Why is it increased? Causes of increased ESR in the blood and norms. Analysis for determining ROE

What is ESR in a blood test? Erythrocyte sedimentation rate, or ESR for short, is a nonspecific laboratory test that may indicate the occurrence of an inflammatory, allergic or other pathological process in the body.

Blood reacts to almost any change in the functioning of the human body. That is why a general (clinical) blood test is prescribed to patients for almost any disease, as well as during a clinical examination. This analysis examines a number of indicators, including ESR.

In children of the first year of life, an increase in ESR can be caused by teething, as well as taking non-steroidal anti-inflammatory drugs.

What does ESR mean in a blood test?

The density of plasma is less than that of red blood cells. Therefore, red blood cells in a test tube, under the influence of gravity, settle to the bottom, and after some time the blood is divided into two parts: transparent plasma and a red precipitate. The speed of this process also depends on the speed of red blood cells sticking together (the process of red blood cell aggregation). Clumped cells are heavier and therefore sink to the bottom faster.

The aggregation of erythrocytes is influenced by many substances that make up the blood, for example, fibrinogen, albumin, globulins. They change the charge of the red blood cell membrane, which helps to increase their ability to stick together and, as a result, increases the ESR.

The use of ESR in blood tests was proposed in 1918 by the Swedish scientist Faro. It was he who discovered that the erythrocyte sedimentation rate increases in women during pregnancy. Subsequently, he discovered that ESR also responds to other conditions and diseases by increasing. However, this laboratory test entered widespread clinical practice much later. This happened in 1926, when another Swedish doctor, Westergren, proposed his method for determining ESR, which is widely used today.

In diagnostic and treatment institutions of the USSR, ESR was determined using the Panchenkov method, which is still used today in many clinics in the CIS countries. The results of determining ESR using these two methods, which are within the normal range, coincide with each other. However, the Westergren test is more sensitive to an increase in erythrocyte sedimentation rate, therefore, in the zone of increased values ​​it gives a more accurate result.

ESR can be due to both pathological and physiological reasons, the elimination of which leads to normalization of the indicator.

ESR cannot be considered a specific symptom of any disease. However, if this indicator is elevated, this is a kind of signal for the doctor about the need for further, more in-depth examination of the patient (biochemical analysis, detailed clinical analysis with leukocyte formula, ultrasound, radiography, etc.).

The erythrocyte sedimentation rate in modern test forms is designated “ESR” and is measured in mm/h.

Normal ESR values

The normal erythrocyte sedimentation rate depends on the age and gender of the patient.

Newborns	Girls and boys
	Girls and boys
2–6 months	Girls and boys
6–12 months	Girls and boys
	Girls and boys
	Girls and boys
31 years and older
61 years and older

In some laboratories, to determine the ESR norm in patients aged 50 years and older, they do not use the data presented in the table, but a formula according to which the upper limit of the ESR norm in men is their age divided by two. For women, the formula is different: B/2+10, where “B” means age. However, this method is not widely used, since it often interprets a high ESR, which requires further examination of the patient, as normal.

In pregnant women, the erythrocyte sedimentation rate can reach 40-50 mm/h, which is not a pathology and does not require any treatment.

Decoding ESR

The cause of an increase in ESR can be a variety of diseases and conditions. That is why ESR is deciphered taking into account other laboratory tests, as well as instrumental examination data and clinical signs of the disease.

In most cases, ESR begins to increase not from the first hours of the disease, but only after 2-3 days. After recovery, this indicator returns to normal only after a few weeks.

The most common causes of increased ESR are:

• cystic fibrosis;
• diseases of the biliary tract and liver;
• almost all infectious and inflammatory diseases.

According to medical statistics, in 40% of cases, a high ESR indicates an infectious process. In 23% of cases, an increase in the rate is caused by malignant neoplasms, and in 17% by rheumatic diseases. Anemia, trauma, diabetes mellitus, inflammatory diseases of the ENT organs, as well as the pelvic and gastrointestinal tract are the cause of increased ESR in 8% of cases. In less than 3% of cases, an increased erythrocyte sedimentation rate was observed in kidney disease.

