Blood test - ESR is increased: causes and treatment. What is an elevated ESR in the blood? Causes, methods of treatment ESR is elevated, is it possible to have surgery?

ESR in urine

To begin with, I would like to note that ESR in urine is a kind of medical myth that is destroyed at the first attempt to conduct such an analysis. ESR can only be determined by a blood test, since red blood cells are not contained in urine in principle; this is impossible according to the very principles of human physiology.

ESR is the erythrocyte sedimentation rate, measured in mm/h.
This laboratory indicator is a direct indication of the presence of inflammation in the body, expressed in different forms and having different causes.

ESR indicators in cancer diseases

How much does ESR increase in cancer? When cancerous tumors form, there is a sharp (up to 70-80 mm/hour) increase in indicators.

But a similar reaction of the body can also occur in the presence of an inflammatory process and other diseases. Thus, exceeding the norm is not a direct sign by which cancer is diagnosed.

If the ESR value changes, the patient is sent for a full examination to establish the true cause of the increase or decrease in values.

The reasons for exceeding erythrocyte sedimentation rates are tumors:

• breasts;
• cervix;
• ovaries;
• bone marrow;
• lymph nodes.

In rare cases, other forms of cancer may be identified, which also require careful examination. ESR in lung cancer may be characterized by an increase in normal values, but if the morphological appearance of leukocytes changes, the disease may not manifest itself for a long time.

Erythrocyte sedimentation time is the main indicator of the presence of various changes that occur in the body. But with any change in normal values, additional diagnostics are prescribed.

In some cases, ESR may decrease in cancer. The cause may be an increase in the number of white blood cells or bile salts during breastfeeding. When the development of cancer cells provokes an increase in the number of leukocytes, the pathology produces two completely opposite effects that compensate for each other. Consequently, the increase in ESR in the presence of cancer occurs more slowly.

What does it mean?

As mentioned in the previous paragraph, erythrocyte sedimentation rate is a sign of inflammation in the body . However, you should not panic right away, because an increase in the value of this indicator and its deviation from the norm can be caused by a variety of reasons.

These include:

• Infectious processes in the body in a severe phase.
• Diseases associated with the immune system.
• Hypothyroidism and thyrotoxicosis.
• Postponed surgery.
• Pregnancy.
• Childbirth.
• Menstrual period.
• Taking certain medications.
• Physical injuries, fractures.
• Poisoning.
• Starvation.

Thus, a deviation from the norm may be a normal consequence of the body's natural processes.

Reasons for increasing ESR

The reasons for the increase in ESR can be divided into several large groups, which will be discussed further.

So, the reasons for the increase in ESR:

1. Myocardial infarction - damage to the muscle tissue of the heart causes an inflammatory response, active synthesis of fibrinogen begins, which leads to an increase in ESR. ESR increases after a heart attack, reaching a peak after 1 week, with a gradual return to normal occurring over the next few weeks.

ESR also increases in all acute and emergency conditions - pulmonary embolism, cerebrovascular accidents,

2. Tumor diseases.

Many patients suffering from cancer of various localizations have a high ESR. However, this indicator is not elevated in all patients, and it is not used in the diagnosis of cancer. In the absence of an infectious or inflammatory disease, a significant increase in ESR (above 75 mm/h) may suggest the presence of a tumor and require further research to diagnose it. With mesothelioma, bronchogenic carcinoma, hepatocellular cancer, breast cancer, ovarian cancer, cervical cancer, the ESR may increase.

A significant increase in ESR - more than 100 mm/h in a cancer patient - is reliable confirmation of the spread of the tumor beyond the primary site (metastasis).

ESR is an integral component in the diagnosis of multiple myeloma, a malignant bone marrow disease with uncontrolled division of plasma cells that causes bone destruction and pain.

ESR is almost always elevated in Hodgkin's disease, a tumor of the lymph nodes. The analysis is not used to make a diagnosis, but is used to monitor the course of the disease and the effectiveness of therapy.

3. Infectious diseases

All infectious diseases are associated with an increased immune response and increased production of immunoglobulins - antibodies. An increase in the concentration of immunoglobulins (a subtype of globulins) in the blood increases the tendency for the formation of “coin columns” of red blood cells, so all infections can contribute to an increase in ESR.

