Erythrocyte sedimentation reaction. Increased ESR in the blood of women - the norm and reasons for the increase. ROE values ​​in diseases

But It is always worth remembering the physiological reasons for the increase, so in this case it is necessary to consult a specialist.

How is the research conducted?

The essence of the study is based on the sedimentation of cellular elements of blood and separation into fractions; under the influence of gravitational forces and mass, red blood cells gradually descend downward, and only the liquid part of the blood remains on top - plasma. Red blood cells sink due to their aggregation abilities, the ability to “stick together,” which contributes to the formation of conglomerates between them, increasing molecular weight and reducing resistance. Aggregation occurs due to the electrical charge of the surface and the protein ratio of the blood plasma.

Ask your question to a clinical laboratory diagnostics doctor

Anna Poniaeva. She graduated from the Nizhny Novgorod Medical Academy (2007-2014) and Residency in Clinical Laboratory Diagnostics (2014-2016).

Analysis of ESR is considered to be one of the main indicators of infectious diseases. In fact, deciphering the results of a general blood test is not a final conclusion about the patient’s health status. In order for the diagnostic results to be as correct as possible, it is necessary to conduct repeated studies of ESR in the patient’s blood, the norm of which was determined as a result of a statistical study of healthy people, as well as other clinical examination methods, over a certain period.

The ESR level is not a sign of any specific disease. Typically, its reference values ​​are used in combination with indicators of other blood cells.

Method for determining the erythrocyte sedimentation rate

The erythrocyte sedimentation rate in laboratory conditions is determined using one of two methodologies: Panchenkov or Westergren. In both cases, the unit of measurement becomes the level of the column based on the height of the red cells in millimeters, which was formed in a unit of time - one hour. The analysis is carried out by adding sodium citrate to the collected material, which prevents blood clotting.

Within an hour, heavier red blood cells settle to the bottom of the tube. The more red blood cells in the blood, the slower the process of sedimentation occurs, and vice versa - a decrease in their number (for example, with anemia) accelerates their movement under gravity. Thus, the analysis shows the result: normal, increased or decreased ESR.

ESR norm for adults and children: indicators with interpretation

Normal values ​​for men and women

The concept of normal ESR for men and women is different, and the same applies to age categories. Thus, men under the age of 50 normally have an ESR of 1–10 mm/hour. The normal ESR in a woman’s blood is 3–15 mm (under the age of 30), 8–25 mm/h (30–60 years), for those women over 60 – 12–53 mm/h. Men over 50 have a normal rate of 2–20 mm/hour.

Blood test indicator ESR in children

Children under six months are 2–17 mm/hour; in addition, in many children the ESR is unstable and depends on nutrition, a complex of vitamins, and body growth processes. Parents should only worry if a general blood test shows an overestimation or underestimation of the level of other indicators monitored over time.

ESR level in the blood: normal for pregnant women

We should separately highlight the category of women who are pregnant. Already at 10–11 weeks, their ESR rate is 25–45 mm/hour and remains at this level for 4 weeks after birth. If the pregnancy is progressing normally, then the dynamic analysis will show results within the specified limits. This level of ESR is associated with a change in blood composition, namely with an increase in protein mass as a percentage.

Reasons for increasing or decreasing the level of "SOI"

There are several reasons for changes in erythrocyte sedimentation rate in adulthood. In patients with chronic infectious diseases, the “norm” indicator will be exceeded by 15–30 units. This applies to inflammation of the upper respiratory tract, diseases of the genitourinary system, anemia, autoimmune diseases, intoxication and injuries with shock. Even when taking oral contraceptives, women experienced an increase in ESR.

Malignant neoplasms, purulent-septic processes in the body increase ESR significantly - the norm deviates by 30–60 units. In this case, the patient already feels the problem, and deciphering other types of tests allows for an accurate diagnosis.

A low level is observed with an increase in the concentration of yellow salts in the blood and a change in the size of the red blood cells themselves. A reduction is possible with a vegetarian diet, taking certain blood thinning medications, muscular dystrophy, in the first two semesters of pregnancy.