Despite the available statistics, it is impossible to make a diagnosis based on an increase in ESR alone. In addition to pathological ones, there are also physiological reasons that affect ESR (pregnancy, type of diet, physical activity, allergic reactions, taking certain medications).

In most cases, ESR begins to increase not from the first hours of the disease, but only after 2-3 days. After recovery, this indicator returns to normal only after a few weeks.

Cases of low ESR are rarely observed in clinical practice. The reasons may be:

• disturbances of water-electrolyte balance with symptoms of overhydration;
• acute and chronic liver failure;
• high-dose corticosteroid therapy;
• smoking;
• early pregnancy;
• prolonged fasting;
• vegetarianism.

Reasons for increased ESR in children

Due to the immaturity of the immune system, the body of children reacts violently to any diseases and other altered conditions.

How to normalize ESR?

It should be understood that a high ESR value is not an independent pathology. It can be caused by both pathological and physiological reasons, the elimination of which leads to normalization of the indicator. For example, in pregnant women after childbirth, the ESR returns to normal levels on its own. If the cause of the increase in ESR is an infectious disease, then normalization of the indicator occurs some time after anti-infective therapy. For iron deficiency anemia, patients are prescribed iron supplements and multivitamins, and for diabetes mellitus, insulin or hypoglycemic drugs are prescribed.

Video from YouTube on the topic of the article:

Erythrocyte sedimentation rate is a test used to detect inflammation in the body.

The sample is placed in an elongated thin tube, red blood cells (erythrocytes) gradually settle to the bottom, and the ESR is a measure of this settling rate.

The test can diagnose many disorders (including cancer) and is a necessary test to confirm many diagnoses.

Let's figure out what it means when the erythrocyte sedimentation rate (ESR) in the general blood test of an adult or child is increased or decreased, should we be afraid of such indicators and why does this happen in men and women?

Women have higher ESR values; pregnancy and the menstrual period can cause short-term deviations from the norm. In pediatrics, this test helps diagnose rheumatoid arthritis in children or.

Normal ranges may vary slightly depending on laboratory facilities. Abnormal results do not diagnose a specific disease.

Many factors such as age or medication use, can affect the final result. Drugs such as dextran, ovidone, silest, theophylline, vitamin A can increase ESR, and aspirin, warfarin, cortisone can reduce it. High/low readings only tell the doctor about the need for further examination.

False promotion

A number of conditions can affect the properties of blood, affecting the ESR value. Therefore, accurate information about the inflammatory process - the reason why the specialist prescribes a test - may be masked by the influence of these conditions.

In this case, the ESR values ​​will be falsely elevated. These complicating factors include:

• Anemia (low red blood cell count, decreased hemoglobin in serum);
• Pregnancy (in the third trimester, ESR increases approximately 3 times);
• Increased concentration of cholesterol (LDL, HDL, triglycerides);
• Kidney problems (including acute kidney failure).

The specialist will take into account all possible internal factors when interpreting the results of the analysis.

Interpretation of results and possible reasons

What does it mean if the erythrocyte sedimentation rate (ESR) in the blood test of an adult or child is increased or decreased, should we be afraid of indicators that are higher than normal or lower?

