Will they take on an operation with increased ESR. What is an elevated ESR in the blood? Causes, methods of treatment. ESR analysis methods

At present, medicine has ample opportunities, however, for a particular type of diagnostics, research methods developed almost a century ago have not lost their relevance. The ESR indicator (erythrocyte sedimentation rate), formerly referred to as ROE (erythrocyte sedimentation reaction), has been known since 1918. Methods for its measurement have been defined since 1926 (according to Westergren) and 1935 according to Winthrop (or Wintrobe) and have been used to this day. A change in ESR (ROE) helps to suspect the pathological process at its very beginning, identify the cause and begin early treatment. The indicator is extremely important for assessing the health of patients. As part of the article, we will consider situations when people are diagnosed with elevated ESR.

ESR - what is it?

The erythrocyte sedimentation rate is really a measurement of the movement of erythrocytes under certain conditions, calculated in millimeters per hour. For the study, a small amount of the patient's blood is needed - the calculation is included in the overall analysis. It is estimated by the size of the plasma layer (the main component of blood) remaining on top of the measuring vessel. For the reliability of the results, it is necessary to create conditions under which only the force of gravity (gravity) will affect the erythrocytes. It is also necessary to prevent blood clotting. In the laboratory, this is done thanks to anticoagulants.

The process of erythrocyte sedimentation can be divided into 3 stages:

1. slow settling;
2. Acceleration of sedimentation (due to the formation of erythrocyte columns formed in the process of gluing individual erythrocyte cells);
3. Settling slowdown and complete stop of the process.

Most often, it is the first phase that matters, but in some cases it is necessary to evaluate the result even a day after blood sampling. This is already done in the second and third stages.

Why does the parameter value go up

The level of ESR cannot directly indicate the pathogenic process, since the reasons for the increase in ESR are diverse and are not a specific symptom of the disease. In addition, the indicator does not always change during the course of the disease. There are several physiological processes in which ESR increases. Why, then, is analysis still widely used in medicine? The fact is that a change in ROE is observed at the slightest pathology at the very beginning of its manifestation. This allows you to take emergency measures to normalize the condition, before the disease seriously undermines human health. In addition, the analysis is very informative in assessing the body's response to:

• Conducted drug treatment (use of antibiotics);
• With suspicion of myocardial infarction;
• Appendicitis in the acute phase;
• angina;
• Ectopic pregnancy.

Pathological increase in the indicator

Elevation above 100 mm/h

The indicator exceeds the level of 100 m/h in acute infectious processes:

• SARS;
• sinusitis;
• Flu;
• Pneumonia;
• Tuberculosis;
• Bronchitis;
• Cystitis;
• Pyelonephritis;
• Viral hepatitis;
• Fungal infections;
• malignant formations.

A significant increase in the norm does not occur immediately, the ESR grows for 2-3 days before it reaches a level of 100 mm / h.

When an increase in ESR is not a pathology

Do not sound the alarm if a blood test showed an increase in the rate of sedimentation of red blood cells. Why? It is important to know that the result needs to be evaluated over time (compared to earlier blood tests) and to take into account some factors that may increase the value of the results. In addition, accelerated erythrocyte sedimentation syndrome can be a hereditary feature.

ESR is always increased:

• During menstruation in women;
• When pregnancy occurs (the indicator can exceed the norm by 2 or even 3 times - the syndrome persists for some time after childbirth, before returning to normal);
• When women use oral contraceptives (birth control pills for oral administration);
• In the morning. Known fluctuations in the value of ESR during the day (in the morning it is higher than in the afternoon or in the evening and at night);
• With chronic inflammation (even if it is a common cold), the presence of acne, boils, splinters, etc., a syndrome of elevated ESR can be diagnosed;
• Some time after the completion of treatment for a disease that can cause an increase in the rate (often the syndrome persists for several weeks or even months);
• After eating spicy and fatty foods;
• In stressful situations immediately before the test or the day before;
• With allergies;
• Some drugs may cause this reaction in the blood;
• With a lack of vitamins from food.

An increase in the level of ESR in a child

In children, the ESR indicator may increase for the same reasons as in adults, however, the list above can be supplemented by the following factors:

1. When breastfeeding (neglecting the mother's diet can cause accelerated sedimentation of red blood cells);
2. Helminthiases;
3. The period of teething (the syndrome persists for some time before and after it);
4. Fear of testing.

Methods for determining results

There are 3 methods for calculating ESR manually:

1. According to Westergren. For research, blood is taken from a vein, mixed in a certain proportion with sodium citrate. The measurement is carried out according to the tripod distance: from the upper border of the liquid to the border of red blood cells settled in 1 hour;
2. According to Wintrobe (Winthrop). The blood is mixed with an anticoagulant and placed in a tube marked with divisions. At a high rate of red blood cell sedimentation (more than 60 mm/h), the inner cavity of the tube is quickly clogged, which can distort the results;
3. According to Panchenkov. For research, blood is needed from the capillaries (taken from a finger), 4 parts of it are combined with a part of sodium citrate and placed in a capillary graduated to 100 divisions.

It should be noted that analyzes performed using different methods cannot be compared with each other. In the case of an increased indicator, the first method of calculation turns out to be the most informative and accurate.

Currently, laboratories are equipped with special devices for automated calculation of ESR. Why is automatic scoring popular? This option is the most effective, since it eliminates the human factor.

When making a diagnosis, it is necessary to evaluate the blood test in the complex, in particular, great importance is attached to leukocytes. With normal leukocytes, an increase in ESR may indicate residual effects after the disease; at low - on the viral nature of the pathology; and at elevated levels - to bacterial.

If a person doubts the correctness of the blood tests performed, then you can always double-check the result in a paid clinic. Currently, there is a method that determines the level of CRP - C-reactive protein, it excludes the influence of third-party factors and indicates the response of the human body to the disease. Why hasn't it become widespread? The study is a very costly undertaking, it is impossible for the country's budget to implement it in all public medical institutions, but in European countries they have almost completely replaced the measurement of ESR with the determination of PSA.

One of the most important indicators, which experts pay close attention to, is the ESR.

