What is elevated esr

People with abnormal ESR values may not always have a medical condition that requires treatment. Slightly higher levels can also occur due to pregnancy, menstruation, or advancing age. People taking certain medications, such as oral contraceptives, cortisone, aspirin , and vitamin A, may also have unusual test results. In cases where a non-medical cause or underlying medical condition may be affecting the test result, doctors usually order a second ESR test and other types of test to help make a diagnosis.

If the doctor concludes that someone does have a medical condition, they are likely to prescribe a treatment specific to the condition. Treatment may involve:.

An ESR test result outside of the normal range is not necessarily a cause for concern. There are some non-medical causes of abnormal results.

Although doctors cannot diagnose a specific medical condition with an ESR test, the result can establish whether or not there is inflammation in the body. If the test indicates that there may be an issue, doctors will need to order further tests and get additional clinical information to make an accurate diagnosis. Sickle cell disease is an inherited condition that can have life threatening consequences.

Learn more about what it involves and the treatment options…. Anemia is the most common blood disorder. The body does not have enough red blood cells and is unable to deliver enough oxygen around the body.

White blood cells fight infection. If someone has too many white blood cells, they may have an underlying condition, such as an infection or cancer…. Temporal arteritis, or giant cell arteritis, is a vascular condition that causes headaches and pain when the arteries in the head become inflamed…. What does it mean if your ESR is high?

Most unexplained ESR elevations are short-lived and not associated with any specific underlying process. In those instances where disease is present, it will usually be obvious after completion of history taking, physical examination and collection of routine laboratory data. Although an elevated ESR may occur with many types of cancer, it rarely indicates an occult tumor because most of these patients have widely metastatic disease.

Recent studies have evaluated the ESR as a screening test for infection in specific clinical instances such as infection associated with orthopedic prostheses, pediatric bacterial infection and gynecologic inflammatory disease. The appropriateness of the ESR as a screening test for infection, even in these well-defined clinical settings, requires further evaluation. However, this investigation specifically excluded patients known to have an ESR-elevating disease and those in whom no disease was suspected.

The authors concluded that combining clinical evaluation with an individual ESR value allowed the identification of groups of patients in whom the likelihood of disease was quite low or reasonably high, possibly limiting unnecessary investigations.

An extreme elevation of the ESR defined as greater than mm per hour is associated with a low false-positive rate for a serious underlying disease. In most series, infection has been the leading cause of an extremely elevated value, followed by collagen vascular disease and metastatic malignant tumors. Because most of these conditions are clinically apparent, any tests performed should be clinically driven.

For instance, if symptoms of infection are present, the appropriate cultures, including urine and blood, and skin testing for tuberculosis should be obtained. No obvious cause is apparent in fewer than 2 percent of patients with a markedly elevated ESR. In such patients, the history and physical examination coupled with readily available tests Table 5 will usually establish the etiology.

Because a notable number of patients with an ESR greater than mm per hour have myeloma or some other type of dysproteinemia, urine and serum protein electrophoretic studies should be included in the testing. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more.

He was formerly a senior medical oncologist at the B. Address correspondence to Malcolm L. Brigden, M. Reprints are not available from the author. Saadeh C. The erythrocyte sedimentation rate: old and new clinical applications. South Med J. Brigden M. The erythrocyte sedimentation rate: still a helpful test when used judiciously. Postgrad Med. The erythrocyte sedimentation rate: guidelines for rational use.

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Arthritis Rheum. Temporal arteritis and polymyalgia rheumatica: clinical and biopsy findings. Goodman BW Jr. Temporal arteritis. Am J Med. Temporal arteritis: a year epidemiologic, clinical, and pathologic study. Weinstein A, Del Giudice J. The erythrocyte sedimentation rate: time honored and tradition bound [Editorial].

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Erythrocyte sedimentation rate predicts early relapse and survival in early-stage Hodgkin's disease. Brigden ML. Iron deficiency anemia: every case is instructive. Smith EM, Samadian S. Use of the erythrocyte sedimentation rate in the elderly. You may need this test if you have symptoms of one of the diseases that may cause ESR to go up.

You may also need this test if you have already been diagnosed with a disease that causes a high ESR. The test can allow your healthcare provider to see how well you are responding to treatment.

The ESR blood test is most useful for diagnosing or monitoring diseases that cause pain and swelling from inflammation. Other symptoms may include fever and weight loss. These diseases include:. ESR is not used as a screening test in people who do not have symptoms or to diagnose disease because many conditions can cause it to increase. It might also go up in many normal cases. ESR doesn't tell your healthcare provider whether you have a specific disease.

It only suggests that you may have an active disease process in your body. You may have other tests if your healthcare provider is doing this test to diagnose a disease. One of these tests is call C-reactive protein, or CRP. This test also measures active inflammation in the body. Your provider may do an ESR alone if he or she is monitoring a disease you already have. Because ESR tells your provider only what is happening right now, you may need to have the test repeated over time.

Test results may vary depending on your age, gender, health history, the method used for the test, and other things.