High levels in blood test

Inflammation in the body provokes red blood cells to stick together (the weight of the molecule increases), which significantly increases their rate of settling to the bottom of the test tube. Increased sedimentation levels may be caused by the following:

• Autoimmune diseases – Libman-Sachs disease, giant cell disease, polymyalgia rheumatica, necrotizing vasculitis, rheumatoid arthritis (the immune system is the body’s defense against foreign substances. Against the background of an autoimmune process, it mistakenly attacks healthy cells and destroys body tissue);
• Cancer (this can be any form of cancer, from lymphoma or multiple myeloma to bowel and liver cancer);
• Chronic kidney disease (polycystic kidney disease and nephropathy);
• Infection, such as pneumonia, pelvic inflammatory disease, or appendicitis;
• Inflammation of joints (polymyalgia rheumatica) and blood vessels (arteritis, diabetic angiopathy of the lower extremities, retinopathy, encephalopathy);
• Inflammation of the thyroid gland (diffuse toxic goiter, nodular goiter);
• infections of the joints, bones, skin, or heart valves;
• Too high serum fibrinogen concentrations or hypofibrinogenemia;
• Pregnancy and toxicosis;
• Viral infections (HIV, tuberculosis, syphilis).

Because the ESR is a nonspecific marker of inflammation foci and correlates with other causes, the results of the analysis should be taken into account together with the patient’s health history and the results of other examinations (complete blood count - extended profile, urinalysis, lipid profile).

If the sedimentation rate and the results of other tests coincide, the specialist can confirm or, conversely, exclude the suspected diagnosis.

If the only elevated indicator in the analysis is ESR (against the background of a complete absence of symptoms), the specialist cannot give an accurate answer and make a diagnosis. Besides, a normal result does not exclude disease. Moderately elevated levels may be caused by aging.

Very large numbers usually have good reasons, such as multiple myeloma or giant cell arteritis. People with Waldenström's macroglobulinemia (the presence of abnormal globulins in the serum) have extremely high ESR levels, although there is no inflammation.

This video describes in more detail the norms and deviations of this indicator in the blood:

Low performance

Low sedimentation rates are generally not a problem. But may be associated with such deviations as:

• A disease or condition that increases red blood cell production;
• A disease or condition that increases white blood cell production;
• If a patient is being treated for an inflammatory disease, the degree of sedimentation going down is a good sign and means that the patient is responding to treatment.

Low values ​​can be caused by the following reasons:

• Elevated glucose levels (in diabetics);
• Polycythemia (characterized by an increased number of red blood cells);
• Sickle cell anemia (a genetic disease associated with pathological changes in cell shape);
• Severe liver diseases.

The reasons for the decline could be any number of factors., For example:

• Pregnancy (in the 1st and 2nd trimester, ESR levels drop);
• Anemia;
• Menstrual period;
• Medicines. Many medications can falsely lower test results, such as diuretics and medications that contain high calcium levels.

Increased data for diagnosing cardiovascular diseases

In patients with cardiac or myocardial disease, ESR is used as an additional potential indicator of coronary heart disease.

ESR used for diagnostics– (inner layer of the heart). Endocarditis develops due to the migration of bacteria or viruses from any part of the body through the blood to the heart.

If symptoms are ignored, endocarditis destroys the heart valves and leads to life-threatening complications.

To make a diagnosis of endocarditis, a specialist must prescribe a blood test. Along with high levels of sedimentation rates, endocarditis is characterized by a decrease in platelets(lack of healthy red blood cells), the patient is often also diagnosed with anemia.

Against the background of acute bacterial endocarditis, the degree of sedimentation may increase to extreme values(about 75 mm/hour) is an acute inflammatory process characterized by severe infection of the heart valves.

When diagnosing congestive heart failure ESR levels are taken into account. This is a chronic, progressive disease that affects the power of the heart muscles. Unlike regular “heart failure,” congestive heart failure refers to the stage in which excess fluid accumulates around the heart.

To diagnose the disease, in addition to physical tests (echocardiogram, MRI, stress tests), the results of a blood test are taken into account. In this case, analysis for an extended profile may indicate the presence of abnormal cells and infections(sedimentation rate will be higher than 65 mm/hour).

At myocardial infarction An increase in ESR is always provoked. The coronary arteries deliver oxygen in the blood to the heart muscle. If one of these arteries becomes blocked, part of the heart is deprived of oxygen, causing a condition called “myocardial ischemia.”

