Why is the ESR rate in the blood Rise or less?

The ESR means Erythrocyte Sedimentation Rate. 

The rate plays a very important role in the diagnosis of many clinical diseases. In 1896, Polish pathologist Indomund Bryannaki was the first to determine the ESR rate from red blood cells(RBC). We all have questions in the face of any epidemic and complex disease in the medical sector, what is the ESR rate of this patient! Everywhere in the ward or hospital or clinic emergency professors ask juniors doctors, did the patient do complete Blood Count(CBC)? What is the ESR rate? Because having less than one ESR means there can be any pathology. Such as- infection or inflammation! Let’s not know which diseases increase and decrease the ESR rate. 

Usually the normal rate of ESR (westergren methods).

Normal Level of ESR in Westergren Method.

  • Men’s- 0 to 10mm in first 1 hour
  • Women’s- 0 to-20mm in first 1 hour

Normal Level of ESR in Wintrob Method.

  • Men’s- 0 to 10mm in first 1 hour
  • Women’s- 0 to-10mm in first 1 hour

We all know many reasons for the increase in ESR rate, we will know from the beginning today what diseases are likely to occur if the ESR decreases. 

Diseases that can cause ESR rates to decrease

  1. Sickle cell anemia
  2. Polycythemia
  3. Leukemia
  4. Decreased plasma protein levels (due to kidney and liver) 
  5. Congenital heart failure
  6. Hyper viscosity
  7. Microtosis
  8. Sphenocytosis
  9. Decreased fibrogen levels
  10. When the blood sample clots
  11. RBC Abnormality
  12. Protein abnormality
  13. Hemolytic anaemia 
  14. Hypophybroniogen
  15. Technically fault (technologist’s incompetence) etc. 

Reasons for increase in ESR rate

  1. Infection
  2. Inflammation
  3. Pregnant mother
  4. Anemia
  5. Autoimmune Disease (SLE)
  6. Rheumatoid arthritis (gout) 
  7. Rheumatoid Fiber
  8. Typhoid fever
  9. Appendicitis
  10. TB
  11. Cancer
  12. Nephrotic syndrome
  13. ESR may increase in old age
  14. RBC Abnormality
  15. Maligrancy
  16. Technically faulty
  17. Pneumonia

ESR rate may increase or decrease in any short or long term infection or inflammation, etc. 

Mechanism of raise ESR

Rouleaux formation characteristic of RBCs shear fores and viscosity of plasma bridging forces of macromolecules, high Moleculer Weight of fibrogen tends to bessen the negative charge between RBCs and promotes aggregation. Alpha globulin protein are positively charged thus raise ESR level.

CRP (C-reactive protein) is closely related to the increase in ESR rate


Author :

Noman Islam Nirob 

Rangpur Medical College, Rangpur. 

Doctors Gang
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