Biochemistry of ESR. Erythrocyte sedimentation rate is increased - what does this mean, how to quickly reduce ESR

Now let's study what ESR (erythrocyte sedimentation rate) is according to Westergren in a blood test.

The Westergren technique is considered international and is used in many countries around the world as the main method for determining the ESR level. For the study, blood is taken from a vein, but, in addition, despite the similarity of the methodology, there are differences in the conduct of the study and the instruments used. In this case, the mixture of blood and anticoagulant settles not in a capillary vessel, but in a test tube, and the determination scale has a slightly different calibration.

The norms in these methods are different, although when studied by the Westergren method, the results are more accurate, since this technique has greater sensitivity than the Panchenkov technique.

For this method, instead of a 5% sodium citrate solution, a solution with a concentration of 3.8% is taken, but it is also mixed with the patient’s blood in a ratio of 1:4. The settling is carried out in special test tubes, the internal diameter of which is approximately 2.5 mm, which is 2.5 times greater than the diameter of graduated capillaries.

ESR norms in children and adults

Let's consider what the ESR should be in a healthy person. For each age, there is its own norm of ESR in the blood, since this indicator is unstable and almost constantly changes as the human body matures. It is also important to note that for men and women the norms for this indicator will be different, but the division here begins only during puberty. In children under 12 years of age, the ESR level does not depend on gender.

In addition, many factors influence the erythrocyte sedimentation rate, in particular, the presence of certain diseases, including chronic form, as well as the concentration of protein found in the blood plasma.

Standards for children according to Panchenkov:

Standards for teenagers according to Panchenkov already differ by gender and are:

• Girls from 12-15 to 18 years old - from 2 to 15 mm/h.
• Boys from 12-15 to 18 years old - from 1 to 10 mm/h.

For adults, according to Panchenkov’s method, the norms remain the same throughout the entire period of adult life (the same as for adolescence), with the exception of special conditions when deviations occur due to physiological factors.

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Westergren's norms have some differences and are:

The difference in the indicators for both methods is based on the fact that the Panchenkov capillary vessel is graduated by 100 divisions, and the Westergren test tube has 200 divisions at once and requires more material for research, but at the same time allows you to more accurately determine the level of ESR and possible deviations from established standards.

How to take an ESR test

A blood test and determination of the ESR level allows an experienced doctor to identify the presence possible illness and, if necessary, order additional examination. Therefore, in order not to get false results, it is important to properly prepare for the blood sampling procedure, which is not particularly difficult.

For the Panchenkov technique, blood sampling (capillary) is carried out from a finger, and for Westergren research - from a vein. You must come for the test in the morning and always on an empty stomach.

It is very important that at least 8 hours pass between the time of blood sampling and the last meal.

A few days before the procedure, it is necessary to exclude from the diet heavy foods, fried, spicy, spicy, smoked and fatty foods, as well as pickles and marinades, alcohol and carbonated drinks.

It is important and emotional condition as well as rest. The day before donating blood, you should limit physical activity and sports. If you had to climb stairs to get to the laboratory or treatment room, you need to rest for at least 15–20 minutes and only then draw blood. You should also calm down. It is important to stop taking and medicines approximately 4 - 5 days before the procedure and stop smoking at least 3 hours before the test.

How to decipher the ESR analysis

As a rule, the results of a blood test for ESR are ready on the day of delivery, and the next morning they are delivered to the doctor’s office or given to the patient. If the analysis was taken in a private laboratory, then its result can be obtained within 1.5-2 hours, since employees in such institutions work more quickly.

At general research Blood results may contain quite a few parameters, and to find out the level of ESR, you need to find among them (on the left side) the abbreviation ESR (international designation), ROE or ESR (Russian designation). Opposite this abbreviation with right side sheet will be indicated ESR value, written in mm/h.

To find out for yourself whether this indicator is normal or there are deviations, its value should be compared with tables of norms, taking into account gender and age, as well as the characteristics of the body.

Reasons for elevated levels

One of the most common reasons for such an analysis result is an increase in the amount of proteins in the blood plasma, primarily albumin and globulin, which occurs as a result of the penetration of any harmful microorganisms into the body, for example, bacteria, viruses or even fungi that cause an infectious disease and the onset of inflammatory process.

Globulins are protective bodies, so when an infection occurs, their number increases sharply. Such diseases include acute respiratory infections, influenza, ARVI, sore throat, pneumonia, osteomyelitis, arthritis, syphilis, tuberculosis and others. With any of these diseases, there is always an increase in the ESR level.

But an increase in the parameter is not always caused precisely by the inflammatory process. Other factors may also affect the erythrocyte sedimentation rate, in particular:

• The level of red blood cell production, since its decrease or increase will also affect the sedimentation rate of these cells.
• Changes in the ratio of erythrocyte mass and blood plasma in general composition blood. The methodology for studying and determining ESR is based precisely on the separation of plasma (the lighter part that rises to the top) and the mass of red blood cells that settles to the bottom of the vessel.
• Disturbance in the production of proteins occurring in the liver.

In addition, the ESR rate can be increased if:

• Severe disorders of the kidneys or liver.
• Blood diseases.
• Anemia.
• Cancer processes and malignant formations.
• Pulmonary or myocardial infarction, stroke.
• Too frequent blood transfusions.
• Introduction of vaccines.
• General intoxication.
• Autoimmune diseases.
• Injuries, including fractures.
• Large blood losses.

You can find out how to lower ESR in the blood.

In some cases, an increase in the indicator can also be caused by physiological factors, for example, the period after the birth of a baby, menstrual bleeding, stress. Also, the rate is naturally increased in old age.

Reasons for lowering the level

Sometimes deviations can also be observed towards a decrease in the indicator, which happens when:

• The concentration of albumin proteins increases.
• The blood pH level decreases and acidosis develops.
• The number of bile pigments increases.
• Blood acid levels increase.
• Blood viscosity increases.
• The concentration of red blood cells increases or their shape changes.

Various diseases can cause a decrease in levels, for example:

• Erythremia or erythrocytosis.
• Neuroses.
• Sickle cell anemia.
• Anisocytosis, hemoglobinopathy or spherocytosis.
• Circulatory disorders.
• Epilepsy.

In addition, a decrease in the level can also be caused by physiological temporary factors, for example, taking certain medications, in particular calcium chloride, salicylic group drugs and mercury-based drugs. IN in this case a decrease in ESR levels is considered normal and even a favorable sign, indicating the effectiveness of treatment.

