INFO - Clinical utility of the erythrocyte sedimentation rate (ESR, sed rate)

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An oldie, but goodie:

American Family Physician

01 Oct 1999

Clinical Utility of the Erythrocyte Sedimentation Rate

MALCOLM L. BRIGDEN, M.D., B.C.

Cancer Agency, Kelowna, British Columbia, Canada

The erythrocyte sedimentation rate (ESR) determination is a commonly

performed laboratory test with a time-honored role. However, the

usefulness of this test has decreased as new methods of evaluating

disease have been developed. The test remains helpful in the specific

diagnosis of a few conditions, including temporal arteritis,

polymyalgia rheumatica and, possibly, rheumatoid arthritis. It is

useful in monitoring these conditions and may predict relapse in

patients with Hodgkin's disease. Use of the ESR as a screening test to

identify patients who have serious disease is not supported by the

literature. Some studies suggest that the test may be useful as a

" sickness index " in the elderly or as a screening tool for a few

specific infections in certain settings. An extreme elevation of the

ESR is strongly associated with serious underlying disease, most often

infection, collagen vascular disease or metastatic malignancy. When an

increased rate is encountered with no obvious clinical explanation,

the physician should repeat the test after an appropriate interval

rather than pursue an exhaustive search for occult disease. (Am Fam

Physician 1999;60:1443-50.)

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Read the entire article here:

http://www.aafp.org/afp/991001ap/1443.html

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Not an MD