In women, the rate of ESR in the body varies depending on age, and too high rates indicate the development of inflammation. In the event that the ESR rate in a woman is 30 mm / h, then this may signal an active menstruation or the development of the initial stage of such a pathology as anemia.

Characteristics of the ESR and its functions

ESR is one of the main indicators of a blood test, which indicates the possible presence of an inflammatory process in the body.

ESR is considered an important indicator of a complete blood count, which displays the relationship between the cellular components of blood and plasma. In a healthy person, all blood cells, including red blood cells, have a small electrical charge on their surface, which helps prevent them from sticking together. This property ensures high stability of blood and its rheological properties.

The impact on the body of various adverse factors leads to the fact that the plasma composition is subject to sharp fluctuations. The result of this is a sharp decrease in the charge on the surface of the red blood cells and this causes the blood cells to stick together and settle.

An increase in ESR in the human body in most cases is a signal of the onset of the inflammatory process. The fact is that it is inflammation that causes the formation of a large amount of protein in the blood plasma, which has a certain charge. Such blood cells gradually stick together, and there is a sharp increase in the rate of sediment formation.

It should be remembered that during pregnancy the ESR is mm / h and the reason for such a high rate is considered to be a change in the protein composition of the plasma.

The inflammatory process is usually not observed, but simply there is a change in the metabolism in the body of the expectant mother. It is for this reason that such a high ESR in pregnant women is considered the norm.

A decrease in ESR in the female body occurs with various defects in red blood cells. This can be expressed in a change in their shape or in too much accumulation of red blood cells in the body.

Analysis for ESR

ESR according to Westergren - for him you need to donate venous blood in the morning on an empty stomach

The determination of ESR is a non-specific test of high sensitivity, thanks to which it is possible to diagnose the presence or absence of inflammation in the female body. Such an analysis reveals only the very fact of the presence of inflammation, but is not able to establish the cause of the development of such a pathology.

A woman takes blood from a vein or a finger, and this procedure is usually performed in the morning and always on an empty stomach. To determine the ESR in the blood, experts use the Panchenkov or Westergren method. Two such research methods have much in common, and it is possible to notice differences only with an increase in the settling rate.

The essence of such a study is that a special substance is added to the test tube with the test material, which prevents the natural process of blood clotting. The tube with the contents is left for one hour in a vertical position. After the time has elapsed after the red blood cells have settled, the sedimentation rate is studied, which is measured in millimeters per hour.

Typically, such a blood test does not require any special preparation.

It is important to remember that such a study must be performed in the morning on an empty stomach. In the event that the patient is diagnosed with an inflammatory process, it may be necessary to repeat the blood test after eating in order to monitor the dynamics.

ESR norm in women

The normal value of ESR in the CBC in women varies depending on age and individual characteristics.

In fact, the ESR norm is considered a relative concept, because it depends on various factors:

• general health
• female hormone levels
• patient's age

Medical practice shows that usually the norm of ESR in the fairer sex is this mm / h. The ESR indicator varies depending on the age of the woman and has the following values:

• for women from 18 to 30 years old, the rate is 4-15 mm / h
• in expectant mothers, the ESR rate can reach mm / h
• for women from 30 to 60 years old, the norm is 8-25 mm / h
• in elderly patients, this figure can be from 12 to 52 mm / h

When expecting a child, the ESR indicator may change and is determined by the state of health of the woman and her physique. The best option for a healthy woman is considered mm / h. In the event that the ESR reaches / h, then this may indicate the onset of pregnancy or menstruation at the moment. If such options are impossible, one can suspect the initial stage of such a pathology as anemia or a bacterial infection.

More information about ESR can be found in the video:

When an ESR of 40 mm / h is reached, one can speak of serious disorders in the work of erythrocytes, severe inflammatory processes, or tumors in the stage of their progression. With this indicator of ESR, it is necessary to seek the advice of a specialist and, if necessary, undergo additional studies.

In the event that a general blood test showed an ESR of 60 mm / h, then this signals serious health problems. In most cases, such an indicator is diagnosed in situations where there is an active process of decomposition or suppuration of tissues. A significant excess of the norm can also be observed when chronic pathology passes into the acute stage of the course.

High ESR

A high level of ESR in the blood in women indicates the presence of an inflammatory process

In fact, ESR in the female body is an unstable indicator, however, it can be used to determine the presence of infection in the body. In the event that a woman is diagnosed with an increase or decrease in ESR, then this is not yet a cause for concern.

In most cases, an increase in the rate of sedimentation occurs with colds, flu, or a viral infection. Usually, after the woman recovers, all indicators return to normal.

In some situations, ESR indicators are greatly increased when following a strict diet, or, conversely, when the diet is too dense.

ESR may increase during menstruation, in the first months after the birth of a child, or if the patient is prone to allergic reactions.

The most common causes that lead to an increase in ESR in the female body can be identified:

• injuries and fractures of varying complexity that a woman suffered in the past
• recovery period after surgery
• malfunction of organs such as the liver or kidneys
• severe intoxication of the female body
• progression of tumors of various nature
• inflammation in the lungs
• the development of diseases such as arthritis

In the event that the indicator reaches 30 mm / h, and pregnancy is excluded, then a serious illness can be suspected. In patients, ESR can reach 32 or higher after surgery or a bacterial infection.

In some cases, there is an increase in the ESR when taking certain groups of drugs in which adrenal hormones are present. Often, the sedimentation rate increases with an increased protein content in the urine and deviations from the normal erythrocyte count.

Decline in women

In some cases, there is a decrease in ESR in the female body and this happens for the following reasons:

• severe stress and nervous disorders
• epileptic seizures
• development of leukemia
• following a strict diet
• violation of the circulatory process
• increased viscosity and acidity of the blood
• pathologies that cause an increase in acids and bile pigments in the blood
• taking calcium chloride and aspirin
• pathologies accompanied by a change in the shape of red blood cells

Taking various contraceptive drugs, vitamin A and theophylline causes an increase in the indicator, and aspirin, quinine and cortisol, on the contrary, reduce it. It is for this reason that when conducting a general blood test for ESR, it is necessary to warn the specialist about the drugs taken.

In medical practice, there is such a thing as a false increase in ESR. Most often, the main reason for obtaining false results is technical error. It is for this reason that it is recommended that blood tests be carried out in one laboratory, and preferably at regular intervals. This will allow you to compare the results and avoid any errors.