Reasons for a false increase in ESR

A false increase is often called physiological. It occurs for a certain, usually short time, and does not indicate the presence of any serious illnesses and problems in the body. A falsely elevated ESR level may be due to:

Also, the ESR level decreases naturally if a person has an allergy and is treated for it. The indicator will be falsely low in women on a strict diet, fasting, and in those people who do not monitor the adequacy of their diet.

Now you know what the erythrocyte sedimentation rate in a blood test is and what the norm is.

General blood test (Complete Blood Count, CBC).

This is the most common blood test, which includes determining the concentration of hemoglobin, the number of red blood cells, leukocytes and platelets per unit volume, the hematocrit value and erythrocyte indices (MCV, MCH, MCHC).

• screening and dispensary examinations;
• monitoring of ongoing therapy;
• differential diagnosis blood diseases.

What is hemoglobin (Hb, Hemoglobin)?

Hemoglobin is a respiratory pigment in the blood, which is contained in red blood cells and is involved in the transport of oxygen and carbon dioxide and the regulation of acid-base status.

Hemoglobin consists of two parts: protein and iron. Men have slightly higher hemoglobin levels than women. Children under one year of age have a physiological decrease in hemoglobin levels. Physiological forms of hemoglobin:

• oxyhemoglobin (HbO2) - a compound of hemoglobin with oxygen - is formed mainly in arterial blood and gives it a scarlet color;
• reduced hemoglobin or deoxyhemoglobin (HbH) - hemoglobin that has given oxygen to tissues;
• carboxyhemoglobin (HbCO2) - a compound of hemoglobin with carbon dioxide - is formed mainly in venous blood, which as a result acquires a dark cherry color.

When can hemoglobin concentration increase?

For diseases and conditions:

leading to blood thickening (burns, persistent vomiting, intestinal obstruction, dehydration or prolonged dehydration);

accompanied by an increase in the number of red blood cells - primary and secondary erythrocytosis (mountain sickness, chronic obstructive pulmonary disease, damage to the blood vessels of the lungs, heavy tobacco smoking, hereditary hemoglobinopathies with increased affinity of hemoglobin for oxygen and deficiency of 2,3-diphosphoglycerate in red blood cells, congenital “blue” defects heart, polycystic kidney disease, hydronephrosis, renal artery stenosis as a result of local renal ischemia, renal adenocarcinoma, cerebellar hemangioblastoma, Hippel-Lindau syndrome, hematoma, uterine fibroids, atrial myxoma, tumor diseases of the endocrine glands, etc.);

physiological conditions (in residents of high mountains, pilots, climbers, after increased physical activity, prolonged stress).

When can hemoglobin concentration decrease?

For anemia of various etiologies (acute posthemorrhagic with acute blood loss; iron deficiency with chronic blood loss, after resection or with severe damage small intestine; hereditary, associated with impaired porphyrin synthesis; hemolytic anemia associated with increased destruction of red blood cells; aplastic anemia associated with the toxic effects of certain medications, chemical substances, idiopathic, the causes of which are unclear; megaloblastic anemia associated with deficiency of vitamin B12 and folic acid; anemia due to lead poisoning).

With overhydration (increase in the volume of circulating plasma due to detoxification therapy, elimination of edema, etc.).

What is a red blood cell (RBC)?

Red blood cells are highly specialized anucleate blood cells that have the shape of biconcave discs. Thanks to this shape, the surface of the red blood cells is larger than if it had the shape of a ball. This special shape of red blood cells helps them perform their main function - the transfer of oxygen from the lungs to tissues and carbon dioxide from tissues to the lungs, and also thanks to this shape, red blood cells have a greater ability to be reversibly deformed when passing through narrow curved capillaries. Red blood cells are formed from reticulocytes as they leave the bone marrow. In one day, about 1% of red blood cells are renewed. The average lifespan of red blood cells is 120 days.

When might red blood cell levels increase (erythrocytosis)?

Erythremia, or Vaquez's disease, is one of the variants of chronic leukemia (primary erythrocytosis).

Secondary erythrocytoses:

absolute - caused by hypoxic conditions (chronic lung diseases, birth defects heart, increased physical activity, stay at high altitudes); associated with increased production of erythropoietin, which stimulates erythropoiesis (kidney parenchyma cancer, hydronephrosis and polycystic kidney disease, liver parenchyma cancer, benign familial erythrocytosis); associated with excess adrenocorticosteroids or androgens (pheochromocytoma, Cushing's disease/syndrome, hyperaldosteronism, cerebellar hemangioblastoma);

relative - with blood thickening, when plasma volume decreases while maintaining the number of red blood cells (dehydration, excessive sweating, vomiting, diarrhea, burns, increasing swelling and ascites; emotional stress; alcoholism; smoking; systemic hypertension).

When might red blood cell levels decrease (erythrocytopenia)?

For anemia of various etiologies: as a result of deficiency of iron, protein, vitamins, aplastic processes, hemolysis, hemoblastosis, metastasis malignant neoplasms.

What are erythrocyte indices (MCV, MCH, MCHC)?

Indices that allow quantitative assessment of the main morphological characteristics of red blood cells.

MCV - Mean Cell Volume.

This is a more accurate parameter than visual assessment of red blood cell size. However, it is not reliable if there are a large number of abnormal red blood cells (for example, sickle cells) in the blood being tested.

Based on the MCV value, anemia is distinguished:

• microcytic MCV< 80 fl (железодефицитные анемии, талассемии, сидеробластные анемии);
• normocytic MCV from 80 to 100 fl (hemolytic anemia, anemia after blood loss,
• hemoglobinopathies);
• macrocytic MCV > 100 fl (B12 and folate deficiency anemia).

MCH is the average hemoglobin content in an erythrocyte (Mean Cell Hemoglobin).

This indicator determines the average hemoglobin content in an individual red blood cell. It is similar color index, but more accurately reflects the synthesis of Hb and its level in the erythrocyte. Based on this index, anemia can be divided into normo-, hypo- and hyperchromic:

• normochromia is typical for healthy people, but can also occur with hemolytic and aplastic anemia, as well as anemia associated with acute blood loss;
• hypochromia is caused by a decrease in the volume of red blood cells (microcytosis) or a decrease in the level of hemoglobin in a red blood cell of normal volume. This means that hypochromia can be combined with a decrease in erythrocyte volume, and can be observed with normo- and macrocytosis. Occurs in iron deficiency anemia, anemia in chronic diseases, thalassemia, some hemoglobinopathies, lead poisoning, impaired porphyrin synthesis;
• hyperchromia does not depend on the degree of saturation of red blood cells with hemoglobin, but is determined only by the volume of red blood cells. It is observed in megaloblastic, many chronic hemolytic anemias, hypoplastic anemia after acute blood loss, hypothyroidism, liver diseases, when taking cytostatics, contraceptives, anticonvulsants.

