Sedimentation Rate (ESR)

CPT Code(s):
85652

Turnaround Time:
4 hours

Specimen Requirements

Preferred Specimen:
Whole Blood

Minimum Volume:
1.5 mL

Transport Container:
Lavender Top Tube (EDTA)

Transport Temperature:
Room Temperature

Collection Instructions:
Whole blood collected in lavender EDTA tube; inverted several times to mix blood with anticoagulant. Specimen must be received and testing performed within 24 hours of draw.

Rejection Criteria:
Hemolysis; clotted specimen; specimen drawn in any anticoagulant other than EDTA; specimen diluted or contaminated with IV fluid; tube not filled with minimum volume; improper labeling; transfer tubes with whole blood; specimen received with plasma removed (plasma is used for other testing)

Stability Criteria

Room Temperature:
24 hours

Refrigerated:
24 hours

Frozen:
Unacceptable

Clinical Significance

The Sedimentation Rate (ESR) test is a diagnostic tool used to measure the rate at which red blood cells settle in a vertical tube of blood over a certain period of time. It is a non-specific marker of inflammation and can provide valuable information in the diagnosis and monitoring of various medical conditions.

The clinical significance and diagnostic use of Sedimentation Rate include:

1. Inflammatory Conditions: ESR is often used as an indicator of the presence and severity of inflammatory conditions. Inflammation in the body can increase the levels of certain proteins in the blood, known as acute-phase reactants, which cause red blood cells to clump together and settle faster. An elevated ESR can suggest the presence of conditions such as infections, autoimmune disorders, vasculitis, and certain types of arthritis.

2. Disease Monitoring: ESR can be used to monitor the progression and response to treatment of inflammatory diseases. Serial measurements of ESR over time can help healthcare providers assess the effectiveness of therapies and make adjustments as needed. A decreasing ESR level may indicate improvement, while a persistently elevated or increasing ESR may indicate ongoing inflammation or treatment resistance.

3. Diagnosis of Certain Conditions: ESR is not specific to any particular disease but can provide supporting evidence for the diagnosis of certain conditions. When combined with other clinical findings and laboratory tests, an elevated ESR can contribute to the diagnostic evaluation and help differentiate between various inflammatory and non-inflammatory conditions.

4. Prognostic Indicator: In some cases, ESR may have prognostic value. For example, in certain types of cancer or chronic inflammatory diseases, a high ESR at the time of diagnosis may be associated with a more aggressive disease course or poorer prognosis. Monitoring changes in ESR over time can provide additional information about disease progression and response to therapy.

It's important to note that an elevated ESR alone is not specific to any particular disease and further investigations are usually required to determine the underlying cause. Additionally, certain factors such as age, gender, anemia, and medications can influence ESR values and should be taken into consideration when interpreting the results.

In summary, the Sedimentation Rate (ESR) test is a non-specific marker of inflammation and is used in the diagnosis, monitoring, and assessment of various inflammatory conditions. It helps healthcare providers evaluate disease activity, track treatment response, and provide additional information in the diagnostic workup of patients with suspected inflammatory disorders.