Taranaki Lab Manual

Tests:Erythrocyte Sedimentation Rate, Blood: Difference between revisions

Tests:Erythrocyte Sedimentation Rate, Blood
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[[Category:Tests]]  
[[Category:Tests]]  


[[Category:Haematology]]
[[Category:Haematology]]
[[Category:Hawera]]
{| class="wikitable"
{| class="wikitable"
! colspan="2" |
! colspan="2" |
=== ''Overview'' ===
== Overview ==
|-
|-
|Department  
|Department  
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Sedimentation rate    
Sedimentation rate    
|-
|Base Lab Availability
|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 hrs  
|1.5-4 hrs  
|-
|-
|Stability – Add test  
|Stability – Add test  
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|-
|-
! colspan="2" |
! colspan="2" |
=== ''Specimen Requirements'' ===
== Specimen Requirements ==
|-
|-
|Specimen Type
|Specimen  
|Whole Blood
|Whole Blood
|-
|Specimen Transportation
|Please affix patient labels to top half of tube, do not cover the glass end.
|-
|-
|Preferred  
|Preferred  
|1.3mL <span style="background-color: #080808;color: #ffffff;">Black-Top</span> Monosed ESR tube, filled between guidelines
|-
| Acceptable
|2mL minimum EDTA <span style="background: #ba55d3"> Purple-Top </span>
|2mL minimum EDTA <span style="background: #ba55d3"> Purple-Top </span>
|-
|-
|Unacceptable
|Acceptable
|
|
|-
|-
|Paediatric Requirements  
|Unacceptable
|Clotted Sample
Patients with cold agglutinins
 
Samples less than 2 mL


Samples older than 12 hours
|-
|Specimen Transportation
|
|
|-
|Paediatric Requirements  
|2mL minimum EDTA <span style="background: #ba55d3"> Purple-Top </span>
|-
|-
! colspan="2" |
! colspan="2" |
===''Aliquot Requirements''===
== Aliquot Requirements ==
|-
|-
|Sample Type
|Sample Type  
 
|
|-
|Preferred Volume
|
|
|-
|-
|Minimum Volume
|Minimum Volume  
|
|
|-
|-
| Aliquot Transportation
|Aliquot Transportation  
|
|
|-
|-
! colspan="2" |
! colspan="2" |
===''Clinical Information''===
== Clinical Information ==
|-
|-
|Reference Intervals
|Reference Intervals  
| { |class="wikitable"
|
|Age
{| class="wikitable"
|mm/hr
|Male
|
|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
|}
|}
|-
|-
| Test Method
|Test Method  
|Modified Westergen Method performed on Mixrate X20 analyser  
|Modified Westergen Method performed on Mixrate X20 analyser    
|-
|-
|Advanced Notice
|Advanced Notice  
|Not required    
|Not required    
|-
|-
|Patient Preparation
|Patient Preparation  
|Not required  
|Not required    
|-
|-
! 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. 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.  
| 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.
 
 
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  
 
Giant cell/temporal arteritis  
 
Polymyalgia Rheumatica (PMR)  
 
Prosthetic joint infection  
 
Vasculitis  


Any insurance company request  
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).


Any request by a Rheumatologist  
* 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


 
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.


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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