis, often accompanied by a moderate increase in ESR.

A significant acceleration of ESR occurs with generalized xanthomatosis, in particular with Buerger-Grütz syndrome, or hypercholesterolemic xanthomatosis (a disease of middle-aged people; typical are tuberous xanthomas on the face, limbs and mucous membranes, hepatosplenomegaly, chronic pancreatitis, central nervous system damage) and Harbitz-Müller syndrome, or familial hypercholesterolemia (external xanthomas, xanthomatous changes in blood vessels, which can lead to changes in various organs). This process is also described in Urbach-Wiethe syndrome, or mucocutaneous lipoid proteinosis (hyalinosis of the skin and mucous membranes). Typical are nodular deposits in the skin, oral cavity, and vocal cords (which leads to persistent hoarseness), and dysphagia. Possible damage to the central nervous system with epileptiform seizures and mental infantilism. Disorders of fat and carbohydrate metabolism are detected.

conclusions

To summarize, we can say that in order to get an idea of ​​the possible scope of the “diagnostic search” with an increased ESR as a leading sign, it is necessary to obtain detailed anamnestic information. Examination of a patient with an incomprehensible acceleration of ESR requires attention to the main “hot” spots: the size and consistency of the lymph nodes, careful palpation of the spleen, kidneys, listening to the heart, lungs, etc. The doctor must have laboratory and instrumental data.

MCH norm indicators

The figure varies depending on gender and age. For newborns (up to 1 month), ESR ranges from 1 to 2 mm/h. These limits are explained by reduced protein concentration. From 1 month to six months it ranges from 12 to 17 mm/h. This sharp increase in the norm is explained by age-related processes that occur in the growing body. Then the data is stabilized - for a child under 10 years of age, normal limits are considered to be numbers from 1 to 10 mm/h.

Since blood viscosity has several gender differences, the ESR rate will be different for men and women. For representatives of the fair sex from 10 to 50 years old, the acceptable limits are 0-20 mm/h, and from 50 years old - from 0 to 30 mm/h. The number may change during pregnancy, which is normal, but requires monitoring by your attending physician. In men from 10 to 50 years old, this figure should be from 0 to 15 mm/h, and over 50 years old - from 0 to 20 mm/h.

The final result is influenced by many factors: improper preparation, anxiety, taking medications and much more. In addition, the value may even depend on the time of day. As a rule, the maximum is determined around noon.

Diseases in which there is an increased ESR in the blood

If a patient has an elevated ESR in the blood, what this means is determined by the doctor during the diagnostic process. After all, this indicator is very important for diagnosis if the development of a certain disease is suspected. In the diagnostic process, a qualified doctor takes into account not only the fact that the patient has an increased value, but also determines what the presence of other symptoms indicates. But still this indicator is very important in many cases.

ESR: increased in diseases

An increased ESR in the blood of a child and an adult is observed if a bacterial infection - during the acute phase of a bacterial infection.

In this case, it does not matter where exactly the infections are localized: the picture of the peripheral blood will still reflect the inflammatory reaction.

viral infectious diseases occur . What specifically causes this indicator to increase is determined by the doctor during a comprehensive examination.

Thus, we are talking about the development of a certain pathological process if the ESR is higher than normal. What this means depends on the value of the indicator. Very high values ​​– more than 100 mm/h – occur with the development of infectious diseases:

• for sinusitis , bronchitis , pneumonia , ARVI , colds , tuberculosis , influenza , etc.;
• for cystitis , pyelonephritis and other urinary tract infections ;
• for fungal infections , viral hepatitis ;
• in oncology (high rates can be observed for a long time).

During the development of an infectious disease, this value does not increase quickly; an increase is observed after 1-2 days. If the patient has recovered, the ESR will be slightly elevated for several more weeks or months. The reasons for a high ESR with normal leukocytes may indicate that the person has recently suffered a viral disease: that is, the leukocyte count has already returned to normal, but the red cell sedimentation rate has not yet.

The reasons for increased ESR in the blood in women may be associated with pregnancy, therefore, in the diagnostic process, the doctor must take into account these reasons for the increase in ESR in the blood in women.

An increase in ESR is a typical symptom in the following diseases:

• diseases of the biliary tract and liver;
• inflammatory diseases of a purulent and septic nature ( reactive arthritis , etc.);
• blood diseases ( sickle anemia , hemoglobinopathies , anisocytosis );
• ailments in which tissue destruction and necrosis ( stroke , heart attack , tuberculosis , malignant neoplasms);
• pathologies of the endocrine glands and metabolic disorders ( obesity , diabetes , cystic fibrosis , etc.);
• malignant degeneration of the bone marrow, in which red blood cells enter the blood that are not ready to perform direct functions ( myeloma , leukemia , lymphoma );
• autoimmune diseases ( scleroderma , lupus erythematosus , rheumatism , etc.);
• acute conditions in which the blood becomes more viscous ( diarrhea , bleeding , vomiting , postoperative conditions , etc.).

Increasing ESR

A similar result may be caused by the following pathologies:

• Infection or inflammation.
• Connective tissue diseases (RA, SLE, vasculitis, etc.).
• Burn disease.
• Neoplasms of different etiology and localization.
• Myocardial infarction. In the post-infarction period, the maximum occurs after about 7 days (in this case, you need to contact a vascular surgeon).
• Anemia. These diseases are characterized by a decrease in red blood cells and an increase in their sedimentation rate.
• Injury.
• Amyloidosis (a pathology characterized by the formation of a pathological protein - amyloid).

