Sedimentation Rate, Modified Westergren

CPT: 85652
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Synonyms

  • Erythrocyte Sedimentation Rate
  • ESR
  • Westergren Sedimentation Rate

Expected Turnaround Time

Within 1 day


Related Documents


Specimen Requirements


Specimen

Whole blood


Volume

Tube fill capacity


Minimum Volume

2 mL


Container

Lavender-top (EDTA) tube


Collection

Invert tube immediately 8 to 10 times once tube is filled at time of collection.


Storage Instructions

Refrigerate


Stability Requirements

Temperature

Period

Refrigerated

24 hours


Causes for Rejection

Hemolysis; clotted specimen; underfilled tube; specimen older than 24 hours; improper labeling; transfer tubes with whole blood; specimen received in any anticoagulant other than EDTA; specimen diluted or contaminated with IV fluid; patient specimen with presence of cold agglutinins or cryoglobulins; specimen received with plasma removed


Test Details


Use

Evaluate the nonspecific activity of infections, inflammatory states, autoimmune disorders, and plasma cell dyscrasias


Limitations

Optimum results are from blood less than two hours old. The ESR is of limited diagnostic value in severe anemia or in hematologic states that affect increased size and shape variation (poikilocytosis) of the RBC (ie, presence of sickle cells or spherocytes). Extreme plasma viscosity will result in a decreased ESR.


Methodology

Modified Westergren; automated and manual methods are employed.


Reference Interval

• Male: 0 to 50 years: 0−15 mm/hour, 50 years and older: 0−30 mm/hour

• Female: 0 to 50 years: 0−32 mm/hour, 50 years and older: 0−40 mm/hour


Additional Information

Elevations in fibrinogen, α- and β-globulins (acute phase reactants), and immunoglobulins increase the sedimentation rate of red cells through plasma. The test is important in the diagnosis of temporal arteritis, as well as its management.1


Footnotes

1. Wong RL, Korn JH. Temporal arteritis without an elevated erythrocyte sedimentation rate. Case report and review of the literature. Am J Med. 1986; 80(5):959-964.3518441

References

Gambino SR, Dire JJ, Monteleone M, et al. The Westergren sedimentation rate using K3 EDTA. Tech Bull Regist Med Technol. 1965; 35:1-8.
Harmening D. Clinical Hematology and Fundamentals of Hemostasis. 2nd ed. Philadelphia, Pa: Lippincott;1992:532-534.

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