ESR Test

ESR test is a test that measures the rate of blood sedimentation into plasma and red blood cells. This rate is mainly determined by the degree of their aggregation, i.e., the ability to stick together.

Research method

Capillary photometry method.

Units

Mm/h (millimeter per hour).

What biomaterial can be used for research?

Venous, capillary blood.

How to prepare for the test?

• Get rid of alcohol within 24 hours before ESR test;
• Do not eat for 2-3 hours before the test (you can drink clean still water);
• Stop taking medications 24 hours before the test (as agreed with the doctor);
• Eliminate physical and emotional stress for 30 minutes before the test;
• Do not smoke for 30 minutes before visiting a healthcare institution.

ESR test overview

Determining the erythrocyte sedimentation rate (ESR) is an indirect method for identifying inflammatory, autoimmune or oncological diseases. It is carried out on a sample of venous or capillary blood, into which a substance is added, preventing its clotting (anticoagulant). When examined by the Panchenkov’s method, blood is placed in a thin glass or plastic tube and monitores for an hour. At this time, red blood cells, as having a large specific gravity, settle, leaving a column of transparent plasma above them. ESR is calculated from the distance from the upper boundary of the plasma to the red blood cells. Normally, red blood cells settle slowly, leaving very little clean plasma. For this method, the Panchenkov’s apparatus is used, consisting of a tripod and capillary pipettes with a scale of 100 mm.

In capillary photometry, the kinetic stopped flow method is used. At the beginning of the test, a programmed sample mixing takes place to disaggregate the red blood cells. Ineffective disaggregation or the presence of microclots can affect the final result, because the analyzer actually measures the kinetics of red blood cell aggregation. In this case, the measurement takes place in the range from 2 to 120 mm/h. The results of ESR measurements by this method are highly correlated with the Westergren method.

The outcomes obtained using the capillary photometry method in the normal range coincide with the results obtained when determining ESR by the Panchenkov’s method. However, the method of capillary photometry is more sensitive to an increase in ESR, and the results in the zone of increased values are higher than the results obtained by the Panchenkov’s method.

An increase in the level of pathological proteins located in the liquid part of the blood, as well as some other proteins (the so-called acute phase ones that appear during inflammation) promotes the “sticking together” of red blood cells. Because of this, they settle faster and ESR increases. It turns out that any acute or chronic inflammation can lead to an increase in ESR.

The fewer red blood cells, the faster they settle, so women have a higher ESR than men.

What is the test used for?

ESR test is used for the diagnosis of diseases associated with acute or chronic inflammation, including infections, cancer and autoimmune diseases. The determination of ESR is sensitive, but one of the least specific laboratory tests, since its increase alone does not allow to determine the source of inflammation, in addition, it can occur not only due to inflammation. That is why ESR analysis is usually used in combination with other tests.

When is the test prescribed?

It is prescribed when conducting diagnostics and monitoring of the following health states:

• inflammatory diseases;
• infectious diseases;
• oncological diseases;
• autoimmune diseases.

It is also prescribed when conducting preventive examinations in combination with other tests (general blood count, leukocyte formula, etc.).

ESR reading

Sex	Age	ESR reading
Male	under 15 years old	2 – 20 mm/h
	15-50	2 – 15 mm/h
	over 50	2 – 20 mm/h
Female	under 50 years old	2 – 20 mm/h
	over 50 years old	2 – 30 mm/h

The results of ESR test either 30 or 60 mm/h must be read taking into account clinical data, medical history, as well as other tests.