Bacterial infections are stronger than viral infections and are manifested by an increase in ESR.

ESR increases in non-infectious diseases caused by bacteria: pneumonia, pancreatitis, cholecystitis, lung abscesses, paratonsillar abscess, parapharyngeal abscess, arthritis, deviated nasal septum, perichondritis, septic thrombophlebitis, osteomyelitis.

In case of parasitic diseases, ESR does not increase significantly - opisthorchiasis, amoebiasis, scabies.

Particularly high ESR (above 75 mm/h) is often found in people suffering from chronic infections, such as tuberculosis or subacute bacterial endocarditis (infection of the heart valves).

With infectious mononucleosis, the ESR increases, but with measles, rubella and viral hepatitis it remains within the normal range or slightly exceeds it.

1. Inflammatory diseases – rheumatic, immune, autoimmune, allergic.

Any disease with an acute or chronic inflammatory component may be associated with an increase in ESR.

ESR analysis is used to further confirm inflammation in the diagnosis of chronic diseases such as rheumatoid arthritis, acute rheumatoid fever, Takayasu's disease, Crohn's disease and ulcerative colitis, ankylosing spondylitis.

An increase in ESR in patients suffering from chronic inflammatory diseases, such as rheumatoid arthritis, indicates the activity of the process and, therefore, a lack of response to therapy. On the contrary, a decrease in ESR indicates that inflammation has subsided in response to proper treatment.

A high ESR may be the only laboratory symptom of temporal arteritis and polymyalgia rheumatica.

5. Blood diseases - anemia, leukemia, aleukia.

6. Kidney diseases - pyelonephritis, glomerulonephritis.

7. Liver diseases - in which it actively synthesizes inflammatory proteins, as well as in vitamin deficiency.

Norms (for men, women and children)

There are standards for ESR, age and gender.

After birth, the child’s normal value is 1-2 mm/h , while from 1 to 6 months the indicator increases and reaches a value of 12-17 units. Then the rate decreases again and becomes equal to 1-10 mm/h .

Please note that in children, ESR can increase for several natural reasons - if the child is teething, there is a lack of vitamins or poor nutrition.

Differences in normal ESR for men and women are based on different degrees of blood viscosity. For women, the normal value is 20 mm/h , and after 50 years the figure increases to 30 mm/h. For men, the norm does not exceed 15 mm/h ; at retirement age, the norm increases – 20 mm/h .
Fluctuations in indicators depending on age are associated with hormonal changes occurring in the body.

Blood ESR analysis: norm and interpretation of results

You feel fine, nothing causes serious concern... And suddenly, when you take your next blood test, it turns out that your erythrocyte sedimentation rate (ESR) has changed. Should I worry? How important is the value of this indicator and what should be done in such a situation? Let's figure it out together.

ESR analysis: what is it?

ESR (ESR) - erythrocyte sedimentation rate - is a very important characteristic that can indirectly indicate inflammatory and pathological processes present in the body, including those occurring in a latent form.

The ESR indicator is influenced by a number of factors, including: infectious diseases, fever, chronic inflammation.

If you receive an ESR analysis result that does not meet the standard values, the doctor will always prescribe an additional examination to identify the cause of the deviation.

To determine the level of ESR, an anticoagulant (a substance that prevents clotting) is added to the blood taken for analysis. Then this composition is placed in a vertically mounted container for one hour. The specific gravity of red blood cells is higher than the specific gravity of plasma.

That is why, under the influence of gravity, red blood cells settle to the bottom. The blood is divided into 2 layers. Plasma remains in the upper one, and red blood cells accumulate in the lower one. After this, the height of the top layer is measured.

The number corresponding to the boundary between red blood cells and plasma on the test tube scale will be the erythrocyte sedimentation rate, measured in millimeters per hour.

Why is a blood test important? Blood consists of plasma and formed elements: red blood cells, leukocytes and platelets, the balance of which reflects the state of the patient’s body. Many pathological processes develop asymptomatically, so a timely analysis often helps to identify a number of diseases in the early stages, which allows them to begin to treat them on time and avoid many problems.

When is an erythrocyte sedimentation rate test prescribed?

Determination of ESR is necessary in the following situations:

• for diagnostics and preventive examinations;
• to monitor the patient's condition during treatment;
• for infectious diseases;
• for inflammatory diseases;
• for autoimmune disorders;
• in the presence of oncological processes occurring in the body.

