A non-specific indicator of a general blood test, reflecting the ratio of plasma protein fractions , is called the erythrocyte sedimentation rate, abbreviated ESR. A test for it is mandatory and is carried out in the diagnosis of pathologies, dispensary or preventive examination. When ESR is normal, this means that the individual does not have a pronounced inflammatory process in tissues and organs. The unit of measurement of the erythrocyte sedimentation rate is mm / hour. However, it should be evaluated in conjunction with other indicators.
Determination of erythrocyte sedimentation rate in the laboratory by the Panchenkov method
The essence of this method is as follows. The taken biomaterial is mixed with sodium citrate (anticoagulant), as a result, the blood is divided into two layers. The lower one is red blood cells, i.e. red blood cells, and the upper one is plasma. The subsidence of the lower layer is associated with blood properties, and this process goes through several stages:
- The first is the formation of the so-called coin column, so-called vertical clusters of cells that form during the first ten minutes.
- The second is sedimentation, which takes forty minutes in time.
- The third - gluing and densification of red blood cells, as in the first stage, takes ten minutes.
In total, the whole reaction takes one hour.
For analysis, a drop of biomaterial is taken from an individual’s finger and placed in a solution of sodium citrate. Diluted blood is drawn into glass capillary tubes and mounted vertically using a special tripod. Exactly 60 minutes later, the height of the erythrocyte column is recorded. The rules that you should follow when performing this study:
- make a deep injection of the fingertip, as squeezing blood can destroy red blood cells;
- capillary tubes must be dry and clean;
- observe the necessary ratio between blood and sodium citrate;
- air temperature for determining ESR should not be below 18 and above 22 degrees.
Any deviations from the above rules do not guarantee an accurate result.
There is another method for determining ESR - according to Westergren, it is considered the reference. In this case, the biomaterial for analysis is taken from a vein, mixed with an anticoagulant in a test tube and placed in a special analyzer. Next, the apparatus calculates the erythrocyte sedimentation rate. The results obtained with different methods are comparable. However, the latter is most sensitive to an increase in ESR. The medical institutions of our country mainly use the Panchenkov method.
ESR rates by age
In healthy individuals, red blood cells settle slowly, respectively, and their rate will be low. In pathological conditions in the blood, the number of protein compounds increases, which contribute to a more rapid sedimentation of red blood cells, which as a result leads to an increase in ESR. Permissible values of this indicator depend on gender, age, physiological condition. If the decryption showed an increased value, the doctor may suspect:
- inflammation;
- allergies
- systemic disease;
- blood disease
- neoplasm;
- tuberculosis;
- metabolic diseases and other pathologies.
In addition, an increase in ESR is associated with age, pregnancy and menstruation.
A low indicator indicates damage to red blood cells, which is caused by:
- erythremia;
- burns with a large area of damage;
- congenital heart defects;
- fasting;
- dehydration;
- taking hormonal medications (corticosteroids) and other reasons.
With a single detection of an increased or decreased result, it is recommended that the analysis be repeated.
Under what conditions is a general blood test prescribed?
Based on the results of this type of study, the level of ESR is also evaluated. The following are cases in which this analysis is required:
- Pregnancy. Several times over the entire period, a woman controls the erythrocyte sedimentation rate.
- If a bacterial infection is suspected. Deciphering the results in this case will show a high level of ESR, but this is also characteristic of an infection of viral origin. Therefore, to clarify the pathology, additional examinations will be required.
- Rheumatological problems, such as arthritis, gout, lupus erythematosus, can lead to joint deformation, pain, stiffness of movements. These pathologies also affect the connective tissue, which leads to an increase in ESR.
- Myocardial infarction. According to the results of the analysis, it is possible to identify in advance the development of the disease, as a result of which the normal blood flow in the arteries of the heart is disturbed.
- When diagnosing cancer pathology in order to track the development of the disease and the effectiveness of therapy.
Reasons for ESR deviation in women
If the erythrocyte sedimentation rate deviates from normal values, a second analysis is prescribed. ESR returns to normal with the elimination of the reasons that provoked its change. For example, after a fracture, a rather long period is required for this indicator to fit into the allowable range. At the same time, excess ESR in the blood is one of the symptoms of the following conditions:
- infectious disease;
- injuries
- intoxication of the body;
- malfunction of the thyroid gland;
- kidney disease
- tuberculosis;
- metabolic disorders;
- anemia;
- myocardial infarction;
- neoplasms;
- systemic pathologies.
