What is the fullform of ESR?

Answer 1

Definition

ESR stands for erythrocyte sedimentation rate. It is a test that indirectly measures how much inflammation is in the body. However, it rarely leads directly to a specific diagnosis.

Alternative Names

Erythrocyte sedimentation rate; Sed rate; Sedimentation rate

How the test is performed

Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

The blood sample is sent to a lab. The test measures how fast red blood cells called erythrocytes fall to the bottom of a tall, thin tube.

How to prepare for the test

There are no special preparations needed.

How the test will feel

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed

This test can be used to monitor inflammatory or cancerous diseases. It is a screening test, which means it cannot be used to diagnose a specific disorder.

However, it is useful in detecting and monitoring tuberculosis, tissue death, certain forms of Arthritis, autoimmune disorders, and inflammatory diseases that cause vague symptoms.

Normal Values

Adults (Westergren method):

• Men under 50 years old: less than 15 mm/hr
• Men over 50 years old: less than 20 mm/hr
• Women under 50 years old: less than 20 mm/hr
• Women over 50 years old: less than 30 mm/hr

Children (Westergren method):

• Newborn: 0 to 2 mm/hr
• Neonatal to puberty: 3 to 13 mm/hr

Note: mm/hr. = millimeters per hour

What abnormal results mean

An increased ESR rate may be due to:

• Anemia
• Endocarditis
• Kidney disease
• Osteomyelitis
• Pregnancy
• Rheumatic fever
• Rheumatoid arthritis
• Syphilis
• Systemic lupus erythematosus
• Thyroid disease
• Tuberculosis
• Other inflammatory conditions

Very high ESR levels occur with:

• Body-wide (systemic) infection
• Giant cell arteritis
• Hyperfibrinogenemia (increased fibrinogen levels in the blood)
• Multiple myeloma
• Macroglobulinemia - primary
• Necrotizing vasculitis
• Polymyalgia rheumatica

Lower-than-normal levels occur with:

• Congestive heart failure
• Hyperviscosity
• Hypofibrinogenemia(decreased fibrinogen levels)
• Low plasma protein (due to liver or kidney disease)
• Polycythemia
• Sickle cell anemia

Additional conditions that may affect test results:

• Allergic vasculitis
• Atrial myxoma
• Autoimmune hepatitis
• Endometritis
• Eosinophilic fasciitis
• Erysipelas
• Juvenile rheumatoid arthritis
• Legionnaire's disease
• Osteomyelitis
• Pelvic inflammatory disease
• Pericarditis after a heart attack
• Retroperitoneal fibrosis
• Skin lesion of blastomycosis
• Subacute thyroiditis
• Scleroderma

What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

References

Pisetsky DS. Laboratory testing in the rheumatic diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 278.

Answer 2

Definition

ESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate."

It is a test that indirectly measures how much inflammation is in the body.

Alternative Names

Erythrocyte sedimentation rate; Sed rate; Sedimentation rate

How the test is performed

A blood sample is needed. For information on how this is done, see: Venipuncture

The blood sample is sent to a lab. The test measures how fast red blood cells called erythrocytes fall to the bottom of a tall, thin tube.

How to prepare for the test

There are no special preparations needed.

How the test will feel

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed

A "sed rate" is often ordered for someone who is having unexplained fevers, certain types of arthritis, muscle symptoms, or other vague symptoms that cannot be explained.

Once a diagnosis has been made, this test may be used to monitor whether the illness is becoming more active or flaring up.

This test can be used to monitor inflammatory diseases or cancer. It is a screening test, which means it cannot be used to diagnose a specific disorder.

However, it is useful for detecting and monitoring:

• Autoimmune disorders
• Certain forms of arthritis
• Inflammatory diseases that cause vague symptoms
• Tissue death
• Tuberculosis

Normal Values

Adults (Westergren method):

• Men under 50 years old: less than 15 mm/hr
• Men over 50 years old: less than 20 mm/hr
• Women under 50 years old: less than 20 mm/hr
• Women over 50 years old: less than 30 mm/hr

Children (Westergren method):

• Newborn: 0 to 2 mm/hr
• Newborn to puberty: 3 to 13 mm/hr

Note: mm/hr. = millimeters per hour

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

Although it can help diagnose some illnesses, an abnormal ESR does not prove that you have a certain condition. Other tests are almost always needed.

An increased ESR rate may be due to:

• Anemia
• Cancers such as lymphoma or multiple myeloma
• Kidney disease
• Pregnancy
• Thyroid disease

The immune system helps protect the body against harmful substances. In autoimmune disorder is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. ESR is often higher than normal in people with an autoimmune disorder.

Common autoimmune disorders include:

• Lupus
• Rheumatoid arthritis in adults or children

Very high ESR levels occur with less common autoimmune disorders, including:

• Allergic vasculitis
• Giant cell arteritis
• Hyperfibrinogenemia (increased fibrinogen levels in the blood)
• Macroglobulinemia - primary
• Necrotizing vasculitis
• Polymyalgia rheumatica

An increased ESR rate may be due to some infections, including:

• Body-wide (systemic) infection
• Bone infections
• Infection of the heart or heart valves
• Rheumatic fever
• Severe skin infections, such as erysipelas
• Tuberculosis

Lower-than-normal levels occur with:

• Congestive heart failure
• Hyperviscosity
• Hypofibrinogenemia(decreased fibrinogen levels)
• Low plasma protein (due to liver or kidney disease)
• Polycythemia
• Sickle cell anemia

What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

References

Kushner I, Ballou SP. Acute-phase reactants and the concept of inflammation. In: Firestein GS, Budd RC, Harris ED, et al, eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 52.

Pisetsky DS. Laboratory testing in the rheumatic diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 278.

Reviewed By

Review Date: 06/01/2011

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.