1) The ESR (erythrocyte sedimentation rate) can be affected by physiological factors like age, sex, pregnancy, and temperature, as well as pathological conditions like tuberculosis, anemia, tumors, arthritis, liver disease, and infections. 2) The ESR is determined by several blood factors including red blood cell size, count, and properties as well as plasma proteins. Conditions that increase these factors like inflammation will raise the ESR while those that decrease them will lower it. 3) The ESR is a nonspecific test used to help diagnose diseases, determine disease severity, and monitor treatment response for certain inflammatory conditions, though it does not make a diagnosis on its own.

1. Interpretation
of blood reports

2. PHYSIOLOGICAL
RISE
• Age
• Females
• Menstruation
• Pregnancy
•  Temp.
PATHOLOGICAL VARIATION
• Tuberculosis
• All types of anemia
except SCA
• Malignant tumors
• Rheumatoid arthritis
• Rheumatic fever
• Liver diseases
• Allergic
conditions
• Sickle cell
anemia
• Polycythemia
• Leukocytosis
High
ESR
Low
ESR
ESR Variations

3. Factors affecting ESR
 Specific gravity of RBCs
 Size of RBC
 Globulin & Fibrinogen
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 Viscosity of blood
 RBC count
 ESR
 ESR

4. • All types of anemia except SCA

5. Factors that
accelerate ESR
•  Rouleaux formation
•  Specific gravity
•  Temperature
•  Fibrinogen & globulin
•  Cholesterol
•  RBC count
•  Albumin conc.
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Factors that
retard ESR
•  Rouleaux form.
•  Specific gravity
•  Temperature
•  Fibrinogen &
globulin
•  RBC count
• Deformed RBCs
like spherocytes

6. Significance of ESR
PROGNOSIS
• ESR is not for a diagnosis
• Presence of a disease
• To exclude organic disease
• Functional disorders
• Feigned illness
• Tuberculosis (PTB)
• Rheumatoid
arthritis
• Polymyalgia
rheumatica
• Temporal arteritis
• ESR can evaluate the degree of activity of
disease and effectiveness of the treatment

7. Uses of ESR values
1) DIAGNOSIS
• It can sometimes be useful in diagnosing some diseases,
such as multiple myeloma, temporal arteritis, polymyalgia
rheumatica, various auto-immune diseases, systemic lupus
erythematosus, rheumatoid arthritis, and chronic kidney
diseases.
• In many of these cases, the ESR may exceed 100 mm/hour.
• It is commonly used for a differential diagnosis for
Kawasaki's disease and it may be increased in some chronic
infective conditions like tuberculosis and infective
endocarditis.
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8. Uses of ESR values
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2) Disease severity
• It is a component of the PCDAI (Pediatric Crohn's Disease
Activity Index), an index for assessment of severity of
inflammatory bowel disease in children.
3) Monitoring response to therapy
• Certain inflammatory d such as temporal arteritis,
polymyalgia rheumatica and rheumatoid arthritis.
• Used as a crude measure of response in Hodgkin's
lymphoma.
• Additionally, ESR levels are used to define one of the
several possible adverse prognostic factors in the staging of
Hodgkin's lymphoma.

9. ESR helping in Diagnosis
• Distinguishes functional from organic disorders
• Rise in active RA, acute gout, infective arthritis
but normal OA
• High in AMI but normal in angina
• Differentiates Ca stomach from peptic ulcer
• Increased in pelvic inflammation but normal in
unruptured ectopic gestation

10. ESR helping in Prognosis and T/t
• Fever
– Rising ESR Worsening
– Falling ESR Recovery
• Rheumatic fever
– Rising ESR persistent rheumatic infection
• Coronary thrombosis
– Successive falling ESR Healing
• Acute nephritis
– ESR remains high if passing into chronic stage

11. Very rapid rise in ESR
• Temporal arteritis
• Rheumatoid arthritis
• Leukemia
• Hemolytic anemia
• Chronic renal disease
• Multiple myeloma
• Sarcoidosis

12. Low ESR is seen in
• Dehydration
• Polycythemia vera
• Congestive heart failure
• Whooping cough