Erythrocyte

2. Definition .
History .
Factors influencing E.S.R .
Stages of ESR .
westergren,s method .
Procedure-westergren .
ESR- normal values ( westergren,s) .
Clinical significance of ESR .
Limitation of ESR .
References .

3.  The length of fall of the top of the column of RBCs in a
given interval of time is called ERYTHROCYTE
SEDIMINTATION RATE

4. o The ESR was invented in 1897 by polish doctor
EDMUND BIERNACKI .
o In 1918 Swedish pathologist ROBERT SANNO
FAHRAEUS declared the same & along with ALF
VILHELM WESTERGREN are remembered for
FAHRAEUS-WESTERGRE TEST .

5.  FACTORS THAT INCREASE ESR
 OLD Age
 Gender ( females higher than males)
 PREGNANCY
 ANEMIA
 RBCS ABNORMALITIES ( MACROCYTOSIAS …)
 TECHNICAL FACTORS ( DILUENT PROBLEMS – TILTED ESR
TUBE …)
 ELEVATED FIBRINOGEN LEVEL
 INFECTION
 INFLAMMATION
 MALIGNANCY

6.  FACTORS THAT DECREASES ESR
 EXTREME LEUKOCYTOSIS
 POLYCYTHEMIA
 RBCS ABNORMALITIES ( SPHEROCYTOSIS –
ACANTHOCYTOSIS – MICROCYTOSIS )
 TECHNICAL FACTORS ( INADEQUANTE MIXING –
CLOTTED BLOOD SAMPLE – VIBRATION DURING
TESTING )
 PROTIEN ABNORMALITIES
 HYPOFIBRONGENEMIA

7.  INITIAL 10 MINUTES - little sedimentation as
Rouleaux formation – STAGE OF ROULEAUX .
 Next 40 minutes – settling occurs at constant rate –
STAGE OF SEDEMTATION
 Final 10 minutes – sedimentation slows as cell pack at
bottom of tube .

8. 30 cm long 2.5 mm internal diameter .
Calibrated from 0-200 .
Capacity 1 ml
ESR rack for vertical tube .
Reagent – 0.105 m of sodium citrate is used as
anticoagulant – diluents .

10. • Add 1 ml of whole blood to the diluent tube & mix .
• Fill pipette up to zero mark .
• Place pipette in vertical position in ESR rack at room
temperature .
• After 1 hour distance from 0 mark to top of RBC
column is recorded as ESR .

12.  MEN ……from 0 to 30 mm in hr
 Women …..from 0-35 mm in hr
 Pregnancy
First half ….48 (62 if anemia) .
Second half …..70 ( 95 if anemia ) .

13.  To follow the course of disease .
 To establish prognosis in certain chronic diseases .
 Increase in two or more consecutive tests indicates
continuation of increased activity .
 To distinguish between organic / non organic
disorders .
 To support the diagnosis .

14.  ESR is non specific phenomenon & reflects only
chance in plasma proteins pattern & variation in red
cell count .
 Cannot be used as a diagnostic tool .
 Does not indicate the nature of disease.

15.  HENRY,S CLINICAL DIAGNOSIS & MANAGEMENT BY LAB .
METHODS 21/E.
 DACIE & LEWIS PRACTICAL HEMATOLOGY 10/E
 T.B. OF MEDICAL LAB TECHNOLOGY – GODKAR 2/E
 VARIOUS INTERNET SITES