SEMINAR PRESENTATION

ON
ERYTHROCYTE SEDIMENTATION RATE (ESR);
IMPORTANCE IN CLINICAL DIAGNOSIS

BY
TAIWO AMINA .M.
DEPARTMENT OF HAEMATOLOGY
NIGER DELTA UNIVERSITY TEACHING HOSPITAL,
OKOLOBIRI.

SUPERVISED BY;
SCT. TEKENAH
 OUTLINE
• INTRODUCTION
• MECHANISM OF ESR
• STAGES OF ESR
• METHODS OF ESR
• RESULTS
• FACTORS AFFECTING ESR
• CLINICAL SIGNIFICANCE
• CONCLUSION
• REFERENCES
 INTRODUCTION

• Erythrocyte Sedimentation Rate (ESR) is a commonly

performed hematological tests that may indicate or
monitor increased inflammatory activity in the body that
may be because of autoimmune disease, infection or
tumors.
• ESR is not specific for any single disease but it is used in
combination with other tests to determine the presence
of inflammatory activity.
• The rate of settle down of RBC after 1 hour is ESR.

(Pagana KD et al., 2019)

MECHANISM OF ESR
 STAGES OF ESR
• AGGREGATION; This takes
10mins for Ruoleaux
formation.
• SEDIMENTATION; This
occurs in a rapid stage and
takes 40mins.
• PACKING; This is also
known as the stationary
phase, it also takes around
10mins to complete.

(Burris CA et al., 2006)

 METHODS OF ESR
• WINTOBE’S METHOD.

• Tube is closed at lower end and opened at upper end.

• It contains less volume of blood sample
• EDTA as anticoagulant.

• Normal Range;
• Male – 0-9mm/hr
• Female – 0-20mm/hr

• WESTERGREN’S METHOD;

• Tube is opened at both ends

• It contains large volume of blood
• 3.8% Tri-sodium citrate as anticoagulant.

(McPherson R et al., 2011 )

 RESULTS
• FOR ADULTS (Westergren method)

• Men under 50 years: 0 to 15mm/hr

• Men over 50 years: less than 20mm/hr
• Women under 50 years: 0 to 20mm/hr
• Women over 50years: less than 30mm/hr

• FOR CHILDREN (Westergren method)

• Newborn: 0 to 2mm/hr
• Newborn to puberty: 3 to 13mm/hr

(Wallach J et al., 1996 )

 FACTORS AFFECTING ESR TEST
• Plasma proteins
• Concentration of RBC
• Shape of RBC
• Temperature
• Time
• Tilting of tube
• Vibration
• Pregnancy

(McCarthy E et al., 2014)

 CLINICAL SIGNIFICANCE
• ESR helps in diagnosis, but is used in
combination with other investigations to
determine the presence of inflammation.
• LOW ESR
• Polycythaemia
• Sickle cell anemia
• Spherocytosis
• Dehydrations

(Lin J et al., 2014 )

 CLINICAL SIGNIFICANCE
• An increased ESR rate may occur in people with;
• Anemia
• Rheumatoid Arthritis in adults
• lupus
• Lymphoma
• Multiple Myeloma
• Systemic disease
• Kidney disease
• pregnancy
• Infection (T.B., HIV, Bacterial endocarditis, infection of the heart or
heart valves, bone infections etc)

(Karlsson T et al ., 2010)
 CONCLUSION
• In conclusion ESR is an hematological tests that
measures how fast red blood cells (erythrocytes)
fall to the bottom of a tall, thin tube. The test is not
specific but may also be used to monitor
inflammatory diseases or cancer and if an illness is
responding to treatment or not. Despite its
importance in many clinical conditions, ESR should
be used only as a clinical guide to aid the diagnosis,
management, and follow-up of these different
clinical situations.
 REFERENCES
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Louis, Mo: Elsevier; 2019.
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ed. St. Louis: Elsevier Saunders; 2006. 1633:962-967.
• McPherson RA, Matthew R. Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory
Methods. 22nd ed. Philadelphia: Elsevier Saunders; 2011. 254-5.
• Wallach J. Interpretation of Diagnostic Tests. 6th ed. New York: Little, Brown; 1996. 717.
• McCarthy EM, MacMullan PA, Al-Mudhaffer S, Madigan A, Donnelly S, McCarthy CJ, et al. Plasma
fibrinogen along with patient-reported outcome measures enhances management of polymyalgia
rheumatica: a prospective study. J Rheumatol. 2014 May. 41(5):931-7.
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cells in patients with new-onset systemic lupus erythematosus. Scand J Immunol. 2014 Feb. 79(2):131-6.
• Karlsson, Håkan; Ahlborg, Björn; Dalman, Christina; Hemmingsson, Tomas (August 2010).
"Association between erythrocyte sedimentation rate and IQ in Swedish males aged 18–20". Brain,
Behavior, and Immunity. 24 (6): 868–873.
• Sidore C, Busonero F, Maschio A, Porcu E, Naitza S, Zoledziewska M, et al. (November 2015).
• International Council for Standardization in Haematology (Expert Panel on Blood Rheology) (March
1993).