Deviation from the norm indicates the beginning of some inflammatory processes. But if you prepare incorrectly for analysis, the data will also be unclear and its decoding will not give the correct result that corresponds to reality. You just need to take the test on an empty stomach, at least an hour after eating, preferably in the morning. The day before you should not overeat, abuse fatty and spicy foods, or drink alcohol. You should also refrain from smoking for an hour before taking blood. In the laboratory itself, you should not worry, it is better to rest for 10–15 minutes and calm down - this is just a prick in the finger, which is practically not noticeable.

Video: “SOY” in the blood is the norm in adults

If there is a need to undergo an examination, the doctor will definitely prescribe a general blood test. Indicators of the level of red blood cells, leukocytes, and platelets will paint a picture of the state of the human body at a given period of its life.

Erythrocyte sedimentation rate is a biological parameter that determines the ratio of proteins and blood elements. ESR is an important parameter of a general blood test, since sedimentation rates change in some diseases and specific conditions of the body.

When infectious and inflammatory reactions occur in the body, a large number of protein compounds are released into the blood (proteins of the acute phase of inflammation). During laboratory testing, red blood cells stick together under the influence of proteins and then settle to the bottom of the test tube.

The essence of the study is to measure the sedimentation rate: the more proteins there are in the plasma (markers of inflammatory processes in the body), the faster the red blood cells form fractions and settle.

Methods for determining ESR

There are several methods for determining the erythrocyte sedimentation rate: according to Panchenkov, according to Westergren, according to Wintrobe, microESR. These laboratory research methods differ in the method of blood sampling, the technique of conducting laboratory research and the dimensional scale of the results.

Panchenkov method

This method is used in public hospital laboratories and is included in a general blood test, for which biological material is taken from a finger.

During the study, a Panchenkov apparatus is used, which consists of a tripod into which special capillaries (thin tubes) with size marks are inserted.

After drawing blood from a finger, a reagent (sodium citrate solution) is added to the laboratory capillary to prevent coagulation (formation of a dense clot). Next, the biological material is placed in a capillary with a measuring scale of 100 divisions.

After an hour, the laboratory assistant determines how many millimeters the fractions of clumped red blood cells drop in 1 hour.

Westergen method

The Westergen determination method is used for a more accurate diagnosis of inflammatory processes and is an international laboratory research method.

The collection of biological material for the method of determining ESR according to Westergen is carried out from a vein on an empty stomach. The biological material is added to a test tube with a reagent (sodium citrate) that prevents clotting.

There are 200 divisions on the test tube using the Westergen method, which allows for a more accurate determination of ESR. The units of measurement for this indicator are similar in both versions of the study - millimeters per hour (mm/h).

There are factors that affect the accuracy of the analysis results, namely:

• temperature in the laboratory where the research is being carried out (at a temperature of more than 25 degrees Celsius, the ESR value increases, and if it is less than 18 degrees, a low erythrocyte sedimentation rate is detected);
• storage time (if biological material is stored for more than 4 hours before laboratory analysis);
• reagent used;
• degree of dilution and quality of mixing of biological material with the reagent;
• correct installation of the capillary in the tripod;
• using a plastic capillary instead of a glass one.

Taking into account possible errors, if ESR values ​​are too high or low for no apparent reason, it is necessary to re-take the test to confirm the pathology.

Norm of ESR in the blood of women by age (table)

The ESR parameter is relatively stable in healthy men, but in women the sedimentation rate may differ, depending on many factors:

• age (after 50 the ESR level increases);
• physique (in women who are overweight and have high cholesterol levels, ESR increases);
• hormonal background;
• pregnancy;
• taking hormonal contraceptives.

Also, physiological reasons for changes in the ESR parameter include diet: eating protein foods increases the ESR rate regardless of gender and age.

Determining ESR is an important diagnostic test that shows the presence of an inflammatory process in the body, but does not reveal the nature and location of the source of infection.

When is it appointed?

A general (biochemical) blood test with ESR measurement is prescribed in several cases:

• during a preventive examination, as a method of determining the degree of health of the body;
• for the diagnosis of diseases accompanied by inflammatory processes (infections, tumors, etc.), erythermia, acidosis, etc.