MCHC (Mean Cell Hemoglobin Concentration).

The average concentration of hemoglobin in an erythrocyte reflects the saturation of an erythrocyte with hemoglobin and characterizes the ratio of the amount of hemoglobin to the volume of the cell. Thus, unlike MSI, it does not depend on the volume of red blood cells.

An increase in MSHC is observed in hyperchromic anemias (congenital spherocytosis and other spherocytic anemias).

A decrease in MSHC can occur in iron deficiency, sideroblastic anemia, and thalassemia.

What is hematocrit (Ht, hematocrit)?

This is the volume fraction of red blood cells in whole blood (the ratio of the volumes of red blood cells and plasma), which depends on the number and volume of red blood cells.

The hematocrit value is widely used to assess the severity of anemia, at which it can decrease to 25-15%. But this indicator cannot be assessed soon after blood loss or blood transfusion, because You may get falsely high or falsely low results.

The hematocrit may decrease slightly when taking blood in a supine position and increase when the vein is compressed for a long time with a tourniquet when taking blood.

When can hematocrit increase?

Erythremia (primary erythrocytosis).

Secondary erythrocytosis (congenital heart defects, respiratory failure, hemoglobinopathies, kidney tumors accompanied by increased formation of erythropoietin, polycystic kidney disease).

A decrease in the volume of circulating plasma (blood thickening) in case of burn disease, peritonitis, dehydration of the body (severe diarrhea, uncontrollable vomiting, excessive sweating, diabetes).

When can hematocrit decrease?

• Anemia.
• Increase in circulating blood volume (second half of pregnancy, hyperproteinemia).
• Overhydration.

What is a leukocyte (White Blood Cells, WBC)?

Leukocytes, or white blood cells, are colorless cells of varying sizes (from 6 to 20 microns), round or irregular in shape. These cells have a nucleus and are able to move independently like a single-celled organism - an amoeba. The number of these cells in the blood is much less than that of red blood cells. Leukocytes are the main protective factor in the human body’s fight against various diseases. These cells are “armed” with special enzymes capable of “digesting” microorganisms, binding and breaking down foreign protein substances and breakdown products formed in the body during vital activity. In addition, some forms of leukocytes produce antibodies - protein particles that attack any foreign microorganisms that enter the blood, mucous membranes and other organs and tissues of the human body. The formation of leukocytes (leukopoiesis) takes place in the bone marrow and lymph nodes.

There are 5 types of leukocytes:

• neutrophils,
• lymphocytes,
• monocytes,
• eosinophils,
• basophils.

When can the white blood cell count increase (leukocytosis)?

• Acute infections, especially if their causative agents are cocci (staphylococcus, streptococcus, pneumococcus, gonococcus). Although a whole series acute infections(typhoid, paratyphoid, salmonellosis, etc.) can in some cases lead to leukopenia (decrease in the number of leukocytes).
• Suppuration and inflammatory processes of various localization: pleura (pleurisy, empyema), abdominal cavity (pancreatitis, appendicitis, peritonitis), subcutaneous tissue(felon, abscess, phlegmon), etc.
• Rheumatic attack.
• Intoxications, including endogenous (diabetic acidosis, eclampsia, uremia, gout).
• Malignant neoplasms.
• Injuries, burns.
• Acute bleeding (especially if the bleeding is internal: into the abdominal cavity, pleural space, joint or in close proximity to the dura mater).
• Surgical interventions.
• Heart attacks internal organs(myocardium, lungs, kidneys, spleen).
• Myelo- and lymphocytic leukemia.
• The result of the action of adrenaline and steroid hormones.
• Reactive (physiological) leukocytosis: exposure to physiological factors (pain, cold or hot bath, physical activity, emotional stress, exposure to sunlight and UV rays); menstruation; period of childbirth.

When can the white blood cell count decrease (leukopenia)?

• Some viral and bacterial infections (flu, typhoid fever, tularemia, measles, malaria, rubella, parotitis, Infectious mononucleosis, miliary tuberculosis, AIDS).
• Sepsis.
• Bone marrow hypo- and aplasia.
• Damage to the bone marrow by chemicals and drugs.
• Exposure to ionizing radiation.
• Splenomegaly, hypersplenism, condition after splenectomy.
• Acute leukemia.
• Myelofibrosis.
• Myelodysplastic syndromes.
• Plasmacytoma.
• Metastases of neoplasms to the bone marrow.
• Addison-Biermer disease.
• Anaphylactic shock.
• Systemic lupus erythematosus, rheumatoid arthritis and other collagenoses.
• Taking sulfonamides, chloramphenicol, analgesics, non-steroidal. anti-inflammatory drugs, thyreostatics, cytostatics.

What is a platelet count (PLT)?

Platelets, or blood platelets, are the smallest among the cellular elements of blood, the size of which is 1.5-2.5 microns. Platelets perform angiotrophic, adhesive-aggregation functions, participate in the processes of coagulation and fibrinolysis, and ensure retraction of a blood clot. They are able to carry circulating immune complexes, coagulation factors (fibrinogen), anticoagulants, biologically active substances (serotonin) on their membrane, and also maintain vasospasm. Platelet granules contain blood clotting factors, peroxidase enzyme, serotonin, calcium ions Ca2+, ADP (adenosine diphosphate), von Willebrand factor, platelet fibrinogen, platelet growth factor.

When does the platelet count increase (thrombocytosis)?

Primary (as a result of proliferation of megakaryocytes):

• essential thrombocythemia;
• erythremia;
• myeloid leukemia.

Secondary (arising against the background of any disease):

• inflammatory processes (systemic inflammatory diseases, osteomyelitis, tuberculosis);
• malignant neoplasms of the stomach, kidney (hypernephroma), lymphogranulomatosis;
• leukemias (megacarytic leukemia, polycythemia, chronic myeloid leukemia, etc.). In leukemia, thrombocytopenia is an early sign, and as the disease progresses, thrombocytopenia develops;
• cirrhosis of the liver;
• condition after massive (more than 0.5 l) blood loss (including after major surgical operations), hemolysis;
• condition after removal of the spleen (thrombocytosis usually persists for 2 months after surgery);
• in sepsis, when the platelet count can reach 1000 * 109/l.;
• physical exercise.

When does the platelet count decrease (thrombocytopenia)?

Thrombocytopenia is always an alarming symptom, as it creates a threat of increased bleeding and increases the duration of bleeding.

