The Esr Test: An Old Test With New Contents

Journal of Diagnostic Pathology

The erythrocyte sedimentation rate (ESR) is one of the most common and traditional laboratory tests in the world for detecting acute and chronic inflammation. This simple test has served as a nonspecific indicator of presence of disease. It also has been found useful in monitoring response to therapy, especially in rheumatologic disease. It reflects both plasma concentration of acute-phase proteins of large molecular size and anaemia. The ESR test is easy to perform and inexpensive, is used today as a routine test worldwide. However, the ESR has some demerits, in requiring large volume of sodium citrate or EDTA blood and at least 1 hr testing time. The minimum of 1 hr testing time is not practical for modernized laboratories. In this paper we investigated the possibility of using a rapid ESR test done on an inclined tube. We compared the results obtained by the rapid method and the traditional Westergren method of ESR using Pearson correlation. Blood samples from 153 patients with ESRs ranging from 1-165 were used for the study. Four ml of sodium citrate blood (3.2 ml of blood & 0.8ml of 3.8% of sodium citrate) is prepared and two Westergren tubes filled. Both tubes are mounted on two separate Westergren tube racks. After mounting, one ESR tube is tilted to an angle of 45 degrees from vertical and readings were taken at 4,

Indian journal of pathology & microbiology

International Journal of Scientific Research, 2012

MicroSED-10® (Electra Lab,Italy) is automated method for measurement of erythrocyte sedimentation rate (ESR). The aim of our study was to compare the ESR values by MicroSED-10® against the standard Westergren's method. Study was conducted in outpatient department of pathology at P.D.U. MEDICAL COLLEGE & HOSPITAL-RAJKOT on 209 patients. The samples taken were as per the recommendations charted out by International Council for Standardization in Haematology (ICSH). Bland and Altman statistical analysis was applied for evaluation. The analysis revealed a low degree of agreement between the manual and automated method especially for higher ESR values[>25mm/hour],mean difference~2.58±9.17(95% limits of agreement,-15.39 to 20.55) as compare to lower ESR value[<25mm/hour],mean difference~1.22±1.90(95% limits of agreement,-2.50 to 4.94) & Over all whole ESR data analysis shows, mean difference~2.37±8.34(95% limits agreement,˗13.94 to 18.68) for 1 hour. The fully automated system MicroSED-10® for ESR measurement tends to underestimate the manual ESR readings especially at higher ESR values.

Scandinavian Journal of Clinical & Laboratory Investigation, 2010

Background: Various modifi cations of the Erythrocyte Sedimentation Rate (ESR) determination have been suggested since the original Westergren procedure that has been adopted as the gold standard by the International Council for Standardization in Haematology (ICSH). Recently, an automated method, (Alifax Test 1), based on a technique completely different from Westergren, has been introduced. Material and methods: In this comparative study, ESR of blood from 680 patients with various rheumatic diseases was determined on both Test 1 and the StaRRsed automated ESR analyser which performs measurements in accordance with ICSH specifi cations. Furthermore the robustness of the new technique was evaluated. Results: Direct correlation of Test 1 and StaRRsed measurements confi rmed the results of previous studies: an overall correlation coeffi cient of R ϭ 0.90. However, further statistical analysis showed that, depending on the instrument that was used, in 78 samples (i.e. 11.5%) the results could lead to different treatment suggestions. Furthermore it appeared that several procedural factors could infl uence the fi nal Test 1 outcome. Conclusions: Due to its sensitivity for procedural variations, Test 1 measurements should be carried out under strictly standardized conditions. Especially at the higher ESR levels the Test 1 technique is, however, not a reliable alternative for the ICSH approved 'Westergren' method.

American Journal of Clinical Pathology, 2002

2018

The erythrocyte sedimentation rate (ESR), or sedimentation rate (sed rate), is a measure of the settling of red blood cells in a tube of blood during one hour. The rate is an indication of inflammation and increases in many diseases. Westergreen method is routinely used determination of ESR, however, it requires large volume of blood and it is time consuming as it takes one hour for analysis. In order to overcome these challenges, new technologies have implemented an automated system which saves on labour, no need for aliquots, shorter turnaround time and minimizes exposures of laboratory staff to biohazard risks. The main objective of this study was to compare Westergreen method and automated IRIA analyzer in determination of ESR. The specific objectives were to determine the ESR using both Westergreen tube method and automated IRIA analyzer and to determine the correlation between Westergreen tube method and automated IRIA analyzer methods. This cross-sectional study was carried o...

International Journal of Research in Medical Sciences, 2018

Background: Erythrocyte sedimentation rate (ESR) test provides valuable information in screening, diagnosis, as well as monitoring disease activity and therapeutic response in numerous health conditions. The most commonly used method for determination of ESR is Westergren method, which is time-consuming and requires a large amount of blood sample. There are several other methods, like Micro-ESR method which overcome the limitations of conventional Westergren method, hence the present study was performed to compare results of Westergren method with Micro-ESR method for determination of ESR.Methods: In the present study, blood samples from 100 patients were processed for ESR determination by Westergren method and Micro-ESR method. The results obtained were compared using Pearson’s correlation test.Results: The Westergren method was the reference method and the Micro-ESR method was testing method. The comparison was done between Micro- ESR method results (X-axis) and results of Westerg...

Annals of Pathology and Laboratory Medicine

Erythrocyte Sedimentation Rate(ESR) determined by Westergren method is used in diagnosis and monitoring inflammatory activities. Extremely elevated ESR (&gt;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.

International Journal of Laboratory Hematology, 2011

The International Annals of Medicine, 2018

Introduction: Erythrocyte sedimentation rate (ESR) is a biological analysis to diagnosis an inflammatory syndrome. This study aims to identify the factors which can modify the interpretation of the result of the ESR. Methods: This is a descriptive study in a period of 12 months in the Laboratory of the University Hospital of Befelatanana Antananarivo. During the study period, ESR and Blood Count have been done simultaneously in 451 patients. Results: Concerning associated factors with elevation of ESR levels, the ESR increases with age (p=0.002) and in women (71%) (p=0.008). All hospitalized patients in the infectious disease department have high ESR (100%) (0.0002). Similarly, patients with arthralgias frequently have elevated ESR (86.7%) (p=0.02). Concerning the relationship between ESR and RBC, ESR increases when the patient has anemia (90.0%) (p<10-6) and decreases when he has polycythemia (75%) (p<10-6). Conclusion: ESR is not a good marker of inflammatory syndrome because it can be modified by other situations. Therefore, ESR must be tested simultaneously with other markers of inflammation to confirm the diagnosis of inflammatory syndrome. Thus, the disease will be well managed, and the life expectancy of the patient will be improved.