The determination of ESR is fundamental for identifying pathological processes in the body during the diagnosis of infectious diseases of the respiratory tract, namely:

• sinusitis, sinusitis;
• angina;
• inflammation of the pharynx, larynx and trachea;
• bronchitis;
• pneumonia;
• ARVI;
• flu.

After drug treatment of these diseases, a control clinical blood test for ESR is performed, which returns to normal within 7-10 days after recovery.

How to prepare for analysis

Preparing for blood collection for analysis is not difficult. It is necessary to follow some recommendations that contribute to the most realistic analysis results:

• biological material is collected on an empty stomach, 10-12 hours after the last meal;
• on the eve of the procedure, you need to refrain from eating large amounts of protein foods and not drinking alcoholic beverages at all;
• the day before the analysis, intense physical activity and stressful situations are excluded.

The procedure for removing material for analysis of erythrocyte sedimentation rate cannot be carried out after certain medical studies that can lead to a temporary disruption of the normal composition of the blood, namely:

• X-ray;
• probing of internal organs;
• physiotherapeutic procedures;
• treatment with heparin, dextran, corticotropin, fluorides, oxalates, cortisone;
• taking vitamin A;
• introduction of hepatitis B vaccine.

If it is necessary to analyze ESR, stop taking certain types of medications 3-5 days before the procedure (glucocorticosteroids, hormonal drugs, etc.).

Reasons for increasing ESR

The development of an acute or chronic inflammatory reaction in the body is accompanied by an increased content of coarse proteins in the blood (globulins, fibrinogens, paraproteins), which contribute to the rapid adhesion of red blood cells and an increase in ESR values. Manifests itself in the following diseases:

• diseases of the upper respiratory tract (ARVI, influenza, bronchitis, pneumonia, sinusitis);
• infections of the genitourinary system (cystitis, urethritis, pyelonephritis);
• rheumatism;
• rheumatic and bacterial endocarditis;
• infectious polyarthritis;
• cholecystitis;
• tuberculosis;
• pneumonia;
• abscess, gangrene of the lungs;
• pancreatitis;
• pleurisy, etc.

Also, the erythrocyte sedimentation rate can be increased in other pathologies, during which the amount of albumin in the blood decreases, namely:

• diseases of the gastrointestinal tract with impaired absorption of nutrients;
• parenchymal hepatitis;
• neoplasms in the liver;
• thyrotoxicosis;
• nephrotic syndrome.

An increase in ESR depends on indicators such as the level of cholesterol, lecithin, bile acids and pigments, which may deviate from the norm in the following diseases:

• poisoning;
• injuries;
• prolonged bleeding;
• heart attack, heart failure;
• pulmonary infarction;
• nephritis, renal failure;
• some types of anemia.

An increase in the erythrocyte sedimentation rate in women when taking hormonal drugs with estrogen, during pregnancy, during menstruation, as well as during fasting and a strict diet is not dangerous.

The main symptoms of elevated ESR, which may appear along with signs of the underlying disease, are as follows:

• migraines, prolonged headaches, dizziness;
• fast fatiguability;
• nausea;
• abdominal pain, sometimes intestinal upset;
• cardiopalmus;
• pale skin.

Reasons for low ESR levels

In some cases, the ESR level is determined to be too low. There are three main reasons that influence the decrease in erythrocyte sedimentation rate:

• blood thickening - increasing plasma viscosity due to increased red blood cell content;
• hyperbilirubinemia - increased bilirubin levels;
• acidosis is a violation of the alkaline-acid balance in the body.

As a rule, these pathologies occur with the following diseases:

• pathologies of the heart and circulatory system with congestion;
• simultaneous malfunctions of the liver and biliary tract;
• lack of nutrients;
• long-term vegetarian diet;
• starvation;
• vegetarian diet;
• excessive fluid intake;
• use of corticosteroid drugs,
• frequent use of aspirin.

The main manifestations of a reduced erythrocyte sedimentation rate depend on pathological processes in the body and can be as follows:

• shortness of breath, dry cough;
• weakness, dizziness;
• increased breathing;
• nausea and vomiting;
• weight loss;
• formation of hematomas with minor injuries;
• frequent nosebleeds.

During pregnancy

During pregnancy, ESR testing is carried out four times:

• at the beginning of pregnancy until the 12th week;
• at 20-21 weeks;
• at 28-30 weeks of pregnancy;
• before childbirth.