To date, a complete blood count is considered one of the most informative and simple research methods. Evaluation of the ESR indicator allows you to diagnose various inflammatory processes in the female body in time and start treatment in a timely manner. You can avoid the development of various health problems if you are regularly examined by a specialist.

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What does an elevated ESR mean?

The erythrocyte sedimentation rate (ESR) is an index, which today is of great importance for the purpose of diagnosing the body.

The ESR norm for a full clip is used to diagnose adults and children. Such a test is recommended to be taken annually, and in old age - once every six months. An increase or decrease in the number of bodies in the blood (erythrocytes, leukocytes, platelets, etc.) is an indicator of certain diseases or inflammatory processes. Especially often, diseases are determined if the level of the measured components is increased.

In total, it is quite possible to note the following categories of diseases in which the rate of sedimentation of red blood cells increases:

• Diseases of the kidneys.
• Metabolic and endocrine disorders
• Malignant degeneration of the bone marrow, in which red blood cells enter the bloodstream without being ready to perform their functions.
• Infections.
• Diseases in which there is not only an inflammatory process, but also decay (necrosis) of tissues: purulent and septic diseases; malignant neoplasms; myocardial infarction, lungs, brain, intestines, lung consumption, etc.
• ESR grows very strongly and remains at a high level for a long time in autoimmune diseases. These include a variety of vasculitis, thrombocytopenic purpura, lupus erythematosus, rheumatic and rheumatoid arthritis, scleroderma.
• Hemoblastosis (leukemia, lymphogranulomatosis, etc.) and paraproteinemic hemoblastoses (multiple myeloma, Waldenström's disease).

ESR increased after surgery can be quite long. Do not worry about this, as this is normal, after surgery, the ESR may be elevated for several months.

When elevated ESR in women

The results of the analysis of ESR in women, according to averaged data, are modified within 5-25 mm / h. There are many circumstances that can accelerate the sedimentation of red blood cells.

Causes of increased ESR in the blood in women:

• pregnancy;
• menstruation;
• postpartum period;
• preclimatic period.

A woman is obliged to warn a medical worker if there is any condition from the list above. These conditions are not pathological, yet at this time the concentration of plasma proteins in the blood increases.

Due to monthly blood loss, hemoglobin decreases, anemia may develop. The same thing happens after childbirth, and during the period of bearing the baby, the mother gives him some of the vitamins, thanks to which the indicator becomes high.

In other cases, an approximate calculation by age is used:

• from 4 to 15 mm / h - inlet;
• from 8 to 25 mm / h - inlet;
• from 12 to 52 mm / h - at 60 years and older.

Elevated ESR during pregnancy

During pregnancy, the processes in the female body go in a special way. The protein composition of the blood also varies somewhat, which affects the ESR.

The indicator can jump up to 45 units, and this will not speak of the manifestation of diseases. ESR begins to gradually increase already at the 10th week of pregnancy. The highest value is usually recorded in the third trimester.

Almost a month after the birth, the ESR is also overestimated. The cause is anemia, which has matured even during the gestation of the baby. It activates significant blood thinning and raises the rate of red cell sedimentation.

The size of the ESR is affected by the constitution of a woman. For skinnier future mothers, the indicator grows to a greater extent than for overweight women. A month or a half after the birth of crumbs, the ESR momentarily returns to normal. However, even such objective processes should not be ignored. Only a doctor is able to calculate how normal the pregnancy is and whether everything is in order with the expectant mother.

Causes of increased ESR in children

An increased ESR in children in the blood most likely indicates an infectious-inflammatory process, which is determined not only by the result of the analysis. At the same time, other indicators of the general blood test will also be changed, as well as in children, viral and other diseases will invariably be accompanied by disturbing symptoms and a shift for the worse in the general condition of the child.

In addition, ESR may increase with non-communicable diseases in children:

• rheumatoid arthritis, bronchial asthma, systemic lupus erythematosus in metabolic disorders
• hyperthyroidism, diabetes mellitus, hypothyroidism in anemia, hemoblastoses, blood diseases, diseases accompanied by tissue breakdown
• autoimmune or systemic diseases
• oncological processes, pulmonary tuberculosis and extrapulmonary forms, myocardial infarction and other injuries

• Babies: 2 to 4 mm/h.
• Toddlers under 6: 5 to 11 mm/h.
• Adolescents under 14: 5 to 13 mm/h.
• Young people over 14 years old: 1 to 10 mm/h.
• Girls over 14: 2 to 15 mm/h

The amount of red cell sedimentation can go beyond the normal range in small children if they do not have enough vitamins, or if there was an active process of teething during the test period. In older patients, the body responds by increasing this blood parameter to stress or strong feelings and fears in children.

Causes of increased ESR in men

Often a significant deviation indicates liver disease. It is important to pay attention to healthy ones in time and take all the proper tests. If the red blood cells stick together vigorously, this indicates that the man has an increased level of bile acid in the blood. The reaction of the blood can change when acidity rises. This is what happens with acidosis.

In this situation, the reason for the change in reaction is an unhealthy diet. An increase in the ESR level may be due to immature red blood cells or an increased number of blood cells. This happens with respiratory failure.

Changes in test values ​​can be caused by increased blood viscosity. ESR also increases due to the fact that the balance of various blood proteins changes. The inflammatory process may appear due to the various classes of immunoglobulin.

When the level of ESR in the blood of a man rises, most often you can suspect:

• heart attack,
• Diseases of the kidneys, liver.
• Malignant tumor.
• Hypoproteinemia.

When elevated ESR and low hemoglobin.

Increased ESR - reduced hemoglobin, and vice versa: ESR indicators in practice invariably depend on the amount of hemoglobin.

If the iron-containing protein in the blood is increased, then the ESR decreases all the time. But not many of the patients comprehend the connection between these 2 signs and seek to find out why low hemoglobin and elevated ESR are indicated as indicators of a violation?

ESR in anemia, the erythrocyte sedimentation rate is usually measured by the height parameter (in mm) of the column, which is formed during the precipitation of erythrocytes in a special laboratory tube in 60 minutes.

