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Synonyms
- Erythrocyte Sedimentation Rate
- ESR
- Westergren Sedimentation Rate
Test Details
Turnaround Time
Within 1 day
Use
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 (ie, presence of sickle cells or spherocytes). Extreme plasma viscosity will result in a decreased ESR.
Methodology
Modified Westergren; automated and manual methods are employed.
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 8 to 10 times once tube is filled at time of collection.