Due to hormonal changes that occur throughout pregnancy, a woman's erythrocyte sedimentation rate changes significantly during the 9 months of pregnancy, as well as for some time after childbirth.

1st trimester. The norm of ESR in the blood in the first months of pregnancy is very wide: depending on the body type and individual characteristics, this indicator can be either low (13 mm/h) or excessively high (up to 45 mm/h).

2nd trimester. At this time, the woman’s condition stabilizes somewhat and the erythrocyte sedimentation rate is approximately 20-30 mm/h.

3rd trimester. The last stages of pregnancy are characterized by a significant increase in the permissible norm of ESR - from 30 to 45 mm/h. Such a sharp increase indicates rapid fetal development and does not require treatment.

After childbirth, the erythrocyte sedimentation rate in women remains elevated because a woman may lose a lot of blood during labor. For 2-3 months after birth, ESR can reach 30 mm/h. When hormonal processes return to normal, a woman’s ESR level decreases to 0-15 mm/h.

During menopause

The climacteric period of a woman's life is characterized by strong hormonal changes, which significantly affects the chemical composition of the blood. During menopause, the ESR rate in the blood, as a rule, increases significantly and can reach up to 50 millimeters per hour.

In women over 50 years of age, the ESR level can be quite high (up to 30 mm/hour), which is normal if other blood parameters do not exceed the permissible norm.

However, after the onset of menopause, an ESR in the blood of women greater than 50 mm/hour can signal the following diseases:

• diseases of the thyroid gland (hyperthyroidism, hypothyroidism), occurring in 50-60% of women after 50 years of age;
• chronic infections;
• tumor growth;
• active rheumatological processes;
• kidney disease;
• allergic reactions;
• fractures.

A reduced level of ESR in women during menopause and in the postmenstrual period always indicates pathological processes in the body. A reduced erythrocyte sedimentation rate (below 15-12 mm/hour) can be caused by the following diseases:

• diseases of the gastrointestinal tract (duodenitis, gastritis, stomach ulcer);
• leukocytosis - an increase in the number of leukocytes that occurs during many inflammatory and oncological processes (meningitis, peritonitis, pyelonephritis, malignant tumors);
• erythrocytosis, manifested in polycythemia vera, diseases of the respiratory system (pulmonary pleurisy, lung tumors), etc.;
• hepatitis;
• blood clotting disorder.

It should be remembered that the ESR level drops below normal after taking aspirin.

For cancer

Suspicion of oncological processes in the body arises if the ESR value is higher than normal, despite long-term treatment with anti-inflammatory drugs (up to 70 mm/s). At the same time, the hemoglobin level decreases from 120-130 units to 70-80 units, and the level of leukocytes also increases.

A prolonged increase in the red blood cell sedimentation rate may indicate the formation of malignant tumors:

• intestinal tumors;
• cancerous tumors of the breast, cervix and ovaries in women;
• oncological processes in the bone marrow;
• brain tumors.

An increase in the ESR level also occurs with the development of benign tumors, namely:

• myeloma;
• polyps;
• papillomas;
• fibroids;
• lymphangiomas, etc.

Laboratory analysis of the ESR norm in women is not a direct indicator of the presence of cancer processes in the body, therefore, after determining the erythrocyte sedimentation rate of more than 70-80 mm/hour, an additional examination is carried out to confirm the diagnosis (ultrasound, magnetic resonance imaging, etc. ).

How to reduce ESR using folk remedies

In order to reduce the ESR level to normal, you can use effective folk remedies: beets, honey, garlic, lemons, herbal infusion, etc. The action of folk recipes is aimed at cleansing the blood, relieving inflammatory processes in the body and strengthening the immune system.

Beetroot decoction. Red beets have many beneficial properties that can improve health, namely:

• Due to B vitamins, metabolism can be normalized;
• with the help of vitamin C and beta-carotene, the functioning of the immune system improves;
• contains quartz, which strengthens the vascular system and helps cleanse the body;
• removes toxins;
• normalizes plasma levels.

To prepare the decoction you will need 3 small beets, which must be thoroughly washed and cooked unpeeled. There is no need to trim the beet tails.

