Erythrocyte Sedimentation Rate

CPT 85652
Synonyms

 

  • ESR
  • Sed Rate

 

Test Details

Use

This test is used to evaluate the nonspecific activity of infections, inflammatory states, autoimmune disorders and plasma cell dyscrasias.

Limitations

Optimum results are from blood less than two hours old. The ESR is of limited diagnostic value in severe anemia or in hematologic states that affect increased size and shape variation (poikilocytosis) of the RBC (i.e., presence of sickle cells or spherocytes). Extreme plasma viscosity will result in a decreased ESR.

Methodology

Method varies depending on the instrument/reagent used. All methods used correlate well with the Westergren method.

References

Gambino SR, Dire JJ, Monteleone M, et al. The Westergren sedimentation rate using K3 EDTA. Tech Bull Regist Med Technol. 1965; 35:1-8.
Harmening D. Clinical Hematology and Fundamentals of Hemostasis. 2nd ed. Philadelphia, Pa: Lippincott;1992:532-534.

Additional Information

Elevations in fibrinogen, α- and β-globulins (acute phase reactants), and immunoglobulins increase the sedimentation rate of red cells through plasma. The test is important in the diagnosis of temporal arteritis, as well as its management.1

Specimen Requirements

Information on collection, storage, and volume

Specimen

Whole blood

Volume

Tube fill capacity

Minimum Volume

2 mL (Note: This volume does not allow for repeat testing.)

Container

Lavender-top (EDTA) tube

Storage Instructions

Refrigerate.

Causes for Rejection

Hemolysis; clotted specimen; underfilled tube; specimen older than 24 hours; improper labeling; transfer tubes with whole blood; specimen received in any anticoagulant other than EDTA; specimen diluted or contaminated with IV fluid; patient specimen with presence of cold agglutinins or cryoglobulins; specimen received with plasma removed

Collection

Invert tube immediately eight to 10 times once tube is filled at time of collection.