The level of ROE (erythrocyte sedimentation reaction), which differs from generally accepted standards, is interpreted as an indirect indicator of a painful change in the content of proteins and the concentration of immunoglobulins.

Proteins that can be attributed to the "acute phase" are a heterogeneous group, it includes protease inhibitors and fibrinogen. The synthesis of “sharp” proteins by the body is a specific response of the liver to the ongoing process of inflammation. The inflammatory cytokine (interleukin-6) appears to be the strongest mediator that stimulates the production of "acute phase" proteins in the liver.

In any condition associated with an acute quantitative increase in the proteins of the “acute phase” or an increase in the amount of gamma globulins (mono- and polyclonal hypergammaglobulinemia), the erythrocyte sedimentation rate increases (due to an increase in the dielectric plasma constant), and this inevitably leads to a decrease in hemoglobin level.

Low hemoglobin and ESR are interconnected, because there is a limitation of inter-erythrocyte repulsive forces, and this contributes to erythrocyte aggregation, accelerating their settling. ESR can grow regardless of inflammatory processes, this condition is inherent in patients of middle age, postoperative and pregnant patients.

What do leukocytes and ESR mean?

Leukocytes, they are also white blood cells, are the common name for blood cells that are rather uneven in appearance and functions, which, however, work side by side on the main problem - protecting the body from foreign agents (mainly bacteria, but not only). If speaking in general terms, leukocytes cover foreign particles, and then die together with them, releasing biologically active substances, which, in turn, force the signs of inflammation familiar to all of us: swelling, redness, pain and temperature.

If the local inflammatory reaction is extremely fast and the leukocytes die in large numbers, pus is formed - this is nothing more than the "corpses" of leukocytes that have fallen on the battlefield with the infection.

In the depths of the leukocyte team, there is a division of labor: neutrophils and monocytes are mainly "responsible" for fungal and antibacterial infection, monocytes and lymphocytes - for viral infections and antibody production, eosinophils - for allergies.

On the blood test form, you will see that neutrophils are also divided into segmented and stab.

This division reflects the "age" of neutrophils.

Stab cells are young cells, and segmented cells are mature, mature cells.

The more young (stab) neutrophils on the battlefield, the more active the inflammatory process. It is the bone marrow that sends young soldiers who have not yet been fully fired and trained to the war.

The erythrocyte sedimentation rate (ESR) is an indicator characterizing the ability of erythrocytes to stick together with each other and fall to the bottom of the test tube. This rate increases when the content of inflammatory proteins, primarily fibrinogen, increases. Usually, an increase in ESR is also analyzed as an indicator of inflammation, although other causes of increased ESR occur, for example, when the number of red blood cells decreases in the blood (with anemia).

If you have high ESR and normal white blood cells, then these are most likely the residual effects of a recent infectious disease; this phenomenon is often observed in people who are under stress. To clarify, you need to take additional tests, which the doctor may prescribe based on your complaints or symptoms, if any. Perhaps it makes sense to retake the tests again, perhaps there was an error in the laboratory.

A significant and acute increase in leukocytes and ESR often indicates the presence of an inflammatory process in the body. If low white blood cells and elevated ESR are accompanied by acute fever, then it is likely that this is rheumatoid arthritis. A low white blood cell count is called leukopenia. Its growth can greatly affect human immunity.

An increase in ESR in the blood - possible causes of deviations from the norm

The abbreviation ESR stands for Erythrocyte Sedimentation Rate and is a diagnostic indicator of a blood test at the first stage of diagnosing a patient's condition.

Previously, the designation and abbreviation P (reaction) OE was used. The replacement of the terms ROE by ESR is quite natural, because ROE is the designation of the process of erythrocyte sedimentation itself.

ESR (ESR) is a quantitative indicator of the degree of sedimentation of erythrocytes in a blood sample over a certain period of time. In most, but not all cases, a high erythrocyte sedimentation rate may indicate the presence of an infectious, oncological, or rheumatoid pathology.

ESR norms

In a laboratory study, blood is mixed with anticoagulants, after which a separation reaction occurs into two layers: the lower layer consists of erythrocytes, and the upper one consists of plasma and leukocytes. Therefore, when determining the ESR, the level of leukocytes is immediately calculated.

Research methods

To determine the ESR, two of the most common, non-interchangeable methods are used:

• Panchenkov's method - a traditional method from the heritage of the USSR;
• Westergren's method is the standard of ICSH (International Committee for Standardization of Hematological Research).

Why should the attending physician know exactly the method by which the analysis was carried out? Because in the case of an acceleration of the OE speed, the Westergren method produces higher values.

Important! For more reliable results and an objective picture, you need to re-analyze after 4-6 days.

This is necessary because the results of the study depend on compliance with the storage conditions of the blood sample, so it is better to re-analyze in another laboratory, but be sure to follow the previous examination method.

In the case of elevated ESR in subjectively healthy patients, which occurred without apparent causes and symptoms, it is advisable not to panic and avoid a detailed examination until any complaints appear. A re-analysis should be taken no earlier than after 6 months, after which an annual check is desirable.

Norms for different sex and age

Normal values ​​of erythrocyte sedimentation rate depend on age and gender. After the examination, the obtained ESR value is recorded in mm / h in the ESR column (international designation).

The table below shows normal values ​​for children under 12 years of age, while the gender of the child does not matter.

A low ESR in a child may be a consequence of prolonged diarrhea and dehydration or indicate in favor of chronic circulatory failure, the presence of dystrophic heart diseases.

For children over 12 years old, adults and people over 60, the indicators are graded according to gender. For pregnant women, the ESR rate differs significantly from the average for their age category.

A low rate is possible in the 1st trimester of pregnancy. In pregnant women, ESR returns to normal 3 weeks after delivery. Why does the erythrocyte sedimentation rate increase during pregnancy? This is due to an increase in plasma volume, a shift in the distribution and amount of hemoglobin, an increase in cholesterol and globulin proteins, and a drop in calcium levels.

If a low rate is recorded in an adult, then this indicates a violation of water-salt metabolism or progressive muscle dystrophy. The decrease is typical for starvation, observance of the vegetarian principle of nutrition, and occurs as a result of taking steroid hormones.