Against the background of a heart attack, ESR reaches peak values(70 mm/hour and above) for a week. Along with increased sedimentation rates, the lipid profile will show elevated levels of triglycerides, LDL, HDL and cholesterol in the serum.

A significant increase in erythrocyte sedimentation rate is observed against the background acute pericarditis. This, which begins suddenly, causes blood components such as fibrin, red blood cells and white blood cells to enter the pericardial space.

Often the causes of pericarditis are obvious, such as a recent heart attack. Along with elevated ESR levels (above 70 mm/hour), an increase in urea concentration in the blood was noted as a result of renal failure.

Erythrocyte sedimentation rate increases significantly against the background of the presence of an aortic aneurysm or . Together with high ESR values ​​(above 70 mm/hour), blood pressure will be elevated; in patients with an aneurysm, a condition called “thick blood” is often diagnosed.

conclusions

ESR plays an important role in the diagnosis of cardiovascular diseases. The indicator appears to be elevated against the background of many acute and chronic painful conditions characterized by tissue necrosis and inflammation, and is also a sign of blood viscosity.

Elevated levels directly correlate with the risk of myocardial infarction and coronary heart disease. For high subsidence levels and suspected cardiovascular disease the patient is referred for further diagnostics, including an echocardiogram, MRI, electrocardiogram to confirm the diagnosis.

Experts use erythrocyte sedimentation rate to determine foci of inflammation in the body; measuring ESR is a convenient method of monitoring the progress of treatment of diseases accompanied by inflammation.

Accordingly, high sedimentation rates will correlate with greater disease activity and indicate the presence of possible conditions such as chronic kidney disease, infections, thyroid inflammation and even cancer, while low values ​​indicate less active disease development and its regression.

Although sometimes even low levels correlate with the development of some diseases, for example, polycythemia or anemia. In any case, consultation with a specialist is necessary for a correct diagnosis.

Erythrocyte sedimentation rate is an important laboratory blood parameter, the results of which can be used to determine the ratio of plasma protein fractions. If the ESR deviates from the norm, this indicates the presence of a certain pathological process in the body.

Who is the test prescribed for?

ESR is one of the most important ways to diagnose many diseases. As a rule, using this analysis it is possible to detect the following pathologies:

1. Inflammatory diseases.
2. Infections.
3. Neoplasms.
4. Screening diagnostics during preventive examinations.

Determining ESR is a screening test that is not specific for a particular disease. Erythrocyte sedimentation rate is a test that is actively used in general blood tests.

Preparatory activities

Determination of ESR is an analysis that must be carried out on an empty stomach. It is necessary not to consume fatty, fried foods and alcoholic beverages 3 days before the erythrocyte sedimentation test. An hour before blood is taken to determine the erythrocyte sedimentation rate, you need to refrain from smoking.

Decoding

The interpretation of ESR in the analysis is very nonspecific. The type of disease in women and men can be more accurately determined by taking the ESR level and the number of leukocytes together. The determination of these indicators in women and men is carried out after the doctor studies them over time by days of illness.

For example, if there is an acute myocardial infarction, then the leukocyte rate is increased already in the first hours of the disease, but the ESR in women and men is normal. On days 5–10, the “scissors” symptom occurs, in which the leukocyte rate drops, but the erythrocyte sedimentation rate rate in women and men is increased. After this, the norm of leukocytes is maintained, but the formation of scars on the heart muscle and the effectiveness of the therapy are judged by the erythrocyte sedimentation rate in men and women.

The combination of a high white blood cell count and an increased erythrocyte sedimentation rate makes it possible to continue the diagnosis and find the source of inflammation.

The rate of erythrocyte sedimentation rate in women and men is increased when allergic processes are diagnosed, especially for diseases such as lupus erythematosus and rheumatoid polyarthritis.

Interpretation of elevated erythrocyte sedimentation rate figures allows one to identify tumor diseases, acute leukemia, and myeloma. Also, the erythrocyte sedimentation rate is important in diagnosing anemia, determining the degree of blood loss in injuries, surgical treatment, and kidney diseases.