Preparing and carrying out the blood sampling procedure

An ESR test does not require special preparation, but before donating blood you need to follow a few simple rules.

Firstly, one day before the test you should refrain from drinking alcohol, and 40-60 minutes from smoking. Secondly, you should not eat food 4–5 hours before the test; you can only drink still water.

Thirdly, if you take medications, check with your doctor, as it is advisable to stop taking medications before the study.

And most importantly, try to avoid any emotional and physical overload before taking the test.

Methodology for performing analysis

Determination of the erythrocyte sedimentation rate is carried out in one of two ways: the Panchenkov method or the Westergren method.

Panchenkov method

A five percent solution of sodium citrate (anticoagulant) is poured into a capillary divided into 100 divisions until about. After this, the capillary is filled with blood (biomaterial is taken from a finger) until about. The contents of the vessel are mixed, then placed strictly vertically. ESR readings are taken after an hour.

Westergren method

For the Westergren test, blood from a vein is needed. It is mixed with sodium citrate 3.8% in a ratio of 4:1. Another option: blood from a vein is mixed with ethylenediaminetetraacetic acid (EDTA), and then diluted with the same sodium citrate or saline in a 4:1 ratio. The analysis is carried out in special test tubes with a scale of 200 mm. ESR is determined after an hour.

This method is recognized in worldwide practice. The fundamental difference is the type of tubes and scale used. The results of both methods coincide in standard values. However, the Westergren method is more sensitive to increased erythrocyte sedimentation rate, and in this situation the results will be more accurate compared to the Panchenkov method.

Decoding the ESR analysis

Erythrocyte sedimentation rate test results are usually available within one business day, not including the day of blood donation. However, commercial medical centers with their own laboratory can provide test results more quickly - within two hours after collecting the biomaterial.

So, you have received a form with the result of the ESR analysis. On the left you will see this abbreviation (either ROE or ESR), and on the right you will see your result, indicated in mm/h.

To find out how much it corresponds to the norm, you should correlate it with the reference (average) values ​​​​corresponding to your age and gender.

The normal ESR indicators for men and women of different ages are as follows:

The ESR norm in women is slightly higher than in men. The indicator also changes during pregnancy - this is a natural process. The value may also depend on the time of day. The maximum ESR value is usually reached around noon.

ESR is increased

An increase in erythrocyte sedimentation rate can be caused by a variety of reasons. Let's look at the main ones:

• Infectious diseases - both acute (bacterial) and chronic.
• Inflammatory processes occurring in various organs and tissues.
• Connective tissue diseases (rheumatoid arthritis, lupus erythematosus, systemic scleroderma, vasculitis).
• Oncological diseases of various localizations.
• Myocardial infarction (damage to the heart muscle occurs, this entails a systemic inflammatory response, resulting in an increase in ESR). After a heart attack, the ESR peaks about a week later.
• Anemia. With these diseases, a decrease in the number of red blood cells and an acceleration of their sedimentation rate are observed.
• Burns, injuries.
• Amyloidosis is a disease associated with the accumulation of pathological protein in tissues.

However, elevated ESR can also be observed in healthy people. For example, in women during menstruation and pregnancy. Also, the result of the analysis is affected by some medications, for example, oral contraceptives, theophylline, and taking synthesized vitamin A.

Please note : ESR may be increased in overweight people. This is due to increased cholesterol levels in their blood.

What to do and how to treat

Doctors note that the ESR indicator alone is not a sufficient basis for prescribing any treatment, and if a deviation from the norm is detected, they resort to a set of tests to identify and confirm the alleged problems. The main thing the patient needs to remember is not to rely on self-medication.

It was previously said that there are a lot of reasons that cause the value to deviate from the norm, and only a qualified specialist will help find a way out of the situation and prescribe the necessary treatment in accordance with the diagnosis.

What does increased blood cell sedimentation mean?

Since many women are interested in what disease is increased sedimentation of blood cells a sign of, it is worth knowing that this is a rather unstable indicator that helps determine the presence of infection. If a patient is found to have a sharp increase in ESR, this is not always a serious reason to panic about one’s own health, since most often it is a symptom of a cold, acute respiratory viral infection, flu, or the development of a viral infection. As soon as the patient is completely cured, this indicator will decrease and return to its normal value.

