ENG | Erythrocyte Sedimentation Rate

Erythrocyte Sedimentation Rate (ESR) test is a nonspecific but widely used laboratory blood test for diagnosing and monitoring inflammatory processes, infections, autoimmune diseases, or oncological conditions. The test is based on the ability of erythrocytes to settle at the bottom of a test tube over a certain period of time, usually one hour. The sedimentation rate is influenced by changes in plasma protein (especially fibrinogen, immunoglobulins) concentrations, which increase in the presence of inflammation or other pathological conditions.

The ESR test is most often used as a supplementary indicator along with other tests (e.g., C-reactive protein – CRP) to evaluate the course or response to treatment of acute and chronic infections, rheumatic diseases, autoimmune disorders. Although it is a nonspecific test, very high ESR values (>100 mm/h) may be associated with severe conditions such as myeloma, leukemia, severe bacterial infections, or advanced anemia.

Principle of the test: The test measures the distance (in millimeters) that erythrocytes settle in a vertical test tube over one hour. The sedimentation rate is influenced by the composition of blood plasma, erythrocyte morphology, and their interactions.

Recommendations:

• It is recommended in cases of suspected inflammatory processes, as well as to monitor the course and effectiveness of treatment.
• An increase in ESR up to 100 mm/h may be associated with infections, rheumatic diseases, myocardial infarction, or nephrotic syndrome.
• ESR >100 mm/h may indicate oncological or severe infectious diseases.
• Decreased ESR may occur during dehydration, heart defects, or corticosteroid use.
• Factors influencing test results include age, sex, pregnancy, medications (especially anti-inflammatory), and certain blood disorders.
• It is recommended to refrain from eating for 8–12 hours before the test, and to avoid physical exertion and stress.