Relationship between ESR and leukocytes

In response to the acute phase of the disease (AOF), the main changes in the peripheral blood in an adult are manifested by the acceleration of ESR and the simultaneous development of leukocytosis. An increase in the erythrocyte sedimentation rate and changes in the level of leukocytes directly depends on the type and stage of the disease:

1. If the number of leukocytes increases due to neutrophilic forms, then a person may have bacterial infections. Such an increase also means the possibility of making a diagnosis: rheumatism, pneumonia, tumors with bone metastases, heart attack, uremia, diabetic coma.
2. A decrease in the number of leukocytes per unit volume indicates a suspicion of influenza, histoplasmosis, brucellosis, spleen tuberculosis, abdominal or paratyphoid fever, bone marrow metastases.
3. Why is the production of leukocytes accelerated? Here you should be examined for helminthic invasions, trichinosis. Check for eosinophilic pulmonary infiltrate. Eliminate allergic reactions to food, plant pollen, as well as to vaccines and medicines.
4. An increase in the number of large granular leukocytes means the possibility of damage to the thyroid gland, the presence of benign (rarely) or malignant tumors. The indicators are typical for rheumatoid arthritis, ulcerative colitis, as well as after exposure to high levels of radiation, taking certain drugs and excessive doses of alcohol.
5. If the number of the largest, non-granular forms of leukocytes has increased, then lobar pneumonia, malaria, pulmonary tuberculosis, brucellosis, subacute septic endocarditis (some stages) are possible. Infectious mononucleosis, eosinophilic fever, mumps, lymphogranulomatosis, metastases, ovarian and breast cancer should be excluded.
6. Lymphocytic leukocytosis (rapid growth of leukocytes) indicates the presence of syphilis, tuberculosis, viral hepatitis, brucellosis, mononucleosis.

• accompanies post-traumatic and postoperative periods;
• is a reaction to extensive burns and / or massive blood loss;
• can occur with pathological menstruation, poisoning with nitrobenzene or aniline;
• appear in the early stages of radiation sickness.

Usually, when the infectious process subsides, the total number of leukocytes returns to normal first (eosinophils remain to complete the reaction), and the ESR remains elevated. In such cases, there is no need to worry - the delay is typical and the indicators will return to normal after a few weeks.

Relationship between erythrocyte sedimentation rate and hemoglobin

A low hemoglobin level and a highly elevated ESR require additional studies. Such a combination of indicators in the general analysis accompanies various types of anemia and requires the exclusion of cancerous lesions, rheumatic and renal pathologies.

In some chronic inflammations, the indicator may increase, while the number of red blood cells and the level of hemoglobin in the blood remain unchanged.

Elevated hemoglobin and elevated ESR - this combination can be with certain diseases, conditions, or appear after exposure to certain factors:

• increased glucose in obesity, DM1 and DM2;
• erythrocytosis;
• anemia of the hemolytic type;
• some oncological diseases;
• congenital heart defects;
• hypervitaminosis B12 and B9;
• pregnancy, breastfeeding;
• during menstruation;
• accommodation in the highlands;
• increased workload in athletes.

Reasons for increasing ESR

The reasons for the acceleration of erythrocyte sedimentation can be both physiological and pathological.

First of all, ESR increases due to a protein shift - an increase in the coefficients of the level of fibrinogen, globulins, pH, a decrease in albumin and a supersaturation of erythrocytes with hemoglobin.

The reasons that increase the erythrocyte sedimentation rate in the general blood test include the following groups of diseases:

1. Acute and chronic inflammatory processes of viral or bacterial etiology - pneumonia, rheumatism, syphilis, tuberculosis, sepsis. It should be remembered that bacterial infections give higher ESR than viral ones.
2. Collagenosis and autoimmune pathologies - rheumatoid arthritis, rheumatism, systemic lupus erythematosus, systemic scleroderma, periarteritis nodosa, dermatomyositis, bronchial asthma.
3. Diseases leading to the destruction and necrosis of tissues - heart attacks, strokes, arthrosis, tuberculosis, malignant tumors.
4. Diseases of the liver, biliary tract, intestines, pancreas, kidneys - hepatitis, Crohn's disease, destructive pancreatitis, ulcerative colitis, nephrotic syndrome,
5. Acute conditions that increase blood viscosity - diarrhea, bleeding (including during menstruation), intestinal obstruction, vomiting, blood transfusion.
6. Purulent and septic diseases.
7. Blood diseases - anemia, lymphogranulomatosis, hemoglobinopathies, anisocytosis, sickle-shaped anemia.
8. Endocrine diseases and metabolic disorders - diabetes mellitus, obesity, thyrotoxicosis, cystic fibrosis, thyroid lesions.
9. Cancer lesions of the red bone marrow - leukemia, myeloma, lymphoma.

To confirm the diagnosis, an analysis to determine the level of CRP (C-reactive protein) should be performed. In Europe and the USA, such a study has necessarily and practically replaced the ESR (ROE).

Very high and non-standard increases in ESR

For some diseases or depending on the stage of the course, an increase in ESR may become "uncharacteristic". So, malignant tumors, as a rule, are immediately accompanied by a very sharp increase - up to 80 mm / h. Rates of about 100 mm / h are possible with acute respiratory viral infections, influenza, sinusitis, bronchitis, pneumonia, tuberculosis, pyelonephritis, cystitis, viral hepatitis and fungal infections.

With lobar pneumonia, for quite a long time after recovery, there may be a persistent increase in ESR.

On the first day with acute appendicitis, the indicator remains within the normal range.

With active rheumatism, reduced erythrocyte sedimentation rates give rise to suspicion of the development of acidosis.

With arthrosis of the joints, accompanied by reactive synovitis, it may be logical to accelerate the ESR domm / h.

Physiological (false) increase in ESR

The physiological reasons for the acceleration of ESR include the following factors or effects on the body:

• injuries of tissues, organs - wounds, fractures, operations;
• blood loss;
• intoxication or poisoning with harmful substances;
• helminthiases;
• high cholesterol;
• group B hypervitaminosis, children's beriberi;
• taking medications - morphine, dextran, vitamins A and D, paracetamol (in children);
• vaccination against hepatitis B;
• the use of contraceptive drugs;
• in the postpartum period or during menstruation.

