The Erythrocyte Sedimentation Rate (ESR) is a test that relates to the ability of red cells to form rouleaux, which is in turn related to levels of acute phase proteins, fibrinogen and immunoglobulin. (1)
The test for ESR measures the distance that red cells have fallen after one hour in a vertical column of anticoagulated blood under the influence of gravity.
ESR is a useful indication of the presence and intensity of an inflammatory process. It is not diagnostic of a particular disease. ESR rises with age and in anaemia.
A normal ESR does not exclude organic disease, a mildly elevated ESR of 20-30 mm/hour may have no consequence but levels above 100 mm/hour are significant and indicate something is wrong (4).
A raised ESR can also be a marker for coronary heart disease (2) including risk of death (3).
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