Congenital thrombocytopenias:

• Wiskott-Aldrich syndrome;
• Chediak-Higashi syndrome;
• Fanconi syndrome;
• May-Hegglin anomaly;
• Bernard-Soulier syndrome (giant platelets).

Acquired thrombocytopenia:

• autoimmune (idiopathic) thrombocytopenic purpura (a decrease in the number of platelets is due to their increased destruction under the influence of special antibodies, the mechanism of formation of which has not yet been established);
• medicinal (when taking a number of medications, toxic or immune damage to the bone marrow occurs: cytostatics (vinblastine, vincristine, mercaptopurine, etc.); chloramphenicol; sulfonamide drugs (biseptol, sulfodimethoxine), aspirin, butadione, reopirin, analgin, etc.);
• at systemic diseases connective tissue: systemic lupus erythematosus, scleroderma, dermatomyositis;
• for viral and bacterial infections (measles, rubella, chicken pox, influenza, rickettsiosis, malaria, toxoplasmosis);
• conditions associated with increased activity spleen with cirrhosis of the liver, chronic and less often acute viral hepatitis;
• aplastic anemia and myelophthisis (replacement of bone marrow with tumor cells or fibrous tissue);
• megaloblastic anemia, tumor metastases to the bone marrow; autoimmune hemolytic anemia and thrombocytopenia (Evans syndrome); acute and chronic leukemia;
• dysfunction of the thyroid gland (thyrotoxicosis, hypothyroidism);
• disseminated intravascular coagulation syndrome (DIC syndrome);
• paroxysmal nocturnal hemoglobinuria (Marchiafava-Micheli disease);
• massive blood transfusions, extracorporeal circulation;
• during the neonatal period (prematurity, hemolytic disease newborns, neonatal autoimmune thrombocytopenic purpura);
• congestive heart failure, hepatic vein thrombosis;
• during menstruation (by 25-50%).

What is erythrocyte sedimentation rate (ESR)?

This is an indicator of the rate of separation of blood in a test tube with an added anticoagulant into 2 layers: upper (clear plasma) and lower (settled red blood cells). The erythrocyte sedimentation rate is estimated by the height of the formed plasma layer in mm per 1 hour. The specific gravity of erythrocytes is higher than the specific gravity of plasma, therefore, in a test tube, in the presence of an anticoagulant, under the influence of gravity, erythrocytes settle to the bottom. The rate at which erythrocyte sedimentation occurs is mainly determined by the degree of their aggregation, i.e., their ability to stick together. The aggregation of erythrocytes mainly depends on their electrical properties and the protein composition of the blood plasma. Normally, red blood cells carry a negative charge (zeta potential) and repel each other. The degree of aggregation (and therefore ESR) increases with increasing plasma concentration of so-called acute phase proteins - markers of the inflammatory process. First of all, fibrinogen, C-reactive protein, ceruloplasmin, immunoglobulins and others. On the contrary, ESR decreases with increasing albumin concentration. The zeta potential of erythrocytes is also influenced by other factors: plasma pH (acidosis reduces ESR, alkalosis increases), ionic charge of plasma, lipids, blood viscosity, the presence of anti-erythrocyte antibodies. The number, shape and size of red blood cells also influence sedimentation. A decrease in the content of erythrocytes (anemia) in the blood leads to an acceleration of ESR and, on the contrary, an increase in the content of erythrocytes in the blood slows down the rate of sedimentation.

For acute inflammatory and infectious processes a change in erythrocyte sedimentation rate is observed 24 hours after an increase in temperature and an increase in the number of leukocytes.

The ESR indicator varies depending on many physiological and pathological factors. ESR values ​​in women are slightly higher than in men. Changes in the protein composition of the blood during pregnancy lead to an increase in ESR during this period. During the day, fluctuations in values ​​are possible; the maximum level is observed in the daytime.

Indications for the purpose of the study:

• inflammatory diseases;
• infectious diseases;
• tumors;
• screening test during preventive examinations.

When does ESR accelerate?

• Inflammatory diseases of various etiologies.
• Spicy and chronic infections(pneumonia, osteomyelitis, tuberculosis, syphilis).
• Paraproteinemia (multiple myeloma, Waldenström's disease).
• Tumor diseases (carcinoma, sarcoma, acute leukemia, lymphogranulomatosis, lymphoma).
• Autoimmune diseases(collagenoses).
• Kidney diseases (chronic nephritis, nephrotic syndrome).
• Myocardial infarction.
• Hypoproteinemia.
• Anemia, condition after blood loss.
• Intoxication.
• Injuries, bone fractures.
• Condition after shock, surgical interventions.
• Hyperfibrinogenemia.
• In women during pregnancy, menstruation, postpartum period.
• Elderly age.
• Taking medications (estrogens, glucocorticoids).

When does ESR slow down?

• Erythremia and reactive erythrocytosis.
• Severe symptoms of circulatory failure.
• Epilepsy.
• Fasting, decreased muscle mass.
• Taking corticosteroids, salicylates, calcium and mercury preparations.
• Pregnancy (especially 1st and 2nd semester).
• Vegetarian diet.
• Myodystrophies.

What's happened leukocyte formula(Differential White Cell Count)?

The leukocyte formula is the percentage of different types of leukocytes.

Based on morphological characteristics (type of nucleus, presence and nature of cytoplasmic inclusions), there are 5 main types of leukocytes:

• neutrophils;
• eosinophils;
• basophils;
• lymphocytes;
• monocytes.

In addition, white blood cells vary in their degree of maturity. Most of the precursor cells of mature forms of leukocytes (young, myelocytes, promyelocytes, prolymphocytes, promonocytes, blast forms of cells) in the peripheral blood appear only in the case of pathology.

The study of the leukocyte formula is of great importance in the diagnosis of most hematological, infectious, inflammatory diseases, as well as for assessing the severity of the condition and the effectiveness of the therapy.

The leukocyte formula has age-related characteristics (in children, especially during the neonatal period, the ratio of cells differs sharply from adults).

About 60% of the total number of granulocytes is found in the bone marrow, constituting the bone marrow reserve, 40% in other tissues, and only less than 1% in the peripheral blood.

Different types of leukocytes perform different functions, so determining the ratio different types leukocytes, the content of young forms, the identification of pathological cellular forms provides valuable diagnostic information.

Possible options for changing (shifting) the leukocyte formula:

shift of the leukocyte formula to the left - an increase in the number of immature (band) neutrophils in the peripheral blood, the appearance of metamyelocytes (young), myelocytes;

shift of the leukocyte formula to the right - a decrease in the normal number of band neutrophils and an increase in the number of segmented neutrophils with hypersegmented nuclei (megaloblastic anemia, kidney and liver diseases, condition after blood transfusion).