Despite the discrepancy between normal limits, if a complete blood count of ESR showed an increase in this indicator, this does not necessarily indicate the presence of a problem. This result also occurs in healthy individuals: in women during the menstrual cycle, during pregnancy, or in overweight individuals. This also occurs when taking a number of medications, so you should consult your doctor in advance.

Methods used to test ESR blood

Before deciphering what ESR means in a blood test, the doctor uses a certain method to determine this indicator. It should be noted that the results of different methods differ and are not comparable.

Before performing an ESR blood test, it must be taken into account that the obtained value depends on several factors. The general analysis must be carried out by a specialist - a laboratory employee, and only high-quality reagents are used. The analysis in children, women and men is carried out provided that the patient has not eaten food for at least 4 hours before the procedure.

What does the ESR value show in the analysis? First of all, the presence and intensity of inflammation in the body. Therefore, if there are abnormalities, patients are often prescribed a biochemical analysis. Indeed, for high-quality diagnostics it is often necessary to find out in what quantity a certain protein is present in the body.

ESR according to Westergren: what is it?

The described method for determining ESR - the Westergren method - currently meets the requirements of the International Committee for Standardization of Blood Studies. This technique is widely used in modern diagnostics. For such an analysis, venous blood is needed, which is mixed with sodium citrate . To measure ESR, the distance of the stand is measured, the measurement is taken from the upper limit of the plasma to the upper limit of the red blood cells that have settled. The measurement is carried out 1 hour after the components have been mixed.

It should be noted that if Westergren's ESR is elevated, this means that this result is more indicative for diagnosis, especially if the reaction is accelerated.

ESR according to Wintrob

The essence of the Wintrobe method is the study of undiluted blood that was mixed with an anticoagulant. The desired indicator can be interpreted using the scale of the tube in which the blood is located. However, this method has a significant drawback: if the reading is above 60 mm/h, the results may be unreliable due to the fact that the tube is clogged with settled red blood cells.

ESR according to Panchenkov

This method involves the study of capillary blood, which is diluted with sodium citrate - 4:1. Next, the blood is placed in a special capillary with 100 divisions for 1 hour. It should be noted that when using the Westergren and Panchenkov methods, the same results are obtained, but if the speed is increased, then the Westergren method shows higher values. Comparison of indicators is in the table below.

Currently, special automatic counters are also actively used to determine this indicator. To do this, the laboratory assistant no longer needs to dilute the blood manually and track the numbers.

Decrease in ESR

A reduced erythrocyte sedimentation rate often signals the presence of water-salt metabolism disorders or active muscular dystrophy. This is often a symptom of erythrocytosis, leukocytosis, hereditary spherocytosis, hepatitis and DIC syndrome. In addition, a similar result is characteristic of polycythemia and the conditions leading to it (CHF or damage to the pulmonary system). Low ESR can also be a consequence of fasting, vegetarianism, taking a number of steroid hormones, and is also often detected in the 1st and 2nd trimester of pregnancy.

You can take an ESR test and undergo other hematological tests at our MedArt medical center. With the help of modern equipment, you can find out absolutely accurate indicators, and highly qualified workers will competently advise you on this or that issue.

Elevated ESR in children

When the ESR norm in children is exceeded, most likely an infectious inflammatory process develops in the body. But it should be taken into account, when determining ESR according to Panchenkov, that other indicators of the CBC ( hemoglobin , etc.) are also increased (or changed) in children. Also, in children with infectious diseases, their general condition worsens significantly. In case of infectious diseases, the ESR is high in the child already on the second or third day. The indicator can be 15, 25, 30 mm/h.

If red blood cells are elevated in a child’s blood, the reasons for this condition may be the following:

• metabolic disorders ( diabetes , hypothyroidism , hyperthyroidism );
• systemic or autoimmune diseases ( bronchial asthma , rheumatoid arthritis , lupus );
• blood diseases , hemoblastosis , anemia ;
• diseases in which tissue decay occurs ( tuberculosis , myocardial infarction , cancer ).

It is necessary to take into account: if even after recovery the erythrocyte sedimentation rate is increased, this means that the process is proceeding normally. It’s just that normalization is slow, but after about one month after the disease, normal levels should be restored. But if there are doubts about recovery, then you need to do a re-examination.

Parents must understand that if a child’s red blood cells are higher than normal, this means that a pathological process is taking place in the body.

But sometimes, if a baby’s red blood cells are slightly elevated, this means that some relatively “harmless” factors are influencing:

• in infants, a slight increase in ESR may be associated with a violation of the mother's diet during natural feeding ;
• period of teething;
• after taking medications ( Paracetamol );
• with a lack of vitamins ;
• with helminthiasis .

Thus, if red blood cells are elevated in the blood, this means that the child is developing a certain disease. There are also statistics on the frequency of increase in this value in various diseases:

• in 40% of cases, a high value indicates infectious diseases ( respiratory tract diseases , tuberculosis , urinary tract diseases , viral hepatitis , fungal diseases );
• in 23% - oncological processes of various organs;
• in 17% - rheumatism , systemic lupus ;
• in 8% - cholelithiasis , inflammation of the gastrointestinal tract , pelvic organs , anemia, ENT diseases , injuries , diabetes , pregnancy ;
• 3% — kidney disease.