Differential Diagnoses for Elevated Sed Rate
Elevated sedimentation rate (ESR) is a non-specific indicator of inflammation. The differential diagnoses can be categorized as follows:
- Single Most Likely Diagnosis
- Chronic infection or inflammation: This is the most common cause of elevated ESR, as it is a non-specific marker of inflammation. Conditions such as chronic bronchitis, chronic sinusitis, or chronic prostatitis can cause a persistent elevation in ESR.
- Other Likely Diagnoses
- Rheumatoid arthritis: An autoimmune disorder that causes inflammation in the joints, leading to elevated ESR.
- Osteoarthritis: A degenerative joint disease that can cause inflammation, resulting in elevated ESR.
- Chronic kidney disease: Inflammation and scarring in the kidneys can cause elevated ESR.
- Diabetes: Chronic inflammation associated with diabetes can lead to elevated ESR.
- Do Not Miss Diagnoses
- Malignancy: Certain types of cancer, such as lymphoma or multiple myeloma, can cause elevated ESR. Missing these diagnoses can have severe consequences.
- Endocarditis: A bacterial infection of the heart valves that can cause elevated ESR. Prompt diagnosis and treatment are crucial to prevent serious complications.
- Temporal arteritis: An inflammatory condition that affects the blood vessels in the head, leading to elevated ESR. If left untreated, it can cause blindness or stroke.
- Sepsis: A life-threatening condition caused by a severe infection, which can cause elevated ESR. Early recognition and treatment are essential to prevent mortality.
- Rare Diagnoses
- Familial Mediterranean fever: A rare genetic disorder that causes recurrent episodes of inflammation, leading to elevated ESR.
- Relapsing polychondritis: A rare autoimmune disorder that causes inflammation in the cartilage, resulting in elevated ESR.
- Sarcoidosis: A rare condition characterized by inflammation in various parts of the body, which can cause elevated ESR.
- Amyloidosis: A rare condition caused by the deposition of abnormal proteins in various organs, leading to elevated ESR.
It is essential to consider these categories and justifications when evaluating a patient with an elevated sed rate, as the underlying cause can have significant implications for treatment and management.