What are neutrophils?

Neutrophils are the most numerous type of white blood cells, they make up 45-70% of all leukocytes. Depending on the degree of maturity and the shape of the nucleus, band (younger) and segmented (mature) neutrophils are distinguished in the peripheral blood. Younger cells of the neutrophil series - young (metamyelocytes), myelocytes, promyelocytes - appear in the peripheral blood in case of pathology and are evidence of stimulation of the formation of cells of this type. The duration of neutrophil circulation in the blood is on average approximately 6.5 hours, then they migrate into tissues.

They participate in the destruction of infectious agents that have entered the body, closely interacting with macrophages (monocytes), T- and B-lymphocytes. Neutrophils secrete substances that have bactericidal effects, promote tissue regeneration by removing damaged cells from them and secreting substances that stimulate regeneration. Their main function is protection against infections through chemotaxis (directed movement towards stimulating agents) and phagocytosis (absorption and digestion) of foreign microorganisms.

An increase in the number of neutrophils (neutrophilia, neutrophilia, neutrocytosis), as a rule, is combined with an increase in the total number of leukocytes in the blood. A sharp decline the number of neutrophils can lead to life-threatening infectious complications. Agranulocytosis is a sharp decrease in the number of granulocytes in the peripheral blood until their complete disappearance, leading to a decrease in the body's resistance to infection and the development of bacterial complications.

When can there be an increase in the total number of neutrophils (neutrophilia, neutrophilia)?

When does the increase in the number of immature neutrophils occur (left shift)?

In this situation, the number of band neutrophils in the blood increases, and metamyelocytes (young) and myelocytes may appear.

This may happen when:

• acute infectious diseases;
• metastases of malignant neoplasms of various localizations;
• initial stage of chronic myeloid leukemia;
• tuberculosis;
• myocardial infarction;
• intoxication;
• state of shock;
• physical stress;
• acidosis and coma.

When does a decrease in the number of neutrophils (neutropenia) occur?

• Bacterial infections (typhoid, paratyphoid, tularemia, brucellosis, subacute bacterial endocarditis, miliary tuberculosis).
• Viral infections(infectious hepatitis, influenza, measles, rubella, chicken pox).
• Malaria.
• Chronic inflammatory diseases (especially in elderly and weakened people).
• Kidney failure.
• Severe forms of sepsis with the development of septic shock.
• Hemoblastosis (as a result of hyperplasia of tumor cells and reduction of normal hematopoiesis).
• Acute leukemia, aplastic anemia.
• Autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, chronic lymphocytic leukemia).
• Isoimmune agranulocytosis (in newborns, post-transfusion).
• Anaphylactic shock.
• Splenomegaly.
• Hereditary forms of neutropenia (cyclic neutropenia, familial benign chronic neutropenia, constant hereditary Kostmann neutropenia).
• Ionizing radiation.
• Toxic agents (benzene, aniline, etc.).
• Vitamin B12 and folic acid deficiency.
• Taking certain medications (pyrazolone derivatives, non-steroidal anti-inflammatory drugs, antibiotics, especially chloramphenicol, sulfonamide drugs, gold preparations).
• Taking antitumor drugs (cytostatics and immunosuppressants).
• Nutritional-toxic factors (eating spoiled overwintered cereals, etc.).

What are eosinophils?

When does the number of eosinophils increase (eosinophilia)?

What are basophils?

The smallest population of leukocytes. Basophils account for an average of 0.5% of the total number of blood leukocytes. In blood and tissue basophils (the latter also include mast cells), they perform many functions: they maintain blood flow in small vessels, promote the growth of new capillaries, and ensure the migration of other leukocytes into tissues. Participate in allergic and cellular inflammatory reactions delayed type in the skin and other tissues, causing hyperemia, exudate formation, and increased capillary permeability. Basophils during degranulation (destruction of granules) initiate the development anaphylactic reaction immediate hypersensitivity. Contain biologically active substances (histamine; leukotrienes, which cause spasm of smooth muscles; “platelet activating factor”, etc.). The lifespan of basophils is 8-12 days, the circulation time in the peripheral blood (like all granulocytes) is several hours.

When does an increase in the number of basophils (basophilia) occur?

• Allergic reactions to food, medications, introduction of foreign protein.
• Chronic myeloid leukemia, myelofibrosis, erythremia, lymphogranulomatosis.
• Hypofunction of the thyroid gland (hypothyroidism).
• Nephritis.
• Chronic ulcerative colitis.
• Hemolytic anemia.
• Iron deficiency, after treatment iron deficiency anemia.
• B12 deficiency anemia.
• Conditions after splenectomy.
• When treated with estrogens, antithyroid drugs.
• During ovulation, pregnancy, at the beginning of menstruation.
• Lungs' cancer.
• Polycythemia vera.
• Diabetes.
• Acute hepatitis with jaundice.
• Ulcerative colitis.
• Hodgkin's disease.

What are lymphocytes?

Lymphocytes make up 20-40% of the total number of leukocytes. Lymphocytes are formed in the bone marrow and actively function in lymphoid tissue. Main function lymphocytes consist in recognizing a foreign antigen and participating in an adequate immunological response of the body. Lymphocytes are a uniquely diverse population of cells, derived from various precursors and united by a single morphology. Based on their origin, lymphocytes are divided into two main subpopulations: T lymphocytes and B lymphocytes. There is also a group of lymphocytes called “neither T-nor B-”, or “0-lymphocytes” (null lymphocytes). The cells that make up this group are identical in morphological structure to lymphocytes, but differ in origin and functional features- immunological memory cells, killer cells, helpers, suppressors.

Different subpopulations of lymphocytes perform different functions:

ensuring effective cellular immunity(including transplant rejection, destruction of tumor cells);

formation of a humoral response (synthesis of antibodies to foreign proteins - immunoglobulins of different classes);

regulation of the immune response and coordination of the work of the entire immune system as a whole (release of protein regulators - cytokines);

ensuring immunological memory (the body’s ability to accelerate and enhance the immune response when it encounters a foreign agent again).

It must be borne in mind that the leukocyte formula reflects the relative (percentage) content of leukocytes of various types, and an increase or decrease in the percentage of lymphocytes may not reflect true (absolute) lymphocytosis or lymphopenia, but be a consequence of a decrease or increase in the absolute number of leukocytes of other types (usually neutrophils ).