The erythrocyte sedimentation rate can also be increased in case of infectious diseases:

• rheumatism;
• tuberculosis;
• viral infection.

Low erythrocyte sedimentation rates indicate changes in blood components and the structure of the red blood cells themselves. In this case, the following diseases are diagnosed:

• polycythemia;
• sickle cell anemia;
• spherocytosis;
• hyperbilirubinemia;
• overhydration.

Very often, low ESR becomes a normal variant in vegetarians who do not eat meat and various foods of animal origin.

Reasons for increased ESR:

• pregnancy, postpartum period, menstruation;
• inflammatory diseases;
• paraproteinemia;
• tumor diseases (carcinoma, sarcoma, acute leukemia);
• connective tissue diseases;
• glomerulonephritis, renal amyloidosis, occurring with nephrotic syndrome, uremia;
• severe infections;
• hypoproteinemia;
• anemia;
• hyper- and hypothyroidism;
• internal bleeding;
• hyperfibrinogenemia;
• hemorrhagic vasculitis;
• rheumatoid arthritis.

Reasons for low ESR:

• erythremia and reactive erythrocytosis;
• pronounced symptoms of circulatory failure;
• epilepsy;
• hemoglobinopathy C;
• hyperproteinemia;
• hypofibrinogenemia;
• viral hepatitis and obstructive jaundice;
• taking calcium chloride, salicylates.

Under normal conditions, the process of erythrocyte sedimentation in men and women occurs slowly, the rate after an hour will be below normal. When diagnosing various diseases, the composition of the blood will suggest an increased content of fibrin and proteins. Under their influence, rapid sedimentation of erythrocytes occurs, and the ESR value increases.

Normal level

The normal ESR level in the blood depends on parameters such as the physiological state and age of the patient. They are different for men and women. There is information that this indicator differs among residents of different territories.

Table 2 - Normal ESR values

The erythrocyte sedimentation rate (ESR) in the blood is one of the main signs that doctors monitor when studying laboratory analysis of this material. Such close attention to this indicator is due to the fact that it can serve as a sign of the presence of an inflammatory process in the body.

Normal ESR values

The rate of erythrocyte sedimentation rate in the blood directly depends on the gender and age of the person whose blood is being tested. Thus, the highest ESR rate is usually observed in infants: it ranges from 12 to 17 millimeters per hour. The normal ESR rate for women is 3-15 mm/hour, - 1-10 mm/hour, for children - 0-2 mm/hour. In older people, the ESR rate is usually higher: it can be up to 38 mm/hour and up to 53 mm/hour in women. Therefore, if your results obtained as a result of the analysis differ significantly from these figures, you should consult a doctor to figure out what is the cause of the elevated ESR level.

ESR indicators

You can independently draw preliminary conclusions about what problems an elevated ESR level in your blood may indicate. Thus, a deviation of the result from the norm by several units is most often due to the specific characteristics of your body and may not be a sign of the presence of any serious dysfunction. However, in order to make sure that the result is normal for you, it is recommended to consult a physician for advice.

If the deviation from the norm is 15-30 mm/hour, this usually indicates the presence of an inflammatory process in the body. In some cases, its presence may be obvious to you, for example, if you currently have a cold. However, the existing disease can also be hidden, for example, if the liver or organs of the gastrointestinal tract are affected. Therefore, in this case, you should definitely consult a doctor who can prescribe additional tests for you. They will allow you to determine the nature of the disease and prescribe adequate treatment.

Even more serious is the excess of the ESR indicator compared to the normal level by 30 units or more. In this case, specialists usually begin to suspect the presence of a progressive destructive process in the body. One of the common examples of diseases that can accompany such a significant increase in ESR levels is oncological manifestations. In such a situation, you must immediately visit a doctor who can prescribe comprehensive treatment taking into account the nature, specificity and intensity of your disease.