Kushner I, Ballou SP. Acute-phase reactants and the concept of inflammation. In: Firestein GS, Budd RC, Harris ED, et al, eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 52.
Pisetsky DS. Laboratory testing in the rheumatic diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 278.
ESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate."
It is a test that indirectly measures how much inflammation is in the body.
Erythrocyte sedimentation rate; Sed rate; Sedimentation rate
A blood sample is needed. For information on how this is done, see: Venipuncture
The blood sample is sent to a lab. The test measures how fast red blood cells called erythrocytes fall to the bottom of a tall, thin tube.
There are no special preparations needed.
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
A "sed rate" is often ordered for someone who is having unexplained fevers, certain types of arthritis, muscle symptoms, or other vague symptoms that cannot be explained.
Once a diagnosis has been made, this test may be used to monitor whether the illness is becoming more active or flaring up.
This test can be used to monitor inflammatory diseases or cancer. It is a screening test, which means it cannot be used to diagnose a specific disorder.
However, it is useful for detecting and monitoring:
- Autoimmune disorders
- Certain forms of arthritis
- Inflammatory diseases that cause vague symptoms
- Tissue death
- Tuberculosis
Adults (Westergren method):
- Men under 50 years old: less than 15 mm/hr
- Men over 50 years old: less than 20 mm/hr
- Women under 50 years old: less than 20 mm/hr
- Women over 50 years old: less than 30 mm/hr
Children (Westergren method):
- Newborn: 0 to 2 mm/hr
- Newborn to puberty: 3 to 13 mm/hr
Note: mm/hr. = millimeters per hour
Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.
Although it can help diagnose some illnesses, an abnormal ESR does not prove that you have a certain condition. Other tests are almost always needed.
An increased ESR rate may be due to:
- Anemia
- Cancers such as lymphoma or multiple myeloma
- Kidney disease
- Pregnancy
- Thyroid disease
The immune system helps protect the body against harmful substances. In autoimmune disorder is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. ESR is often higher than normal in people with an autoimmune disorder.
Common autoimmune disorders include:
Very high ESR levels occur with less common autoimmune disorders, including:
- Allergic vasculitis
- Giant cell arteritis
- Hyperfibrinogenemia (increased fibrinogen levels in the blood)
- Macroglobulinemia - primary
- Necrotizing vasculitis
- Polymyalgia rheumatica
An increased ESR rate may be due to some infections, including:
- Body-wide (systemic) infection
- Bone infections
- Infection of the heart or heart valves
- Rheumatic fever
- Severe skin infections, such as erysipelas
- Tuberculosis
Lower-than-normal levels occur with:
- Congestive heart failure
- Hyperviscosity
- Hypofibrinogenemia (decreased fibrinogen levels)
- Low plasma protein (due to liver or kidney disease)
- Polycythemia
- Sickle cell anemia
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
- Excessive bleeding
- Fainting or feeling light-headed
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Review Date: 6/1/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2010 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