When can the number of lymphocytes increase (lymphocytosis)?

• Viral infection (infectious mononucleosis, acute viral hepatitis, cytomegalovirus infection, whooping cough, ARVI, toxoplasmosis, herpes, rubella, HIV infection).
• Acute and chronic lymphocytic leukemia, Waldenström's macroglobulinemia, lymphomas during the period of leukemia.
• Tuberculosis.
• Syphilis.
• Brucellosis.
• Poisoning with tetrachloroethane, lead, arsenic, carbon disulfide.
• When taking certain medications (levodopa, phenytoin, valproic acid, narcotic analgesics and etc.).

When can the number of lymphocytes decrease (lymphopenia)?

• Acute infections and diseases.
• The initial stage of the infectious-toxic process.
• Severe viral diseases.
• Miliary tuberculosis.
• Systemic lupus erythematosus.
• Aplastic anemia.
• Terminal stage oncological diseases.
• Secondary immune deficiencies.
• Kidney failure.
• Circulatory failure.
• X-ray therapy. Taking drugs with a cytostatic effect (chlorambucil, asparaginase), glucocorticoids, administration of antilymphocyte serum

.What are monocytes?

Monocytes are the largest cells among leukocytes (the system of phagocytic macrophages), making up 2-10% of all leukocytes. Monocytes are involved in the formation and regulation of the immune response. In tissues, monocytes differentiate into organ- and tissue-specific macrophages. Monocytes/macrophages are capable of amoeboid movement and exhibit pronounced phagocytic and bactericidal activity. Macrophages - monocytes are able to absorb up to 100 microbes, while neutrophils - only 20-30. At the site of inflammation, macrophages phagocytize microbes, denatured protein, antigen-antibody complexes, as well as dead leukocytes and damaged cells of inflamed tissue, cleaning the site of inflammation and preparing it for regeneration. Secrete more than 100 biologically active substances. They stimulate the factor that causes tumor necrosis (cachexin), which has cytotoxic and cytostatic effects on tumor cells. Secreted interleukin I and cachexin act on the thermoregulatory centers of the hypothalamus, increasing body temperature. Macrophages are involved in the regulation of hematopoiesis, immune response, hemostasis, lipid and iron metabolism. Monocytes are formed in the bone marrow from monoblasts. After leaving the bone marrow, they circulate in the blood for 36 to 104 hours and then migrate into tissues. In tissues, monocytes differentiate into organ- and tissue-specific macrophages. Tissues contain 25 times more monocytes than blood.

When does the number of monocytes increase (monocytosis)?

• Viral infections (infectious mononucleosis).
• Fungal, protozoal infections (malaria, leishmaniasis).
• The recovery period after acute infections.
• Granulomatosis (tuberculosis, syphilis, brucellosis, sarcoidosis, ulcerative colitis).
• Collagenosis (systemic lupus erythematosus, rheumatoid arthritis, periarteritis nodosa).
• Blood diseases (acute monoblastic and myelomonoblastic leukemia, chronic monocytic and myelomonocytic myeloid leukemia, lymphogranulomatosis).
• Subacute septic endocarditis.
• Enteritis.
• Sluggish sepsis.
• Poisoning with phosphorus, tetrachloroethane.

When does the number of monocytes decrease (monocytopenia)?

• Aplastic anemia.
• Childbirth.
• Surgical interventions.
• Shock states.
• Hairy cell leukemia.
• Pyogenic infections.
• Taking glucocorticoids.

What are reticulocytes?

Reticulocytes are young forms of erythrocytes (precursors of mature erythrocytes), containing a granular-filamentous substance, revealed by special (supravital) staining. Reticulocytes are detected both in the bone marrow and in the peripheral blood. The maturation time of reticulocytes is 4-5 days, of which within 3 days they mature in the peripheral blood, after which they become mature erythrocytes. In newborns, reticulocytes are found in greater numbers than in adults.

The number of reticulocytes in the blood reflects the regenerative properties of the bone marrow. Their counting is important for assessing the degree of activity of erythropoiesis (production of red blood cells): when erythropoiesis accelerates, the proportion of reticulocytes increases, and when it slows down, it decreases. In the case of increased destruction of red blood cells, the proportion of reticulocytes may exceed 50%. A sharp decrease in the number of red blood cells in the peripheral blood can lead to an artificial increase in the number of reticulocytes, since the latter is calculated as a percentage of all red blood cells. Therefore, to assess the severity of anemia, the “reticular index” is used: % reticulocytes x hematocrit / 45 x 1.85, where 45 is a normal hematocrit, 1.85 is the number of days required for new reticulocytes to enter the blood. If index< 2 - говорит о гипопролиферативном компоненте анемии, если >2-3, then there is an increase in the formation of red blood cells.

Indications for the purpose of analysis:

• diagnosis of ineffective hematopoiesis or decreased production of red blood cells;
• differential diagnosis of anemia;
• assessment of response to therapy with iron, folic acid, vitamin B12, erythropoietin;
• monitoring the effect of bone marrow transplantation;
• monitoring of erythrosuppressor therapy.

When does the number of reticulocytes increase (reticulocytosis)?

• Posthemorrhagic anemia (reticulocyte crisis, increase 3-6 times).
• Hemolytic anemia (up to 300%).
• Acute lack of oxygen.
• Treatment of B12-deficiency anemia (reticulocyte crisis on days 5 - 9 of vitamin B12 therapy).
• Therapy of iron deficiency anemia with iron preparations (8 - 12 days of treatment).
• Thalassemia.
• Malaria.
• Polycythemia.
• Tumor metastases to the bone marrow.

When does the reticulocyte count decrease?

• Aplastic anemia.
• Hypoplastic anemia.
• Untreated B12 deficiency anemia.
• Metastases of neoplasms to bone.
• Autoimmune diseases of the hematopoietic system.
• Myxedema.
• Kidney diseases.
• Alcoholism.

Determination of erythrocyte sedimentation rate (ESR) is recognized as mandatory by world medicine. A blood test for ESR is necessary for preventive examination, outpatient examination, diagnostic analysis hospitalized patient.

A high rate of red cell deposition indicates ongoing inflammation. ESR is not considered a definitive and exclusive diagnostic test.

Correct interpretation is possible when combined with other analyses. The concentration of white cells is taken into account. The sedimentation rate is affected by the quantitative and conditional composition of red cells.

There are three methods for determining the deposition rate: Westergren's method, Wintrobe's method, Panchenkov's method. Russia determines ESR using the Panchenkov method. What kind of method is this? The blood is mixed with sodium citrate, which has anti-clotting properties. Citrated blood, if allowed to settle, gradually separates into two layers. Upper part the blood vessel is occupied by a transparent, yellowish color, plasma. Red blood cells settle to the bottom of the test tube or tube.