Cook the beets over low heat for 3 hours, making sure that the water does not boil away. The broth is cooled and stored in the refrigerator.

You need to take 50 grams of the decoction on an empty stomach in the morning, without getting out of bed. After taking the medicine, you should lie down for another 10-15 minutes. Treatment lasts 7 days, followed by a week break, and the course of treatment is repeated.

Infusion of medicinal herbs. To reduce the erythrocyte sedimentation rate, effective herbs such as chamomile, linden flowers, coltsfoot, which have anti-inflammatory, disinfectant, and cleansing properties, are used.

Take dried crushed leaves (0.5 teaspoon) of each plant, pour a glass of boiling water and leave for 30 minutes. The infusion is filtered and drunk 2 times a day after meals. The course of treatment is 20 days.

The results of a blood test, when the erythrocyte sedimentation rate is elevated, will frighten the patient, especially in the absence of signs of the disease. Should I worry? What does this indicator mean and what is its normal value? In order not to succumb to panic, it is advisable to navigate this issue.

What is ESR in blood

This is the designation for one of the blood test indicators – erythrocyte sedimentation rate. More recently there was another name - ROE. It was deciphered as the erythrocyte sedimentation reaction, but the meaning of the study did not change. The result indirectly shows that there is inflammation or pathology. Deviation of parameters from the standard requires additional examinations to establish a diagnosis. The indicator is influenced by:

• elevated temperature;
• infections;
• chronic inflammation.

The body is healthy - and all blood components: platelets, leukocytes, red blood cells and plasma are balanced. Changes are observed during the disease. Erythrocytes - red blood cells - begin to stick to each other. During analysis, they settle and form a layer of plasma on top. The speed with which this process occurs is called ESR - normally this indicator indicates a healthy body. An analysis is prescribed for the purpose of:

• diagnostics;
• medical examination;
• prevention;
• monitoring the outcome of treatment.

It’s good when the ESR is normal. What do its high and low values ​​mean? An increase in the standard - accelerated erythrocyte sedimentation syndrome - indicates the likelihood of having:

• purulent inflammation;
• liver diseases;
• metabolic disorders;
• autoimmune pathologies;
• viral, fungal infections;
• oncology;
• hepatitis A;
• bleeding;
• stroke;
• tuberculosis;
• heart attack;
• recent injuries;
• high cholesterol levels;
• period after surgery.

Low values ​​are no less dangerous. A value that is 2 units less than what the ESR should be according to the norm is a signal to look for a problem. The following reasons can reduce the erythrocyte sedimentation rate:

• poor flow of bile;
• neuroses;
• hepatitis;
• epilepsy;
• vegetarianism;
• anemia;
• hormone therapy;
• circulatory problems;
• low hemoglobin;
• taking aspirin, calcium chloride;
• starvation.

An increased value of an analysis result does not always indicate inflammation or the presence of pathologies. There are situations when ESR is not the norm, but a high or low indicator, but there is no threat to human health. This is typical for the following circumstances:

• pregnancy;
• recent fractures;
• condition after childbirth;
• period;
• following a strict diet;
• a rich breakfast before tests;
• starvation;
• hormone therapy;
• period of puberty in a child;
• allergies.

To get reliable readings when deciphering a general blood test, you need to be prepared. This requires:

• eliminate alcohol one day before;
• come for testing on an empty stomach;
• stop smoking one hour before;
• stop taking medications;
• eliminate emotional and physical overload;
• do not exercise the day before;
• do not undergo x-rays;
• stop physical therapy.

ESR according to Westergren

In order to determine whether the ESR level in the body corresponds to the required parameters, there are two verification methods. They differ in the method of collecting material and equipment for research. The essence of the process is the same, you need:

• take blood;
• add an anticoagulant;
• stand vertically for an hour on a special device;
• evaluate the result based on the height of the plasma in millimeters above the settled red blood cells.

The Westergren method involves taking blood from a vein. Sodium citrate is added in certain proportions to a test tube with a 200 mm scale. Place vertically and leave for an hour. In this case, a layer of plasma forms on top, and red blood cells settle down. A clear division appears between them. The erythrocyte sedimentation rate is the measurement in millimeters of the difference between the upper boundary of the plasma and the apex of the red blood cell zone. The total indicator is mm/hour. Under modern conditions, special analyzers are used that determine parameters automatically.