In some other cases, elevated ESR may also be considered safe. This happens in cases where: antiallergic therapy was carried out, the diet was violated (fasting, strict diets), the rule was not followed when passing a general analysis - there was a hearty breakfast before the examination.

The norm of indicators for ESR in the blood in women and why they increase

There is a simple and, which is also very important, inexpensive analysis that helps to determine the presence of an infection in the body, various autoimmune abnormalities, including HIV or cancer at an early stage. It is called the "erythrocyte sedimentation rate" or abbreviated ESR. The fact is that in a healthy body, these little bodies, having a certain charge, repel each other. This is done in the body on purpose so that they can slip through even the narrowest capillaries. If this charge changes, then there will be no push. The red blood cells just stick together. Therefore, the analysis is carried out in a vertical vessel with the addition of a blood clotting neutralizer. Results are measured in mm per hour. That is, how many mm an erythrocyte settles in a period of time equal to an hour.

How to donate blood for ESR

Blood for erythrocyte sedimentation rate, like most tests, should be taken in the morning and on an empty stomach. For a few days, stop taking sedatives, sleeping pills, limit physical activity. Fatty and spicy foods will also be superfluous, and, as expected, fried food is also impossible. The same applies even to fluorography or x-rays. And it is better that the results are checked by the attending physician. He already knows what the previous tests were like, how the patient usually has an indicator, and will immediately notice the slightest deviation from the individual norm.

Attention! ESR shows results that are different from the norm, not always due to negative reasons. This is especially true for women. Therefore, with negative results, it is worth studying a person’s health in more depth so as not to miss the onset of a serious illness. But “healing” a healthy person is also bad.

Permissible ESR in women

In the fair sex, the rate of erythrocyte sedimentation varies depending on the age category. So in children, this figure is not large - it can reach only from 7 to 10 mm / h. When the transition period begins and hormones go off scale, the rate increases already domm / h. Older women have a wider range of values ​​- from 2 to 15 mm / h. This is due to the menstrual cycle. After 40 years, the rate again rises domm / h.

However, it is worth monitoring the presence of oncological diseases. Even at an early stage, they almost instantly change the value of the speed in the patient.

The doctor can give a referral for ESR if the girls have symptoms:

• anemia (various forms and stages);
• neck/pelvic/head/shoulder pain;
• poor appetite and, consequently, weight loss;
• low mobility of the joints or limbs in general.

Also, women themselves can ask for this analysis from a specialist or do it in a commercial organization / laboratory.

Causes of increased ESR in women

In fact, there are many reasons for a change in one direction or another in the erythrocyte sedimentation rate. Therefore, we highlight the main ones:

those that do not show problems in the body, and, on the contrary, signal danger. The "not terrible" include:

• common cold;
• increased physical activity;
• the menstrual cycle (before menstruation, the indicator usually jumps up, and by the middle of the week it drops to normal);
• postoperative period (including caesarean or natural childbirth);
• pregnancy (starting from about the fifth week, it can reach 40 mm / h, taking into account the absence of complications. Such a jump can also provoke toxicosis, especially if it is severe);
• the period of lactation and breastfeeding (here, many indicators do not behave standardly, not only SOE. Even the temperature in the chest area is always above normal);
• taking hormonal drugs or contraceptives.

The "bad" causes, harbingers of disease, include:

• myocardial infarction and after the infarction period;
• tuberculosis;
• high cholesterol;
• infectious diseases (including HIV or syphilis);
• thyroid diseases (endocrine);
• problems with the immune system (when the body begins to consider its own tissues as a dangerous foreign body and destroys itself, for example, lupus, arthritis, and the like);
• diseases of the blood or blood-forming tissues;
• weight and / or metabolism disorders (courts include diets, fasting, sudden weight gain or vice versa);
• severe poisoning;
• vasculitis (systemic);
• and so on.

Important! However, if a woman's ESR is normal, this does not mean the absence of any disease.

It may well be that the body has not yet had time to react to the “irritant”. If the indicator deviates from the generally accepted standard, but the rest of the tests are good and the diagnosis cannot be made, then the girls are placed for observation in the clinic until the erythrocyte sedimentation rate normalizes or other deviations appear that can help make a diagnosis.

Is it dangerous to reduce ESR in women

First of all, you need to decide what is the reason for the drop in the level of ESR in the body:

• with starvation or a vegetarian diet;
• when taking a certain list of drugs (for example, aspirin or calcium);
• heart failure and/or poor circulation;
• leukemia;
• with non-standard blood viscosity;
• hemoglobinopathies;
• increased acidity and a large amount of bile pigments (jaundice, hepatitis, etc. are suitable here);
• epilepsy or nervous disorders;
• etc.

Attention! If the patient is taking hormonal drugs, oral contraceptives should definitely tell the doctor about it. And specify exactly what. Because vitamin A, for example, increases the erythrocyte sedimentation rate, while aspirin, on the contrary, lowers it.

ESR during pregnancy and lactation, as well as after surgery

I would like to remind once again that the so-called erythrocyte sedimentation rate primarily depends on the composition of the plasma and the number of these same bodies. And during pregnancy, a woman's body is constantly rebuilt to ensure the normal development and safety of the fetus. Therefore, during this period, doctors prescribe an analysis of the reaction of erythrocytes extremely rarely due to its meaninglessness. The same goes for breastfeeding. It should be noted that the peak of the increase in the level of ESR occurs approximately 3-5 days after birth. This is due to the body's reaction to injuries received when the baby was born. It doesn't have to be any complications. Even just the removal of the amniotic sac is already regarded as a signal for a change in blood plasma. This also includes the post-operative, so-called rehabilitation, period. For a long time after surgery, the body will still return to normal, therefore, the composition of the plasma, and the number of red blood cells, along with the rate indicator, too.

In conclusion, I would like to say that you should never resort to self-treatment. Especially in this matter. There are a lot of reasons for increased ESR, so it’s almost impossible to independently determine what happened, or get really correct advice on the forum. Everyone will repeat about his own or subtracted method, leading astray. At the same time, time so important for some diseases will be lost. Therefore, trust your health and future only to professionals. Do not create unnecessary problems for yourself and your loved ones.

