Tests:Erythrocyte Sedimentation Rate, Blood: Difference between revisions

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Tests:Erythrocyte Sedimentation Rate, Blood
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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 and as 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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Revision as of 10:31, 19 November 2025

Overview

Department Haematology  
Test Code ESR
Synonyms ESR  

Sedimentation rate  

Base Lab Availability Monday - Sunday, testing routinely available out of hours
Hawera Lab Availability Monday - Friday 8 am - 3 pm
Turnaround Time 1.5-4 hrs
Stability – Add test 12 hrs

Specimen Requirements

Specimen Whole Blood
Preferred 1.3mL Black-Top Monosed ESR tube, fill between guide lines. 
Acceptable 2mL minimum EDTA Purple-Top
Unacceptable Clotted Sample

Patients with cold agglutinins Under or overfilled black tube Samples older than 12 hours

Specimen Transportation Please affix patient labels to top half of tube, do not cover the glass end.
Paediatric Requirements  

Aliquot Requirements

Sample Type
Preferred Volume
Minimum Volume
Aliquot Transportation

Clinical Information

Reference Intervals
Male Female
≤20 years <10 mm/hr ≤20 years <10 mm/hr
21-50 years <20 mm/hr 21-50  years <25 mm/hr
>51 years <25 mm/hr 51-65 years <30 mm/hr
>66 years            <40 mm/hr
Test Method Modified Westergen Method performed on Mixrate X20 analyser  
Advanced Notice Not required  
Patient Preparation Not required  

Interpretation

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 and as CRP has become the test of choice for acute inflammation, currently ESR has a more limited utility.

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).

  • 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.

The ESR should not be used to screen for inflammatory/infective disorders; CRP is the test of choice.

It is seldom appropriate for both an ESR and CRP to be performed on the same sample.

Owner Craig Mabbett (Mabbett1)
Last reviewed 19.11.2025
Next review 19.11.2026 (OK)
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