ESR according to Panchenkov

The Panchenkov research method differs in the collection of capillary blood for analysis. When comparing indicators with the Westergren method, the norm of clinical ESR coincides in the range of normal values. With increasing readings, the Panchenkov method gives lower results. The parameters are determined as follows:

• take a capillary on which 100 divisions are applied;
• take blood from a finger;
• dilute it with sodium citrate;
• place the capillary vertically for an hour;
• measure the height of the plasma layer above the red blood cells.

Norm of ESR in women

The norm of ESR in the blood of women is associated with physiological characteristics. It is taller than men. Hormonal changes during menstruation, pregnancy, puberty, and menopause contribute to this. The increase in indicators is influenced by the use of contraceptives and excess weight. What should the ESR be for women of different ages? The following indicators are accepted – mm/hour:

• up to 15 years – 4-20;
• from 15 to 50 – 2-20;
• from 51 – 2-30.

ESR during pregnancy

During the period of waiting for a child, the ESR indicator is a norm that is specifically specified. It is increased compared to normal levels and changes during the period; two weeks before birth, its growth is possible. ESR in pregnant women also depends on body type. The following indicators are observed – mm/hour:

• dense constitution – first half – 8-45, second part of the term – 30-70;
• thin figure - up to the middle - 21-63, in the subsequent period of time - 20-55.

Medicine does not stand still - every day new diagnostic techniques appear and are introduced to identify the causes of changes occurring in the human body and leading to diseases.

Despite this, the determination of ESR has not lost its relevance and is actively used for diagnosis in adults and young patients. This study is mandatory and in all cases indicative, whether it is a visit to the doctor due to a disease or medical examination and preventive examination.

This diagnostic test is interpreted by a doctor of any specialty, and therefore belongs to the group of general blood tests. And, if the ESR blood test is elevated, the doctor must determine the cause.

What is soe?

ESR is a term formed from the capital letters of the full name of the test - erythrocyte sedimentation rate. The simplicity of the name does not conceal any medical implications; the test actually determines the very erythrocyte sedimentation rate of blood. Erythrocytes are red blood cells that, when exposed to anticoagulants, settle at the bottom of a medical test tube or capillary over a certain period of time.

The time it takes for a blood sample to separate into two visible layers (upper and lower) is interpreted as the erythrocyte sedimentation rate and is estimated by the height of the resulting plasma layer in millimeters per hour.

ESR is a nonspecific indicator, but is highly sensitive. By changing the ESR, the body can signal the development of a certain pathology (infectious, rheumatological, oncological and other) even before the onset of an obvious clinical picture, i.e. during a period of imaginary prosperity.

The erythrocyte sedimentation rate in the blood helps:

• differentiate the diagnosis, for example, angina pectoris and myocardial infarction, and osteoarthritis and rheumatoid arthritis, etc.
• determine the body's response during treatment for tuberculosis, lymphogranulomatosis, disseminated lupus erythematosus, etc.
• to state a latent disease, however, even a normal ESR value does not exclude a serious disease or malignant neoplasm

Diseases accompanied by high ESR levels

The erythrocyte sedimentation rate has important diagnostic and medical significance when a disease is suspected. Of course, not a single doctor refers to the ESR indicator alone when making a diagnosis. But together with the symptoms and results of instrumental and laboratory diagnostics, it occupies a significant position.

The erythrocyte sedimentation rate almost always increases with most bacterial infections occurring in the acute phase. The localization of the infectious process can be very diverse, but the picture of peripheral blood will always reflect the severity of the inflammatory reaction. ESR also increases with the development of an infection of viral etiology.