Sometimes ESR increases when dieting or, conversely, eating frequent and dense meals. In addition, an increase in ESR can be observed during menstruation, a woman’s tendency to develop allergies, and also in the first few months of childbirth. After a certain time after the first analysis, a second study is carried out and if other results show normal, you will no longer have to worry about your own health.

There are main reasons why ESR increases:

1. Bone fractures of any severity.
2. Poisoning the body with medications or products.
3. 1-3 months of recovery of the body after the operation.
4. The occurrence of a disease such as arthritis.
5. Diseases of the lung cavity.
6. Impaired kidney and liver function.
7. Growth of tumors of any type.

In addition, an increase in ESR can occur when taking certain types of medications that contain hormones produced by the adrenal glands. An increase in protein in the urine, as well as a pathological deviation in the number of red blood cells in the blood flow, is also the cause of an increase in the level of ESR.

When conducting a diagnostic test, a qualified doctor takes into account not only the ESR level, but also the presence of other symptoms indicating the development of a particular disease.

If the UAC shows high values, for example, 60 mm/h, this indicates the development of serious problems occurring in the female body. Most often, these indicators occur with the rapid development of decomposition or with suppuration of tissues. Also, a significant increase in ESR is observed during the transition from the chronic stage of the disease to acute.

If the ESR is more than 100 mm/h, this indicates the development of certain types of diseases, which include:

• fungal infection;
• development of oncology;
• sinusitis;
• pyelonephritis or cystitis;
• tuberculosis;
• pneumonia;
• hepatitis caused by viruses;
• flu.

With the development of the above diseases, an increase in ESR occurs quite quickly - within 1-2 days you can notice deviations in the composition of the blood.

Important: if the woman recovers, the increased test results will last for 2-4 months.

Also, an increase in ESR occurs during pregnancy, when the development of a particular disease begins in the body - in this case, the doctor immediately prescribes a diagnosis in order to identify the disease and prescribe timely treatment to the patient.

, Sedimentation rate , Westergren sedimentation rate

Erythrocyte sedimentation rate (ESR) is a marker reflecting the course of inflammatory processes. The analysis is used for preventive examinations and for diagnosing infections in the case of a disease that occurs with inflammatory processes (heart attack, tumors, infections, connective tissue diseases and many other diseases).

Erythrocyte sedimentation rate (ESR) is an indicator of the rate of separation of blood in a test tube with an added anticoagulant into 2 layers: upper (clear plasma) and lower (settled erythrocytes). The erythrocyte sedimentation rate is estimated by the height of the formed plasma layer (in mm) per 1 hour. The specific gravity of erythrocytes is higher than the specific gravity of plasma, therefore, in a test tube, in the presence of an anticoagulant (sodium citrate), under the influence of gravity, erythrocytes settle to the bottom. The process of erythrocyte sedimentation can be divided into 3 phases, which occur at different rates. First, red blood cells, under the influence of gravity, slowly settle into individual cells. Then they form aggregates - “coin columns”, and subsidence occurs faster. In the third phase, a lot of red blood cell aggregates are formed, their sedimentation first slows down and then gradually stops.

The ESR indicator varies depending on many physiological and pathological factors. ESR values ​​in women are slightly higher than in men. Changes in the protein composition of the blood during pregnancy lead to an increase in ESR during this period. A decrease in the content of erythrocytes (anemia) in the blood leads to an acceleration of ESR and, on the contrary, an increase in the content of erythrocytes in the blood slows down the sedimentation rate. The values ​​may fluctuate during the day; the maximum level is observed during the daytime.

The main factor influencing the formation of “coin columns” during erythrocyte sedimentation is the protein composition of the blood plasma. Acute-phase proteins, adsorbed on the surface of erythrocytes, reduce their charge and repulsion from each other, promote the formation of coin columns and accelerated sedimentation of erythrocytes. An increase in acute phase proteins, for example, C-reactive protein, haptoglobin, alpha-1-antitrypsin, during acute inflammation leads to an increase in ESR. In acute inflammatory and infectious processes, a change in the erythrocyte sedimentation rate is observed 24 hours after an increase in temperature and an increase in the number of leukocytes. In chronic inflammation, an increase in ESR is caused by an increase in the concentration of fibrinogen and immunoglobulins. Dynamic determination of ESR, in combination with other tests, is used to monitor the effectiveness of treatment of inflammatory and infectious diseases.

