Taranaki Lab Manual

Tests:Erythrocyte Sedimentation Rate, Blood: Difference between revisions

Tests:Erythrocyte Sedimentation Rate, Blood
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[[Category:Haematology]]
[[Category:Haematology]]
[[Category:Hawera]]
{| class="wikitable"
{| class="wikitable"
! colspan="2" |
! colspan="2" |
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Sedimentation rate    
Sedimentation rate    
|-
|-
|Availability
|Base Lab Availability
|Monday - Sunday, testing routinely available out of hours  
|Monday - Sunday, testing routinely available out of hours  
|-
|Hawera Lab Availability
|Monday - Friday 8 am - 3 pm (Samples referred to Base Hospital Lab)
|-
|-
|Turnaround Time  
|Turnaround Time  
|1.5-4 hours
|1.5-4 hrs
|-
|-
|Stability – Add test  
|Stability – Add test  
|12 hours
|12 hrs
|-
|-
! colspan="2" |
! colspan="2" |
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|-
|-
|Preferred  
|Preferred  
|1.3mL <span style="background-color: #080808;color: #ffffff;">Black-Top</span>   Monosed ESR tube, fill between guide lines. 
|2mL minimum EDTA <span style="background: #ba55d3"> Purple-Top </span>
|-
|-
|Acceptable  
|Acceptable  
|2mL minimum EDTA <span style="background: #ba55d3"> Purple-Top </span>
|
|-
|-
|Unacceptable
|Unacceptable
|Clotted Sample
|Clotted Sample
Patients with cold agglutinins
Patients with cold agglutinins
Under or overfilled black tube
 
Samples less than 2 mL
 
Samples older than 12 hours
Samples older than 12 hours
|-
|-
|Specimen Transportation  
|Specimen Transportation  
|Please affix patient labels to top half of tube, do not cover the glass end.
|
|-
|-
|Paediatric Requirements    
|Paediatric Requirements    
|
|2mL minimum EDTA <span style="background: #ba55d3"> Purple-Top </span>
|-
|-
! colspan="2" |
! colspan="2" |
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|
|
{| class="wikitable"
{| class="wikitable"
|Age
|Male
|Mm/hr
|
|Female
|
|-
|-
|1-30 years  
|≤20 years  
|1-10
|<10 mm/hr
|≤20 years
|<10 mm/hr
|-
|-
|31-50 years  
|21-50 years  
|1-15
|<20 mm/hr
|21-50  years
|<25 mm/hr
|-
|-
|51-70 years  
|>51 years
|1-20
|<25 mm/hr
|51-65 years
|<30 mm/hr
|-
|-
|71+  years
|
|1-30
|
|>66 years           
|<40 mm/hr
|}
|}
|-
|-
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|-
|-
! colspan="2" |
! colspan="2" |
== Comments ==
== Interpretation ==
|-
|-
| colspan="2" |The ESR is a non-specific test that has limited utility in the monitoring, and diagnosis of diseases that are associated with the acute phase response.  
| colspan="2" |The ESR has significant limitations in terms of measurement accuracy.  It is also affected by numerous physiological variables and by factors other than inflammation, such as haemoglobin and plasma protein levels. For these reasons, CRP has become the test of choice for acute inflammation, currently ESR has a more limited utility.  


This is because analysis methods used to measure the ESR show poor precision and there is significant variation between different methods used.  CRP is the preferred test when assessing inflammatory disease.  
For these reasons, '''ESR requests will only be processed when relevant clinical details are legibly written on the request form and meet the testing criteria''' (refer to the list below).  


The laboratory will only process a request for an ESR if the request has been discussed with a Pathologist/Haematologist, or if one of the following indications is documented legibly on the request form:  
* SLE
* Rheumatoid arthritis
* Kawasaki disease
* Rheumatic fever
* Hodgkins lymphoma
* Temporal (giant cell) arteritis
* Polymyalgia Rheumatica
* Vasculitis
* Connective Tissue disorders
* Paediatric Inflammatory bowel disease (Crohn's and Ulcerative colitis)
* Juvenile idiopathic arthritis
* Bone, joint, or prosthetic joint infection/inflammation
* Osteomyelitis
* Uveitis or Iritis


* SLE  
The ESR should '''not''' be used to screen for plasma cell dyscrasias; if these conditions are suspected, protein electrophoresis and/or serum free light chains should be used.
* Rheumatoid arthritis  
* Kawasaki disease  
* Rheumatic fever  
* Hodgkins's lymphoma  
* Giant cell/temporal arteritis  
* Polymyalgia Rheumatica (PMR)  
* Prosthetic joint infection  
* Vasculitis  
* Any insurance company request  
* Any request by a Rheumatologist  


A CRP will be substituted when an ESR has been requested without these criteria being met, provided that an appropriate sample has been received.  
The ESR should '''not''' be used to screen for inflammatory/infective disorders; CRP is the test of choice.


ESRs will only be available on serial cards after consultation with a Haematologist.
It is seldom appropriate for both an ESR and CRP to be performed on the same sample.
|}
|}
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