Erythrocyte Sedimentation Rate (with its inherent limitations) Remains a Useful Investigation in Contemporary Clinical Practice
AbstractErythrocyte Sedimentation Rate(ESR) determined by Westergren method is used in diagnosis and monitoring inflammatory activities. Extremely elevated ESR (>100mm/hr) is usually indicative of a serious underlying disease. ESR phenomenon occurs in three phases (Aggregation, Decantation & Packaging) and is related to certain laws of physics like Stokes’s law. ESR by Westergren method is affected by RBC, Plasma and Technical factors and also by many physiological and clinical states. ESR by Westergren method is endorsed by International Council for Standardization in Haematology as a “Gold Standard” for ESR determination and provides recommendations to perform ESR by reference method. ESR by conventional Westergren method has many limitations necessitating technical innovations and alternate test methods in ESR determination.
E. Piva, R. Pajola, V. Temporin, and M. Plebani, “A new turbidimetric standard to improve the quality assurance of the erythrocyte sedimentation rate measurement,” Clin. Biochem., vol. 40, no. 7, pp. 491–495, Apr. 2007.
V. G. Kevin Tishkowski, “Erythrocyte Sedimentation Rate.” ttps://www.statpearls.com/Articlelibrary/viewarticle/21307.
A. Kratz, M. Plebani, M. Peng, Y. K. Lee, R. McCafferty, and S. J. Machin, “ICSH recommendations for modified and alternate methods measuring the erythrocyte sedimentation rate,” Int. J. Lab. Hematol., vol. 39, no. 5, pp. 448–457, Oct. 2017.
Josep M. Jou, “Laboratory Hematology Practice,” 2012, p. 638.
“ESR, the factors involved, interpretation and trouble shooting.” http://www.tulipgroup.com/Common_New/Crux_magazine_PDF/Crux_68.pdf.
S. K. Ballas, “The erythrocyte sedimentation rate, rouleaux formation and hyperviscosity syndrome. Theory and fact,” 1975.
J. M. Jou, S. M. Lewis, C. Briggs, S. H. Lee, B. De La Salle, and S. Mcfadden, “ICSH review of the measurement of the erythocyte sedimentation rate,” Int. J. Lab. Hematol., vol. 33, no. 2, pp. 125–132, Apr. 2011.
M. Brigden, “The erythrocyte sedimentation rate: Still a helpful test when used judiciously,” Postgraduate Medicine, vol. 103, no. 5. Medquest Communications LLC, pp. 257–274, 1998.
M. L. BRIGDEN, “Clinical utility of the erythrocyte sedimentation rate,” Clin. Util. Erythrocyte Sediment. Rate - Am. Fam. Physician, 1999.
A. D. Lascari, “The erythrocyte sedimentation rate.,” Pediatr. Clin. North Am., vol. 19, no. 4, pp. 1113–1121, 1972.
V. Alende-Castro et al., “Factors influencing erythrocyte sedimentation rate in adults: New evidence for an old test,” Med. (United States), vol. 98, no. 34, 2019.
American Proficiency Institute, “Educational Commentary - The Erythrocyte Sedimentation Rate and its Clinical Utility,” Event (London), pp. 1–3, 2006.
M. Plebani and E. Piva, “Hematopathology / QUALITY CONTROL OF THE ERYTHROCYTE SEDIMENTATION RATE Erythrocyte Sedimentation Rate Use of Fresh Blood for Quality Control,” Am J Clin Pathol, vol. 117, pp. 621–626, 2002.
J. M. W. Keohane, Elaine M., Catherine N. Otto, RODAK’S HEMATOLOGY: CLINICAL PRINCIPLES AND APPLICATIONS, SIXTH EDITION. Elsevier Inc., 2020.
R. W. MANLEY, “The effect of room temperature on erythrocyte sedimentation rate and its correction,” J. Clin. Pathol., vol. 10, no. 4, pp. 354–356, 1957.
D. Corantijn, “A Classic , Gold Standard : The Westergren method for ESR measurement,” RR Mechatronics, vol. WP-001, no. 003, pp. 1–20, 2015.
S. Europe GmbH, “SEED HAEMATOLOGY The ‘erythrocyte sedimentation rate’: a well-timed indicator of clinical value,” 2016.
“Saadeh-1998-The erythrocyte sedimentation rate.”.
E. S. Ramsay and M. A. Lerman, “How to use the erythrocyte sedimentation rate in paediatrics,” Arch. Dis. Child. Educ. Pract. Ed., vol. 100, no. 1, pp. 30–36, 2015.
H. C. J. Sox and M. H. Liang, “The erythrocyte sedimentation rate. Guidelines for rational use.,” Ann. Intern. Med., vol. 104, no. 4, pp. 515–523, Apr. 1986.
NABL 112, “Specific Criteria for Accreditation of Medical Laboratories.” 2019.
M. R. Hardeman, M. Levitus, A. Pelliccia, and A. A. Bouman, “Test 1 analyser for determination of ESR. 2. Experimental evaluation and comparison with RBC aggregometry.,” Scand. J. Clin. Lab. Invest., vol. 70, no. 1, pp. 26–32, Feb. 2010.
M. Aytekin, “The Current Use and the Evolution of Erythrocyte Sedimentation Rate Measurement,” vol. 4, no. April, pp. 17–23, 2018,
Copyright (c) 2022 Manoj A Kahar
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).