In general, diseases in which an increase in ESR is a typical diagnostic sign can be divided into groups:

• Diseases of the liver and biliary tract (see);
• Purulent and septic diseases of an inflammatory nature;
• Diseases whose pathogenesis involves tissue destruction and necrosis - heart attacks and strokes, malignant neoplasms, tuberculosis;
• – anisocytosis, sickle anemia, hemoglobinopathies;
• Metabolic diseases and pathological changes in the endocrine glands - diabetes mellitus, obesity, thyrotoxicosis, cystic fibrosis and others;
• Malignant transformation of the bone marrow, in which red blood cells are defective and enter the blood unprepared to perform their functions (leukemia, myeloma, lymphoma);
• Acute conditions leading to an increase in intrinsic blood viscosity - diarrhea, bleeding, intestinal obstruction, vomiting, condition after surgery;
• Autoimmune pathologies - lupus erythematosus, scleroderma, rheumatism, Sjögren's syndrome and others.

The highest ESR rates (more than 100 mm/h) are characteristic of infectious processes:

• ARVI, influenza, sinusitis, bronchitis, pneumonia, tuberculosis, etc.
• urinary tract infections (pyelonephritis, cystitis)
• viral hepatitis and fungal infections
• For a long time, high ESR can occur during an oncological process.

It is worth noting that during infectious processes this indicator does not increase immediately, but one or two days after the onset of the disease, and after recovery for some time (up to several months) the ESR will be slightly increased.

ESR – norm and pathology

Because this indicator is standardized, there are physiological limits that are normal for different populations. For children, the ESR norm varies depending on age.

Separately, a woman’s condition such as pregnancy is considered; during this period, an increased ESR of up to 45 mm/h is considered normal, and the pregnant woman does not need additional examination to identify pathology.

Methods for determining ESR and interpretation of results

In medical diagnostics, several different methods for determining ESR are used, the results of which differ from each other and are not comparable with each other.

The essence of the Westergren method, widely practiced and approved by the International Committee for Standardization of Blood Research, is the study of venous blood, which is mixed in a certain ratio with sodium citrate. The erythrocyte sedimentation rate is determined by measuring the distance of the rack - from the upper limit of the plasma to the upper limit of the settled erythrocytes 1 hour after mixing and placing in the rack. If it turns out that Westergren's ESR is elevated, the result is more indicative of diagnosis, especially if the reaction is accelerated.

The Wintrobe method involves testing undiluted blood mixed with an anticoagulant. The ESR is interpreted by the scale of the tube into which the blood is placed. The disadvantage of the method is the unreliability of the results when the reading is above 60 mm/h due to clogging of the tube with settled red blood cells.

The Panchenkov method consists of studying capillary blood diluted with sodium citrate in a quantitative ratio of 4:1. The blood settles in a special capillary with 100 divisions. The result is assessed after 1 hour.

The Westergren and Panchenkov methods give the same results, but with increased ESR, the Westergren method shows higher values. A comparative analysis of indicators is presented in the table (mm/h).

It is worth noting that automatic counters for determining the erythrocyte sedimentation rate are now actively used, which do not require human participation in diluting a portion of blood and monitoring the results. To correctly interpret the results, it is imperative to take into account the factors that determine variations in this indicator.

In civilized countries, unlike Russia (with backward methods of diagnosis and treatment), ESR is no longer considered as an informative indicator of the inflammatory process, since it has a lot of both false-positive and false-negative results. But the CRP (C-reactive protein) indicator is an acute-phase protein, the increase of which indicates a nonspecific response of the body to a wide range of diseases - bacterial, viral, rheumatic, inflammation of the gallbladder and ducts, abdominal processes, tuberculosis, acute hepatitis, injuries, etc. . - is used very widely in Europe, it has practically replaced the ESR indicator as more reliable.

Factors influencing this indicator

Many factors, both physiological and pathological, influence the ESR indicator, among which the key ones are identified, i.e. of greatest importance:

• the ESR indicator in the female half of humanity is higher than in the male half, which is due to the physiological characteristics of female blood;
• its value is higher in pregnant women than in non-pregnant women, and ranges from 20 to 45 mm/h;
• women taking contraceptives have an increased rate;
• people suffering from anemia have a high ESR;
• in the morning, the erythrocyte sedimentation rate is slightly higher than in the afternoon and evening hours (typical for all people);
• acute phase proteins lead to an acceleration of the erythrocyte sedimentation rate;
• with the development of an infectious and inflammatory process, the result of the analysis changes one day after the onset of hyperthermia and leukocytosis;
• in the presence of a chronic focus of inflammation, this indicator is always slightly increased;
• with increased blood viscosity, this indicator is below the physiological norm;
• Anisocytes and spherocytes (morphological variants of erythrocytes) slow down the erythrocyte sedimentation rate, and macrocytes, on the contrary, accelerate the reaction.

