What is it about ?
Sedimentation rate (ESR) is a test that may be requested as part of a blood workup. A small amount of your blood will be deposited in a very fine tube (capillary tube) in the laboratory, which is then left in an upright position for 3 hours. The red blood cells slowly move down the tube so that the red blood cells are below and the serum above. We measure the speed at which this process occurs and we express it in mm per hour. Sometimes the red blood cells descend faster than normal: we are talking about a high or increased sedimentation rate. This is the case when the amount of protein in the blood increases due to an illness.
The measurement of the sedimentation rate is a so-called “non-specific” test, ie. that it does not make it possible to indicate the presence of a very particular disease. The test can look for infections, inflammation (eg rheumatism), cancer, and other conditions that lead to changes in the protein concentration in the blood. A high sedimentation rate therefore indicates the presence of a disease, but additional examinations are necessary to know which disease it is precisely. Conversely, in the event of recovery, the rate of sedimentation returns to normal. The test can therefore also be used to monitor the course of the disease.
The normal sedimentation rate depends on age. It gradually increases over the years, from 1 mm at birth to a maximum of 35 mm in the elderly.
If a slight increase in the sedimentation rate is found but there are no symptoms and the sedimentation rate has not significantly increased compared to previous measurements, we often wait a while before taking measurements. additional examinations, especially at an older age.
It is sometimes very difficult to find the cause of a high sedimentation rate, because the causes are many.
With what conditions will the sedimentation rate be increased?
Conditions that almost always result in an increased sedimentation rate are:
- Severe generalized infection (sepsis) ;
- Deep abscess or infection of the bone;
- Inflammation of the thyroid at an acute stage;
- Certain rheumatic diseases and systemic diseases;
- Certain blood diseases such as blood cancers;
- Renal failure severe.
Conditions that often result in increased sedimentation rate are:
- Infectious diseases: inflammation of the renal pelvis (pyelonephritis), inflammation of the lungs of bacterial origin, chronic inflammation of the liver, tuberculosis, etc. ;
- Certain rheumatic and systemic conditions: rheumatoid arthritis, polymyalgia rheumatic, sarcoidosis, chronic inflammation of the intestines like Crohn’s disease and ulcerative colitis, etc. ;
- Liver cirrhosis;
- Metastatic cancer;
- Sometimes in case increase in certain fats in the blood, in case of overweight and during pregnancy.
Conditions with which the rate of sedimentation is often normal:
- Many types of cancer, especially those of the digestive tract;
- Osteoarthritis ;
- Viral infections (colds, flu, etc.);
- Polycythemia, a blood disease in which the amount of blood cells is increased, but where sedimentation is strangely more often than not normal.
What can your doctor do?
In the event of a high sedimentation rate, the doctor always compares the new value with any previous values that may be available. In addition, the doctor always asks you questions about your symptoms:
- Do you have fever ?
- Has your general health deteriorated?
- Do you feel pain or increased sensitivity anywhere in your body?
- Do you have joint symptoms like morning stiffness or muscle pain?
- Have the stools changed?
- Do you cough more often?
- Do you have a history of tuberculosis?
The doctor will examine you and pay special attention to the following:
- Swelling of the lymph nodes;
- Thyroid swelling or painful thyroid;
- Changes in the skin;
- Abnormal sounds when you auscultate your lungs;
- Flexibility and pain in the stomach area;
- Swelling of the joints;
- Condition of your teeth.
If the doctor cannot find any possible explanation, he may give you additional examinations, such as a blood test or more complete technical examinations (for example a x-ray examination of the chest.
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