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Clinical utility of
the erythrocyte sedimentation rate
O. O. Alao
Department of Haematology and Blood Transfusion, College of
Health Sciences, Benue State University, Makurdi, Nigeria.
E-mail: ooalao@yahoo.com.
Tel: +234-8035885039.
Accepted 16 June, 2010 |
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The erythrocyte sedimentation rate (ESR) determination is a
commonly performed simple and inexpensive laboratory test
with various acclaimed diagnostic implications. While the
test remains helpful in the specific diagnosis of a few
conditions, there is diverse opinion on the exact
significance and implications of an elevated ESR. This paper
examines the physiological basis, the diagnostic
significance, the emerging alternatives of monitoring
disease activity, various factors and determinants of this
simple and inexpensive laboratory tool. Literature on the
subject was reviewed using manual library search, electronic
books such as CD-ROMS and journals articles published by
various authors on the subject; it also included internet
search on relevant aspects of the topic. The ESR is helpful
in the specific diagnosis of a few conditions, notably
temporal arteritis, polymyalgia rheumatica and possibly
rheumatoid arthritis. It may predict relapse in patients
with Hodgkin’s disease. An extreme elevation of the ESR is
strongly associated with serious underlying disease. When an
increased ESR is encountered with no obvious clinical
explanation, the physician should repeat the test after an
appropriate interval rather than pursue an exhaustive search
for occult disease. The usefulness of the ESR is becoming
limited as a result of low sensitivity and specificity and
emergence of new methods of evaluating disease.
Nevertheless, it still remains a key diagnostic criterion
for a few conditions.
Key words:
Clinical, utility, erythrocyte, sedimentation, rate. |
