From the Guidelines
An elevated sedimentation rate (sed rate or ESR) is a symptom of underlying inflammation and requires a thorough evaluation by a healthcare provider to determine the cause, as it is associated with increased morbidity and mortality in conditions such as rheumatoid arthritis 1. When evaluating an elevated sed rate, it is essential to consider the patient's overall clinical presentation, including symptoms such as fever, joint pain, fatigue, or unexplained weight loss.
- Common conditions associated with elevated sed rates include:
- Infections
- Autoimmune disorders (like rheumatoid arthritis or lupus)
- Certain cancers
- Inflammatory conditions
- The sed rate test measures the rate at which red blood cells settle in a test tube, with inflammation causing them to stick together and fall more quickly, resulting in a higher measurement 1.
- Treatment will target the underlying cause once identified, and no specific medication directly treats an elevated sed rate since it's a symptom rather than a disease 1.
- It is crucial to note that an elevated sed rate can be associated with worse mortality in patients with rheumatoid arthritis and heart failure, emphasizing the need for prompt evaluation and management 1.
- Additionally, patients should be educated about the distinctions between disease-related and disease-unrelated symptoms, as well as the possible adverse consequences of therapy, to ensure optimal outcomes 1.
From the Research
Elevated Sed Rate
- An elevated sed rate, also known as an elevated erythrocyte sedimentation rate (ESR), can be an indicator of inflammation in the body 2, 3, 4.
- Studies have shown that statin or nonsteroidal anti-inflammatory drug (NSAID) use is associated with lower ESR in patients with giant cell arteritis 2.
- ESR has been found to be an independent predictor for the development of heart failure, with higher ESR values indicating a greater risk of heart failure 3.
- The diagnostic accuracy of ESR and C-reactive protein (CRP) in acute inflammation has been assessed, with results showing that CRP may have superior diagnostic accuracy in certain conditions 4.
- NSAIDs, which can affect ESR, have been shown to have both beneficial and adverse effects on the body, including protection against certain disorders and risk of organ damage 5.
Factors Affecting ESR
- Statin use has been associated with lower ESR in patients with giant cell arteritis, with a significant difference in ESR values between statin users and nonusers 2.
- NSAID use has also been associated with lower ESR, although the relationship between NSAID use and CRP is less clear 2, 5.
- Inflammation, as measured by ESR, has been found to be an independent predictor of heart failure, highlighting the importance of monitoring ESR in patients at risk of heart failure 3.
Diagnostic Accuracy of ESR
- The diagnostic accuracy of ESR and CRP in acute inflammation has been assessed, with results showing that CRP may have superior diagnostic accuracy in certain conditions 4.
- The combined use of ESR and CRP has been found to yield higher diagnostic accuracy, highlighting the potential benefits of using multiple markers to assess inflammation 4.