Download ESR

Practical physiology 2nd year -2012
Dr.BAN DOSH
ESR
The erythrocyte sedimentation rate (ESR), is the rate at which red
blood cells sediment in a period of 1 hour. It is a common hematology
test that is a non-specific measure of inflammation. The ESR is
governed by the balance between pro-sedimentation factors, mainly
fibrinogen, and those factors resisting sedimentation, namely the
negative charge of the erythrocytes (zeta potential). When an
inflammatory process is present, the high proportion of fibrinogen in
the blood causes red blood cells to stick to each other. The red cells
form stacks called 'rouleaux,
Normal values
Males : 2-8 mm/hr
Females: 4-10 mm/hr
Procedures:1. Draw 0.2 ml of venous blood and transfer it to a container of
anticoagulant. Mix the content gently ,don’t shake as it will cause
frothing.
2. Using the Pasteur pipette fill the wintrobe tube from below
upwards .
3. Transfer the tube to its stand and adjust the screws so that it will
remain vertical. Leave the tube undisturbed for one hour, at the
end of which read the mm of clear plasma above red cells.
Practical physiology 2nd year -2012
Dr.BAN DOSH
Physiological variations in ESR
1. Age. ESRis low in infants (0.5mm/hr) .it is gradually increases to
adult levels in the next few years.
2. Sex. It is higher in females,due to lower hematocrit.
3. High altitude. People living at high altitudes have relatively higher
ESR (polycythemia due to hypoxia actually should decrease ESR.
4. Pregnancy. The ESR begins to rise after about 3rd month of
pregnancy and return to normal a few weeks after delivery, this is
because of hemodilution during pregnancy and increased
fibrinogen:albumin ratio are probably the cause of increased
rouleaux formation.
5. Body temperature. ESR varies with body temp, because it affect
the viscosity.
Pathological increased in ESR:1. All acute and chronic infections ,e.g TB,pneumonia.
2. All anemias except spherocytosis, sickle cell anemia and
pernicious anemia.
3. Bone diseases ,TB,osteomyelitis.
4. Connective tissue diseases ,systemic lupus
erythematosis,rheumatoid arthritis.
5. All malignant diseases.
6. Acute non- infective inflammation ,gout.
7. Trauma,surgery.
Practical physiology 2nd year -2012
Dr.BAN DOSH
Pathological Decrease in ESR .
1. Polycythemia,high red cell counts associated with hyoxia due
to heart and lung diseases, such as congestive heart failure,
cong. Heart dis,show low ESR.
2. Anemia, spherocytosis, pernicious anemia and sickle cell
anemia.
3. Afibrinogenemia, decrease or absence of fibrinogen in plasma
,which is genetic disorder, show low ESR.
4. Sever allergic reactions.