The formation of the erythrocyte layer occurs in 60 minutes in three stages:

• First, “penny columns” are formed. Blood cells form vertically oriented clusters. This phenomenon is observed after ten minutes.
• The tube with blood is left alone for 40 minutes.
• The last minutes of the test are spent gluing the deposited red blood cells.

The taken material is blown out of the capillary into a special recess with a previously added sodium citrate solution. Mix, fill into a thin graduated tube to the top mark, place in a tripod, maintaining an exactly vertical position. Using the lower end of the tube, a label with the patient’s name is drilled. Includes a special laboratory timer with an alarm signal. The height of the erythrocyte column is taken into account by the call. The result is recorded in mm/h.

Rules for taking the analysis

How to donate blood for ESR? The technique is simple, but the results are distorted if certain rules are not followed:

• , in the morning.
• Puncture ring finger make it deep. Squeezing out the drop destroys the cells and distorts the result.
• The requirements for glassware and reagents are met.
• Four volumes of blood are added to one part of sodium citrate solution.
• A blood test for ESR is carried out at room temperature - 20±2°C.

Any inaccuracies in the analysis procedure will distort the results. The training of laboratory personnel is critical. An inexperienced laboratory technician can ruin the analysis.

Norm of indicators

If the blood belongs healthy person, red cells settle slowly. In 60 minutes, the blood stratification is several millimeters. Inflammation attracts excess nitrogen-containing substances and fibrin into the blood, causing red cells to precipitate more quickly. ESR accelerates.

They accept different prices different categories patients size. Physiological, gender, age, and geographical differences occur.

Normal values ​​were determined by extensive examinations. The arithmetic mean is taken as the norm. The greatest differences are observed in newborns, which is confirmed by the data from the erythrocyte sedimentation rate table for children.

ESR norm for a child:

The low erythrocyte sedimentation rate at birth is replaced by a rapid acceleration. The ESR of a two-week-old baby is 10 times higher than that of a baby born today.

The physiological state during pregnancy and body type form their own ESR standards:

The metabolic rate of thin people is higher than that of overweight people; the second trimester of pregnancy is characterized by an increase in the rate.

Differences in age norms of ESR, mm/h:

The red cell sedimentation rate undergoes an age-related increase. Women's red blood cells are deposited at a higher rate than men's. In the elderly, the situation is reversed.

Analysis transcript

Interpretation of ESR, non-specific. indicates inflammation, but does not indicate the cause of the pathology. A specific diagnosis is made based on a comparison of the “two” results - ESR and WBC (leukocytes). Indicators of two are observed in dynamics, day by day.

Focal necrosis of the cardiac muscle is characterized by an increase in WBC at the onset of the disease. ESR does not go beyond the limits. The fifth day is marked by the scissors symptom - leukocytes decrease, erythrocyte deposition accelerates. The dynamics of the pathology are characterized by an acceleration of ESR and normalization of leukocyte concentration. The process of scarring of the heart muscle is controlled by normalizing the ESR level.

ESR sharply accelerates with the development of allergies. A sharp increase in the indicator is characteristic when an autoimmune process of killing body cells by the immune system develops. This is how the symptoms of rheumatoid arthritis and erythematous chronic sepsis manifest themselves.

Deciphering high values ​​of erythrocyte sedimentation rate reveals cancer and reticuloplasmocytosis. The indicator is informative for identifying types of anemia, the degree of traumatic or operational blood loss, nephrological pathologies.

The rate is increased when patients are infected, especially when there are manifestations of secondary bacterial aggression against the background viral pathologies. This happens when scarlet fever, measles, and tuberculosis begin. While inflammation lasts, ESR signals.

For diseases of red blood cells - erythremia, sickle cell anemia, large-scale burns. Low ESR is characteristic of conditions of increased blood viscosity and diagnoses dehydration. This is typical for cholera, hereditary diseases, liver and kidney diseases, which cause a decrease in blood protein levels.

A non-standard result detected once is checked by duplicating the analysis. Constant increase ESR is the basis for a detailed examination.

An accurate diagnosis of the disease causing an increase in erythrocyte sedimentation rate in each case is possible by checking other impartial symptoms of the disease. Clinical examination will detect pathology when clinical manifestations no disease is observed.

The materials are published for informational purposes only and are not a prescription for treatment! We recommend that you consult a hematologist at your medical institution!

ESR stands for " erythrocyte sedimentation rate" This test is a mandatory step in a general examination of the blood condition. Most often, ESR is performed during the diagnosis of various pathologies, examination at a dispensary, or for prevention.

Features of the technique

First, let's figure out what ESR means in a blood test. This test shows the rate at which erythrocyte sedimentation occurs.

A normal ESR blood test indicates that the patient does not have any inflammatory pathologies. However, a diagnosis can be considered correct only if other indicators are taken into account, for example, the leukocyte formula of the blood, various protein fractions, etc.

Important! The result of the study is influenced by the number and condition of the red blood cells themselves.

How to prepare for analysis After this, the hour is recorded, and then the results are calculated based on the height of the resulting column of red blood cells. Thus, red blood cell count readings are measured in mm per hour.

In order for a general ESR blood test to show a realistic level, the patient should prepare for this test:

• The analysis is taken on an empty stomach, so the last meal should be 12 hours before blood sampling.
• The day before blood sampling, it is advisable to avoid smoking and drinking alcohol.

The test procedure involves a number of rules that the laboratory assistant must adhere to:

• The capillary must be filled with blood without air, which collects in characteristic bubbles.
• During the analysis, only dry and well-washed capillaries, as well as fresh reagent, should be used.
• ESR analysis should be carried out at an air temperature of 18-22 degrees.
• The ratio of blood to sodium citrate should be strictly 4:1.

Important! Any deviations from the rules described above may result in incorrect research results. Most often, incorrect test results are caused by the inexperience of the laboratory technician and violation of the technique.

Normal ESR values

Table: ESR norm in comparison with other indicators

Since erythrocyte sedimentation occurs slowly under normal conditions, even after an hour their level should be quite low. The ESR value can increase in various pathologies, which are characterized by an increase in the level of protein and fibrin in the blood.

How is ESR deciphered?

Decoding the ESR blood test is very nonspecific and most often relies on counting the level of leukocytes. For example, if a patient suffers from myocardial infarction in acute form, then an increase in the level of leukocytes is observed in the first hours, while the ESR level remains normal. However, after four days of illness, a drop in white blood cell counts is observed, and the ESR rises sharply.