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Previously, it was called ROE, although some still use this abbreviation out of habit, now they call it ESR, but in most cases they apply the middle gender (increased or accelerated ESR) to it. The author, with the permission of readers, will use the modern abbreviation (SOE) and feminine (speed).

1. Acute and chronic inflammatory processes of infectious origin (pneumonia, syphilis, tuberculosis,). According to this laboratory test, one can judge the stage of the disease, the remission of the process, and the effectiveness of therapy. Synthesis of "acute phase" proteins in the acute period and enhanced production of immunoglobulins in the midst of "military operations" significantly increase the aggregation ability of erythrocytes and the formation of coin columns by them. It should be noted that bacterial infections give higher numbers compared to viral lesions.
2. Collagenosis (rheumatoid arthritis).
3. Heart damage (- damage to the heart muscle, inflammation, synthesis of "acute phase" proteins, including fibrinogen, increased aggregation of red blood cells, formation of coin columns - increased ESR).
4. Diseases of the liver (hepatitis), pancreas (destructive pancreatitis), intestines (Crohn's disease, ulcerative colitis), kidneys (nephrotic syndrome).
5. Endocrine pathology (, thyrotoxicosis).
6. Hematological diseases (,).
7. Injury to organs and tissues (surgical operations, wounds and bone fractures) - any damage increases the ability of red blood cells to aggregate.
8. Lead or arsenic poisoning.
9. Conditions accompanied by severe intoxication.
10. Malignant neoplasms. Of course, it is unlikely that the test can claim to be the main diagnostic feature in oncology, but its increase one way or another will create many questions that will have to be answered.
11. Monoclonal gammopathy (Waldenström's macroglobulinemia, immunoproliferative processes).
12. High cholesterol ().
13. Exposure to certain drugs (morphine, dextran, vitamin D, methyldopa).

However, in different periods of one process or in various pathological conditions, ESR does not change in the same way:

• A very sharp increase in ESR up to 60-80 mm/hour is typical for myeloma, lymphosarcoma and other tumors.
• Tuberculosis in the initial stages does not change the erythrocyte sedimentation rate, but if it is not stopped or a complication joins, the indicator will quickly creep up.
• In the acute period of infection, the ESR will begin to rise only from 2-3 days, but may not decrease for quite a long time, for example, with lobar pneumonia - the crisis has passed, the disease is receding, and the ESR is holding on.
• It is unlikely that this laboratory test can help on the first day of acute appendicitis, since it will be within normal limits.
• Active rheumatism can take a long time with an increase in ESR, but without frightening numbers, however, its decrease should alert in terms of the development of heart failure (, acidosis).
• Usually, when the infectious process subsides, the total number of leukocytes is the first to return to normal (and remain to complete the reaction), the ESR is somewhat late and decreases later.

Meanwhile, the long-term preservation of high ESR values ​​(20-40, or even 75 mm / h and above) in infectious and inflammatory diseases of any kind, most likely, will lead to the idea of ​​complications, and in the absence of obvious infections, the presence of any then hidden and, possibly, very serious diseases. And, although not in all oncological patients, the disease begins with an increase in ESR, however, its high level (70 mm / h and above) in the absence of an inflammatory process most often occurs in oncology, because sooner or later the tumor will cause significant damage to tissues, damage to which will ultimately As a result, the erythrocyte sedimentation rate will increase.

What can a decrease in ESR mean?

Probably, the reader will agree that we attach little importance to the ESR if the numbers are within the normal range, however, a decrease in the indicator, taking into account age and gender, to 1-2 mm / hour will still raise a number of questions from especially curious patients. For example, a general blood test of a woman of reproductive age, with repeated examination, “spoils” the level of erythrocyte sedimentation rate, which does not fit into physiological parameters. Why is this happening? As in the case of an increase, a decrease in ESR also has its own reasons, due to a decrease or lack of the ability of red blood cells to aggregate and form coin columns.

Factors leading to such deviations include:

1. Increased blood viscosity, which, with an increase in the number of red blood cells (erythremia), can generally stop the sedimentation process;
2. Change in the shape of red blood cells, which, in principle, due to their irregular shape, cannot fit into coin columns (crescent, spherocytosis, etc.);
3. Changes in physical and chemical parameters of blood with a downward shift in pH.

Such changes in the blood are characteristic of the following conditions of the body:

• (hyperbilirubinemia);
• Obstructive jaundice and, as a result, the release of a large amount of bile acids;
• and reactive erythrocytosis;
• sickle cell anemia;
• Chronic circulatory failure;
• Decreased fibrinogen levels (hypofibrinogenemia).

However, clinicians do not consider a decrease in the erythrocyte sedimentation rate to be an important diagnostic indicator, so the data are given specifically for especially inquisitive people. It is clear that in men this decrease is generally not noticeable.

It will definitely not work to determine an increase in ESR without an injection in the finger, but it is quite possible to assume an accelerated result. An increase in heart rate (), an increase in body temperature (fever), and other symptoms indicating the approach of an infectious and inflammatory disease may be indirect signs of a change in many hematological parameters, including the erythrocyte sedimentation rate.

Video: clinical blood test, ESR, Dr. Komarovsky

Asked by: Alexey

Question created: 2015-11-20 18:19:00

Good afternoon

Is a high ESR (42) and low hemoglobin (103) a contraindication for cataract surgery (replacement of the lens in one eye). Elderly man 78 years old. It is not possible to change blood parameters within a year. The problem may be in kidney stones and in the condition of the prostate gland, which cannot be cured.

Doctors at the Central Regional Hospital refuse to perform eye surgery.

Answer from an ophthalmologist

Hello Alexey.

Indeed, before cataract surgery, the patient undergoes a series of tests (including hemoglobin and ESR), which are first reviewed by the therapist (hereinafter referred to as the surgical anesthesiologist) and gives a conclusion about the possibility or contraindications for surgery.

In your case, a significant increase in the erythrocyte sedimentation rate (ESR) is more important, which is increased, in fact, by 4 times. Which may indicate the presence of an infectious or autoimmune process, oncology, etc., which may negatively affect the results of the operation. Therefore, doctors refuse to perform cataract surgery.

