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Erythrocyte sedimentation rate

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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).

References:

  1. Bray C et al. Erythrocyte Sedimentation Rate and C-reactive Protein Measurements and Their Relevance in Clinical Medicine. WMJ. 2016 Dec;115(6):317-21
  2. Yayan J. Erythrocyte sedimentation rate as a marker for coronary heart disease. Vasc. Health Risk Manag. 2012;8:219-23
  3. G Erikssen et al. Erythrocyte sedimentation rate: a possible marker of atherosclerosis and a strong predictor of coronary heart disease mortality. European Journal of Cardiology, vol. 21, issue 19
  4. Kevin Tishkowski; Vikas Gupta. Erythrocyte Sedimentation Rate. Treasure Island (FL): StatPearls Publishing. 2024 Jan

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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