If the ESR in a child’s blood is elevated, what does this mean?

An increased ESR in the blood of a child most likely indicates an infectious-inflammatory process, which is determined not only by the result of the analysis. At the same time, other indicators of the general blood test will also change, and in children, infectious diseases are always accompanied by disturbing symptoms and a deterioration in their general condition. In addition, ESR may increase with non-infectious diseases in children:

• autoimmune or systemic diseases - rheumatoid arthritis, bronchial asthma, systemic lupus erythematosus
• in case of metabolic disorders - hyperthyroidism, diabetes mellitus, hypothyroidism
• for anemia, hematological malignancies, blood diseases
• diseases accompanied by tissue decay - oncological processes, pulmonary tuberculosis and extrapulmonary forms, myocardial infarction, etc.
• injuries

It should be remembered that even after recovery, the increased erythrocyte sedimentation rate normalizes quite slowly, approximately 4-6 weeks after the illness, and if in doubt, to make sure that the inflammatory process has stopped, you can get tested for C-reactive protein (in a paid clinic) .

If a significantly increased ESR is detected in a child, the reasons most likely lie in the development of an inflammatory reaction, therefore, in the case of pediatric diagnosis, it is not accepted to talk about its safe increase.

The most harmless factors for a slight increase in this indicator in a child may be:

• if the ESR is slightly increased in a baby, this may be a consequence of a violation of the diet of the nursing mother (an abundance of fatty foods)
• taking medications ()
• time when baby is teething
• vitamin deficiency
• helminthiases (see,)

Statistics on the frequency of increased ESR in various diseases

• 40% are infectious diseases - upper and lower respiratory tract, urinary tract, pulmonary tuberculosis and extrapulmonary forms, viral hepatitis, systemic fungal infections
• 23% - oncological diseases of the blood and any organs
• 17% - rheumatism, systemic lupus erythematosus
• 8% - anemia, cholelithiasis, inflammatory processes of the pancreas, intestines, pelvic organs (salpingoophoritis, prostatitis), diseases of the ENT organs (sinusitis, otitis media, tonsillitis), diabetes mellitus, trauma, pregnancy
• 3% - kidney disease

When is increasing ESR considered safe?

Many people know that an increase in this indicator, as a rule, indicates some kind of inflammatory reaction. But this is not the golden rule. If an increased ESR is detected in the blood, the causes may be completely safe and do not require any treatment:

• allergic reactions, in which fluctuations in the initially increased erythrocyte sedimentation rate make it possible to judge the correct anti-allergy therapy - if the drug works, the rate will gradually decrease;
• a hearty breakfast before the study;
• fasting, strict diet;
• menstruation, pregnancy and the postpartum period in women.

Causes of false-positive ESR tests

There is such a thing as a false positive analysis. The ESR test is considered false positive and does not indicate the development of infection if the following causes and factors are present:

• anemia, in which there is no morphological change in red blood cells;
• an increase in the concentration of all plasma proteins except fibrinogen;
• renal failure;
• hypercholesterolemia;
• severe obesity;
• pregnancy;
• elderly age of the patient;
• technical diagnostic errors (incorrect blood holding time, temperature above 25 C, insufficient mixing of blood with the anticoagulant, etc.);
• administration of dextran;
• vaccination against hepatitis B;
• taking vitamin A.

What to do if the causes of elevated ESR are not identified?

There are often cases when the reasons for the increased erythrocyte sedimentation rate are not found, and the analysis consistently shows high ESR rates over time. In any case, an in-depth diagnosis will be carried out in order to exclude dangerous processes and conditions (especially oncological pathology). In some cases, some people have such a feature of the body when the ESR is increased, regardless of the presence of the disease.

In this case, it is enough to undergo a preventive medical examination with your doctor once every six months, but if any symptoms occur, you should visit a medical facility as soon as possible. In this case, the phrase “God protects those who are careful” is an excellent motivation for being careful about your own health!