Indications for the purpose of analysis:

• inflammatory diseases;
• infections;
• tumors;
• screening examination during preventive examinations;

Measuring ESR should be considered a screening test that is not specific for any particular disease. ESR is usually used as part of a general blood test.

Preparing for the study:

Blood is drawn on an empty stomach.

Material for research:

whole venous blood (with sodium citrate).

Units:

mm/h

Reference values:

Increase (acceleration of ESR):

physiological

• elderly age;
• in women during pregnancy, menstruation, and the postpartum period;

pathological:

• inflammatory processes;
• intoxication;
• acute and chronic infections (pneumonia, osteomyelitis, tuberculosis, syphilis);
• autoimmune diseases (collagenosis);
• myocardial infarction;
• injuries, bone fractures;
• condition after shock, surgical interventions;
• anemia, condition after blood loss;
• kidney diseases (chronic nephritis, nephrotic syndrome);
• malignant tumors;
• paraproteinemia (myeloma, Waldenström's macroglobulinemia);
• hyperfibrinogenemia;
• taking medications (estrogens, glucocorticoids);

Decrease (slowdown of ESR):

• starvation, loss of muscle mass;
• taking corticosteroids;
• pregnancy (especially 1st and 2nd trimester);
• vegetarian diet;
• overhydration;
• myodystrophy;

Diagnosis of conditions and treatment regimen depend on the medical history, symptoms, results of a medical examination, research data and laboratory tests, collectively assessed by the attending physician. The information presented on this site (as well as any other information not received from the attending physician) cannot be used for self-diagnosis or self-medication. Be sure to consult your doctor before changing, stopping, or stopping prescribed treatment.

If the ESR rate in the blood deviates upward or downward, there is a high probability that acute inflammatory processes are developing in the body. These could be problems with the liver, kidneys, viral diseases, cancer. But it may simply indicate that the patient drank alcohol on the eve of the test, took medication, or the woman donated blood during her period.

The test, which measures the erythrocyte sedimentation rate in a person's blood, is the cheapest and simplest test that doctors prescribe to diagnose acute reactions to inflammation. Decoding the ESR allows you to find out at what speed red blood cells will settle to the bottom of the test tube under the influence of gravity within one hour under normal conditions (in the absence of vibrations and room temperature). Since blood is tested to determine the erythrocyte sedimentation rate, it is impossible to determine the values ​​of this indicator in urine.

The ability of red blood cells to settle was first discovered by the Polish researcher E. Biernacki in 1897, but scientists did not attach any significance to this, and therefore the indicator remained in oblivion until 1918. This year, the Swedish hematologist R. Fareus also discovered that red blood cells are capable of sedimentation at different rates and first used this test to determine pregnancy. But he soon noticed that the erythrocyte sedimentation rate also depends on other reasons.

Currently, doctors successfully use ESR measurement in clinical practice to detect inflammatory reactions (especially in the practice of diagnosing rheumatoid arthritis). In addition, ESR analysis helps to identify inflammation that accompanies infectious or autoimmune diseases.

The reasons for a high ESR value may be:

• Autoimmune diseases such as lupus or rheumatoid arthritis.
• Anemia.
• Cancers such as lymphoma and myeloma.
• Chronic kidney diseases.
• Infectious diseases (pneumonia, salpingitis, appendicitis).
• Inflammation of joints and blood vessels.
• Inflammation of the thymus gland.
• Infectious diseases of the kidneys, bones, joints, skin, heart valves.
• Pregnancy and toxicosis during pregnancy.
• Viral diseases.
• Diabetes.

Diabetes can be one of the human diseases in which the ESR reaches very high levels, up to 40-80 mm/h. In some cases, values ​​may exceed 100 mm/h.

Reduced ESR values ​​are also possible. They can be with high blood sugar levels (but not diabetes), diseases associated with red blood cells, and severe liver diseases.

The results of ESR analysis may not have any diagnostic value in the case of pregnancy or the menstrual period in women. Medicines and alcohol can distort the indicators. If the transcript shows negative results, the doctor orders the test again to avoid the possibility of error.