If the transcript of the analysis showed that all the indicators are normal, and only the ESR is overestimated, then it is necessary to control it for some time. Uncontrolled intake of vitamin A, birth control drugs contributes to an increase in ESR. A blood test in this case gives a false result. In addition, if a woman has anemia, high cholesterol, is vaccinated against hepatitis B, the erythrocyte sedimentation rate detected during the examination is unreliable. An indicator may also be false in older women, with renal failure or a high degree of obesity.
Reduced sedimentation rate of red blood cells is present with the following pathologies in women:
- epilepsy;
- circulatory failure;
- mental disorders;
- leukemia;
- heart failure and some others.
Thus, a reduced or increased ESR is not a disease and does not require therapy, and treatment should be aimed at a pathology that provoked a deviation from the norm.
Erythrocyte sedimentation rate in pregnant women
The norm of ESR in the blood of women in expectation of a baby is not a constant value due to hormonal changes. However, its fluctuations should be within a limited corridor. The ESR level is considered to be a normal value, not exceeding the value of 45. At different periods of pregnancy, it is different, for example, it decreases in the first trimester, slightly increases in the second trimester, and this indicator is the highest in the third. Three months after delivery, ESR returns to normal. The causes of deviations are inflammatory processes that occur in the respiratory, genitourinary tract or in the large intestine. In addition, the norm of ESR in women in a position above:
- with diseases of the kidneys, liver;
- infectious processes;
- injuries
- rheumatological diseases;
- diabetes mellitus.
In addition, the level of hemoglobin also affects ESR, a decrease in which contributes to the growth of this indicator. The doctor prescribes an additional examination in case of suspected inflammatory process. For vegetarians, normal values are low red blood cell sedimentation rates.
Erythrocyte sedimentation rate in women
Throughout life, the rate of ESR in women is different. Factors influencing her:
- puberty;
- pregnancy;
- menstruation;
- menopause
Due to some characteristics of the body, the acceptable range of ESR in women is from 3 to 18, i.e., indicators are slightly higher than in men. A high level can be observed for a long time, as well as:
- in the morning hours;
- in the presence of acute inflammation;
- maximum leap during recovery.
If you suspect a disease, including cancer, the doctor recommends additional types of examinations. Consider the standards of ESR in women by age:
- The teenage period and up to 30 years - from 7 to 16. Throughout this stage, the permissible values do not change. An increase in the indicator is observed during menstruation and during pregnancy, which is a physiologically determined process.
- From 30 to 50 years old, red blood cells settle faster, so the range changes slightly and becomes normal from 8 to 25. An increase, as in the previous age category, occurs during critical days.
- In women after 50 years, the ESR rate is quite high - up to 50. This is due to age-related changes that occur in the body against the background of menopause. At this time, regular monitoring is necessary so as not to miss the pathology.
- After the age of 60 years, the permissible boundaries are even wider, since the older the individual, the more chronic pathologies he has. At the same time, constant medication also affects the result of ESR, and its wide range just allows you to take into account all the features of this age category of citizens.
Male ESR
In men, the rate of movement of red blood cells depends on age, i.e., the older, the higher this indicator. However, in old age, its level should not be higher than 35. Norms of ESR by age:
- 30-50 years old - from 1 to 10;
- 50-60 years old - from 5 to 14;
- over 60 years old - from 18 to 35.
Minor deviations from the norm are allowed, but they require monitoring in order to identify pathological violations in time. It should be remembered that it is impossible to make a diagnosis, even preliminary, only on this indicator. A comprehensive examination is required.
The following degrees of deviation from normal ESR in men are distinguished:
- Fourth. In this case, the indicator is higher than the permissible values by more than 60 units. Additional examinations are needed, with which they establish an accurate diagnosis and prescribe therapy. This degree is characteristic of malignant neoplasms.
- The third. Exceeding the norm from 30 to 60 indicates a pathology of necrotic or inflammatory orientation in the progression stage.
- The second one. Normal numbers are overstated by 20 or 30 units. Such values are found in the event of a malfunction of some functions or the presence of an infectious process in the body. Control needed.
- First one. Slight deviations from acceptable values. To determine the exact result, the study is repeated after a few days, since a false result is possible. An incorrect value leads to errors in the diagnosis. The reason for it may be violations directly during the analysis, as well as taking certain medications that affect the erythrocyte sedimentation rate.