Often in the clinic you can hear that you need to do an analysis of ESR in the blood. What kind of indicator is this and what role does it play in diagnosis? various diseases? This abbreviation stands for erythrocyte sedimentation rate. This indicator may deviate from the norm in various pathologies. The analysis is the first diagnostic step in case of hospital treatment or the need for surgical intervention.

Description of the analysis

What is ESR? The ESR indicator indicates the erythrocyte sedimentation rate. During laboratory analysis, blood collected from a patient is left for a certain time in a vertical tube.

Red blood cells are heavier than plasma, so after a certain time they settle to the bottom, forming a red sediment. It is this time that specialists measure to evaluate ESR. The speed will be indicated in mm per 1 hour.

What is ROE? Until recently, this was the name given to the familiar ESR analysis. Doctors called it ESR - red blood cell sediment reaction. Today you can still find this name on the forms of individual laboratories.

Norms of indicators

If you received a form with an ROE indicator, now you know that this is the same as ESR. The rate of ROE in the blood depends on the gender and age of the patient. Today, the following indicators are considered to be the norm for erythrocyte sedimentation time: The ROE indicator can increase with protein imbalance in the body. The main reasons for the increase in erythrocyte sedimentation rate are increased level

globulins and fibrinogen. Today, doctors use two main methods for determining ESR in the blood.

Diagnostic methods Modern doctors use following methods

determination of ESR. ROE in the blood is determined by two methods. The most accurate is the Westergren method. The main difference of this method is that the erythrocyte sedimentation rate in the blood is assessed on a more accurate scale. In addition, the patient's blood is taken from a vein. Blood is mixed with an anticoagulant in a test tube. The measurement is carried out exactly after an hour, which gives the correct subsidence indicators in mm/h. However, despite the accuracy of the previous method in our country, the more popular method for determining the subsidence rate erythrocyte ESR

Panchinkova. Determining ESR using this method requires taking blood from a patient’s finger.

The erythrocyte sedimentation reaction is carried out in a special tube marked with a scale in millimeters.

The anticoagulant is added to the blood on a special glass, after which the blood is drawn into a tube. After an hour, the indicator is assessed and designated mm/h. The ESR formula is quite simple and does not require specialists to use additional equipment. After all, what is ESR ROE? This is simply the rate of sedimentation of blood cells.

1. The sedimentation of erythrocytes using this method occurs in several stages:
2. In the first minutes after adding an anticoagulant to the blood, vertical columns of red blood cells form. These are called coin columns.
3. After this period, the stage of cell compaction begins. It takes 10 minutes.

Thus, the ESR mechanism takes 1 hour. This is what gave the unit of measurement ESR its name, mm/h. This method of assessing ESR is used everywhere in our country. The test can be taken at any clinic; the results are usually ready the next day.

Deviations from norms in the direction of increase

It is immediately worth noting that hematology ESR may deviate from the norm due to physiological reasons. This is especially true for women. In the fairer sex, ESR levels may increase in the postpartum period and during menstruation. For this reason, it is better not to get tested these days. There are also people whose ESR is elevated from birth. It is not considered a pathology and they can live with it long years and at the same time be absolutely healthy. But there are no more than 5% of such people on the planet. In addition, the sedimentation rate is influenced by the content of red blood cells in the blood. With anemia of various types, the rate increases.

If the ESR value is increased not due to physiological reasons, we can assume the presence of the following pathologies in the body:

• Inflammatory diseases.
• Intoxication of the body.
• Infectious diseases.
• Acute heart diseases.
• Injuries of various types.
• Oncological diseases.
• Kidney pathologies.
• Anemia.

Thus, we can say that any serious pathologies in the body are accompanied by an accelerated ESR. In addition, ESR can accelerate drug therapy some medications.

Deviations from norms downwards

If your clinical significance shows too slow a reaction, perhaps it is due to an unbalanced or poor diet. Pathological causes include dehydration and muscular dystrophy. In addition, the erythrocyte sedimentation rate can be influenced by their shape. This picture is observed with sickle and star red blood cells.

How to get tested

Establishing ESR does not require special preparatory actions from the patient. Preparation for the analysis includes a standard refusal to eat for 8 hours before the analysis, a ban on alcohol consumption for a week and a decrease in physical activity one day before blood sampling. Remember that ESR and ROE are the same thing, so if your form contains the designation ROE, do not get confused and know that this is an erythrocyte sediment reaction.

How to reduce the indicator

Treatment of accelerated ESR is simply impossible at home. There are no drugs or traditional methods to reduce these indicators. After all, what does the increase in indicators show? It only means that some pathological process is occurring in the body, which is developing and requires treatment. Only a doctor will be able to determine why your analysis showed deviations from the norm.

With help complex diagnostics and deciphering all your blood parameters, the specialist will identify the disease and prescribe adequate treatment.

Today, doctors say that the sedimentation of red blood cells often deviates from the norm for various physiological and third-party reasons. It is precisely because of the instability of this indicator that it is not always possible to talk about the presence in the body terrible disease. So, for example, an increase in ESR in children, what does this mean? If the child is healthy, the increase may indicate banal teething.

What does promotion mean in adults? Often in adults, test results are increased due to medications, diets, lack of vitamins and other third-party factors. For this reason, analysis of ESR is not an accurate diagnostic method, and if the indicators deviate from the norm, additional diagnostics are necessary.

What to do if the cause of the deviation has not been identified

High ESR without visible reasons, what does it mean? Often patients experience an increase in ESR, but doctors cannot determine the cause of this deviation. In this case, there is no need to attribute deviations to laboratory error or physiological factors. The best solution in this situation would be to go full examination body to exclude the presence of hidden pathological processes. Often the ESR can rise with oncology, which has not yet manifested itself. Doctors recommend not to refuse additional diagnostics, because the early stages diseases can be successfully treated.

However, there are cases when the cause of chronic increasing ESR remains a mystery for the doctor and the patient. In this case, no therapy is carried out, because if the cause is not identified, there is simply nothing to treat. For such patients, doctors recommend regularly visiting a doctor, getting tested and monitoring the ESR level at least 2 times a year.

If you have detected an increase in erythrocyte sedimentation rate, there is no need to panic. Most often, deviations in the ESR level are not a sign of fatal diseases. Just like other blood indicators, this analysis can give deviations in different ways, not always pathological reasons. The fact is that the blood reacts very quickly to any external and internal changes. Even a change in weather causes some changes to be detected in the analysis.

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