The level of hemoglobin, of course, is also taken into account, but given that the operation is performed under local anesthesia and is bloodless, this indicator is not as important as the first.

You can try to contact other clinics (commercial) pointing out the features of the tests. Perhaps they will make an exception for you (but without any guarantees).

27.03.2014, 15:07

Good afternoon
For more than 10 years, a mother (67 years old) has an increased ESR (35-52) in a state of remission of chronic diseases. she, of course, has a "bouquet" of diseases, but doctors do not establish any of them as the reason for such a constantly elevated value.
The mother's high ESR value has been constant for many years to this day. Prior to the discovery of rheumatoid arthritis in 2006, her general condition did not cause her discomfort in this analysis. Doctors have long given up - obviously, such a feature of the body.
At the moment, my mother was diagnosed with a cataract and surgery is indicated for her. The ophthalmologist surgeon refuses to perform it because of ESR. sent to treat/lower ESR.
Tell me, in what direction can I conduct an examination in order to establish the cause and then carry out treatment?
The last, more complete description of the state of health of the mother in the Statement of the First Medical Institute (December 2013).

27.03.2014, 15:17

here is the extract

27.03.2014, 16:18

change an ophthalmologist surgeon to a more sane one - today he finds fault with SOE, tomorrow with unhealed caries ...
And increased SOE is NOT treated!

27.03.2014, 20:04

I may have misrepresented the words of the ophthalmologist. He sent my mother to look for the cause of a bad blood test and to be treated.
Or do you think that this is a feature of the body? How then to force doctors not to pay attention to such values? They regard this as the presence of an inflammatory process. And strong. Even in the sanatorium they told her: we can’t prescribe any procedures for you - you have such an ESR! Who sent you to the sanatorium?
And why is there such an ESR? Is it useless to search for a reason? ..

27.03.2014, 20:15

"How to force doctors not to pay attention to such values?" - similarly, how to force the traffic police inspector not to give the driver a punishment for expired paracetamol in the auto-first aid kit?

27.03.2014, 20:23

But she had such meanings before reaching old age ...

27.03.2014, 20:27

27.03.2014, 20:28

Why is ESR increased in older women and what additional examination is required, read here:

Thank you very much, doctor... It is very correct to send me to study specialized medical information on an English site

27.03.2014, 20:42

The criticality of the search for the cause has arisen now. For refusing to perform eye surgery. Previously, this did not prevent any specialist from carrying out treatment and even surgery (knee arthroplasty last year).

I am not duplicating my question. I tried to get advice from eye specialists. Here I asked a question to hematologists. I have one mother and her tests are the same. Excuse me

27.03.2014, 21:08

I repeat - this is not your mother's fault or her SOE, but the vain bias of a particular specialist. She has nothing to do with medicine. Or you change a specialist or go to a rheumatologist and take a certificate that your mother has a promotion. SOE of non-inflammatory genesis (the latter is unlikely to help, because there is some other far-fetched reason not to undertake an operation).

28.03.2014, 09:34

what prevented you from taking care of your mother and conducting the necessary face-to-face consultations and additional examinations in accordance with global recommendations ??? Note that some causes of increased ESR cannot be corrected ...
And yet - in vain you duplicate topics on the forum: it will not end in anything good for you ...
Why is ESR increased in older women and what additional examination is required, read here:
[Only registered and activated users can see links]

I accept the advice to change the doctor, undergo an additional examination according to international standards and read the American website, I accept it with great gratitude.
Of course, we will change doctors. only the service region will have to be changed.
In the region where my mother lives, there is only one ophthalmologist surgeon in the whole republic.
Neither my mother nor I have the knowledge of English, and even to read the site of medical specialization. The consultation was requested in the RU zone, I have the name of a Russian city in my profile. Please pay attention to this fact.

I strongly recommend not to discuss the actions of the moderator on this forum anymore! Pay a specialist - and he will become both sensitive and attentive ...
The moderator is right about everything and does whatever he likes (including placing posts and then deleting them). Got it.

Seek other doctors
If, nevertheless, it is possible for professionals in the field of care in matters of human health to give free consideration to a request for advice within this forum and in the hematology section in particular, I ask for it.
Since the original question remained unsolved for me, I will repeat it again:
Tell me, please, in what direction / volume can a survey be carried out in order to establish the cause of the long-term high ESR?
Big request - in Russian!
If it is impossible to obtain such information for free, then please clarify what kind of advice can be obtained on this forum?

28.03.2014, 09:56

The survey is meaningless, therefore, there can be no recommendations for its conduct. Elevated ESR in itself should not be grounds for refusing surgery. Vadim Valeryevich pointed out two possible options for you: change a doctor / health facility or get a "paper" that this increase is "safe".

28.03.2014, 10:22

Good afternoon
For more than 10 years, the mother (67 years old) has an increased ESR (35-52), even in a state of remission of chronic diseases. At the same time, her general condition does not cause discomfort in such an analysis. she, of course, has a "bouquet" of diseases, but doctors do not establish any of them as the reason for such a constantly elevated value.
The mother's high ESR value has been constant for many years to this day. Doctors have long given up - obviously, such a feature of the body.
A blood test conducted in March 2014 showed an ESR of 50.
Mom lives in a republic in the south of the country. the level of medical care corresponding to the subsidized region. But she underwent examinations in the capital's medical institutions for rheumatoid arthritis: the Institute of Rheumatology of the Russian Academy of Medical Sciences (2 years ago), the First Medical Institute (December 2013). everyone also shrugged - such an ESR has nothing to do with rheumatoid arthritis.
Last year, my mother underwent a planned operation under general anesthesia - knee arthroplasty. No one paid attention to the ESR.

At the moment, my mother was diagnosed with a cataract and surgery is indicated for her. The ophthalmologist surgeon refuses to perform it because of ESR. sent to look for the cause of such an ESR and be treated. only then he agrees to operate.
There is only one surgeon in the whole republic. there is no one else to turn to at the place of residence. Apparently, you will have to go to a specialized clinic in another region. I would not want to take my mother to another city in vain, so I ask for advice.
How critical is such a consistently high ESR for cataract eye surgery? Or does it depend on the method of operation?