Causes of increased and decreased levels of erythrocyte sedimentation rate in men
The red bodies (erythrocytes), which are examined in a blood test in a practically healthy individual, do not fasten during a collision due to a negative charge, but are repelled from each other. With ESR above normal, they stick together and form into groups. The main provocative factor in identifying an increased rate of subsidence is the inflammatory process. The indicator increases in the following conditions:
- infection;
- rheumatism;
- arthritis;
- tuberculosis;
- inflammatory, septic, purulent manifestations;
- autoimmune pathologies;
- kidney disease, liver;
- tissue necrosis;
- failure of the endocrine system;
- pathology of the heart valve;
- neoplasms of a malignant nature.
If deviations are found below the ESR norm, then the following pathological conditions may be the cause:
- erythremia;
- hepatitis;
- blood disease
- cholecystitis;
- epilepsy;
- jaundice;
- neurosis.
In addition, a low rate of movement of red blood cells is observed in violation of the functions of the circulatory, endocrine and nervous systems.
The erythrocyte sedimentation rate in children
The rate of ESR in children varies depending on the age category. The physiological difference between this indicator in boys and girls manifests as they mature. The female has less red blood cells, and they settle faster, therefore, the ESR level is higher than that of men. In children, the indicator should not be higher than 20, i.e., the maximum allowable value. The low sedimentation rate of red blood cells is rare, and its reason lies in the following conditions:
- tumors;
- dehydration;
- prolonged diarrhea;
- viral hepatitis;
- metabolic failure;
- chronic circulatory failure;
- regular vomiting
- heart diseases.
In completely healthy babies from birth to two weeks of age, a low level of ESR is observed, which is not a pathology.
If a child has an ESR higher than normal, what does that mean? The cause is the inflammatory process and, as a consequence, a violation of the ratio of proteins in the blood, which accelerate the gluing of red blood cells and contribute to their more rapid deposition. The following phenomenon is observed:
- with SARS;
- injuries
- allergies
- flu
- sore throat;
- poisoning;
- stressful conditions;
- anemia;
- oncology;
- tuberculosis
- intestinal infections;
- sepsis
- helminthiasis;
- thyroid disease;
- autoimmune diseases and some other pathologies.
The causes of high ESR in infants are:
- teething;
- an individual feature of the body;
- eating a lactating woman fatty foods;
- taking certain medications on the eve of the delivery of biomaterial.
A particularly high deviation of the indicator from the norm of ESR is observed when diagnosing a child:
- fungal infection;
- pyelonephritis;
- cystitis;
- ARVI;
- pneumonia;
- flu
- bronchitis;
- sinusitis.
Some conditions in children give a false result. These include:
- menstruation in girls;
- excess weight;
- allergy;
- renal failure;
- anemia, in which hemoglobin and the total number of red blood cells in the blood are reduced;
- diet or a solid diet on the eve of the test;
- vaccination;
- intake of vitamin complexes containing vitamin A;
- technical errors during the study.
In these cases, a high level of ESR is not considered the cause of the presence of inflammation in the child's body. In children, as in adults, this indicator must be considered in conjunction with others. The rate of ESR in the blood after the disease is restored after a certain period of time. Sometimes this period can take several months.
Preparation for a general blood test
The implementation of simple measures will help to not doubt the results and reduce the risk of errors to a minimum. To do this, you must:
- Take biomaterial on an empty stomach. A minimum of eight hours should elapse from the last meal.
- On the day of the test, do not brush your teeth, do not eat.
- For a day, refuse to use heavy and indigestible food. Reduce the amount of salt. Limit any load, both physical and psychological. Exclude the use of alcohol-containing drinks.
- Do not smoke the night before.
- In agreement with the doctor, for a while, refuse to take medications, since some drugs affect the results of the study.
- It is advisable for women on critical days not to be tested. In cases of pregnancy, the doctor must be notified.
- Before entering the laboratory, sit quietly, calm down and only then go in.
Ready-made analysis can be obtained the next day. In emergency cases, it will be ready in two hours.
Conclusion
In medical institutions around the world, a test for erythrocyte sedimentation rate is considered mandatory when performing a general blood test. It is prescribed for the diagnosis of pathology, dispensary, mandatory and preventive examination. ESR is not a unique indicator, and its interpretation is acceptable in combination with other, equally important analysis parameters.
The doctor finds out the exact cause of the deviation from the ESR norm by studying and analyzing the results of additional types of examinations. Having identified the source, all forces are directed to its elimination, i.e., the individual is recommended appropriate therapy. In some situations, additional measures are not required, such as during pregnancy. ESR in this case is normalized after delivery.