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Synonyms
- Erythrocyte Sedimentation Rate
- ESR
- Westergren Sedimentation Rate
Expected Turnaround Time
Within 1 day
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
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.