Erythrocyte Sedimentation Rate

(ESR)Mohamed Khalil Mubarak

What is ESR?

• Rate at which Erythrocytes sediment in a tube (Westergern Tube) in an hour.

• Measures amount of clear plasma fluid in a tube.

How is ESR done?

• Anticoagulated blood is placed in a Westerger Tube & the rate at which the erythrocytes fall are recorded in mm/h.• Rouleaux Formation Stage Usually first 10

minutes• Sedimentation stage 40 minutes• Packing stage Last 10 minutes where cells

stop sedimenting & pack together at the bottom of the tube.

How is ESR done?• Anticoagulated blood is placed in a Westerger

Tube & the rate at which the erythrocytes fall are recorded in mm/h.

• What controls the rate is a balance between pro-sedimentation factors such as fibrinogen & anti-sedimentation factors such as the negative charge of electrocytes.

• Normal values are men 3mm/h & women 7mm/h.• Age & gender play a role in the rate.

Uses of ESR

• Diagnostic• Inflammations, Infections & auto-immune

diseases.• Mostly due to increases in pro-sedimentation

factors.• Values can go above 100mm/h!

• Prognostic• Therapy-effectiveness indicator for the same

array of diseases mentioned above.• Values start to gradually decrease.