Erythrocytes Sedimentation test: A blood test as an indicator of inflammation (,Part II)
The normal range of ESR in females:
On average, the normal reference range for ESR is approximately 1 – 20 mm/h for females. According to the University of Rochester Medical Centre, the normal range of ESR in females at different age groups when calculated using the Westergren method is as follows.
Table 1:
Age Gr. (yrs):Normal ESR range (mm/hr)
1. < 20: 0-10
2. 20 – 50: 0 – 20
3. > 50 : 0 – 30
The normal range of ESR in males:
On average, the normal reference range for ESR is approximately 1 – 13 mm/h for males. According to the University of Rochester Medical Centre, the normal range of ESR in males at different age groups when calculated using the Westergren method .
Table 2:
Age Gr. (yrs):Normal ESR range (mm/h)
1. < 20: 0 -10
2. 20 – 50: 0 -15
3. > 50 : 0- 20
The abnormal levels of ESR can indicate different diseases depending upon how much variation is there from the reference range.
Moderate ESR :Moderate ESR does not indicate inflammatory conditions.It may indicate pregnancy, menstruation, or anemia, rather than an inflammatory
disease.
Low Levels of ESR:
Sometimes the ESR can be less than normal.
If the level of the ESR are lower than the reference range, it may be an indicator of one of the following health conditions:
A below normal ESR may indicate a blood disorder, such as Polycythemia that high red blood cells count; Leukocytosis that is an abnormal increase in count of white blood cells (WBC);
Leukaemia ;
Sickle cell anemia;
Congestive heart failure;
Increased blood thickness;
Low levels of fibrinogen a blood protein .
High levels of ESR:
If your ESR is high, it may be related to various inflammatory conditions.
If the ESR levels are slightly higher than the normal range, it might indicate for one of the following health conditions:
bodywide systemic infection;
bone infections(Rheumatoid arthritis and Rheumatic fever );
Heart infections (Infection of the heart or heart valves);
Anaemia ;
Kidney disease;
Thyroid disease;
Lymphoma;
Abnormalities in RBCs;
Tuberculosis;
Vascular disease; Inflammatory bowel disease;
certain cancers.
High ESR value and Cancer:
In oncology, a high ESR has been found to correlate with overall poor prognosis for various types of cancer, including
Hodgkin's disease;
Gastric carcinoma;
Renal cell carcinoma;
Chronic lymphocytic leukemia;
Breast cancer;
Colorectal cancer;
Prostate cancer.
It is possible that the ESR reflects aspects of tumor-host relationship and that both a low and high ESR are markers for patients with receding host defence.
ESR values of 40 and 60 mm/h clearly indicate a state of heightened systemic inflammation among people who already have an inflammatory disease.
The very high ESR value and its significance:
If the levels of ESR in your test report are greater than 100 mm/hr. i.e very high, it may be an indication of any of the following disorders:
White blood cell cancer (Waldenstrom’s macro-globulinemia);
Plasma cell cancer (multiple myeloma);
Blood vessel inflammation (hypersensitivity vasculitis);
and Temporal arteritis.
Thus ESR tells the rate at which your red blood cells settle down when kept at room temperature. The abnormal levels of ESR can be an indication of some underlying health disorders. Now that you know what the reference range of ESR is and what the abnormal levels of ESR may indicate, you can better study and analyze your test report.Let physician decide the line of treatment on basis of Complete Blood Count alongwith ESR as well as other tests.
C- reactive protein (CRP)as an indicator of inflammation:
Apart from ESR test, CRP test is also useful in detection of inflammation in the body. A C-reactive protein(CRP) test measures the level of C-reactive protein (CRP) in the blood. CRP is a protein made by liver. It's sent into the blood stream in response to inflammation. Inflammation is human body's way of protecting the tissues if one has been injured or has an infection.
Author:Dr Bhairavsinh Raol
