Kim - ESR 101 :)

[Guest guest]

Hi Kim,

As far as ESRs are concerned.....it depends on how abnormal it

is and what the corresponding test (CRP) results are.

You are correct that it indicates some kind of inflammatory

process. The inflammation can be from autoimmune diseases,

infections, cancer...a hard physical workout, medicines, anything

that causes tissue damage. Depending on how high the

numbers are, you can get an idea of what is going on. In a

general sense....you will see numbers over 100 mm / hour in

active infections and cancer and numbers from 20 to 100 in

other conditions. I have seen numbers of 100 to 140 in RA and

lupus as well as vasculitis though so there are exceptions to

this. In my understanding this was when the disease was either

in a very active state or untreated. Alot of times though, lupus will

have normal or slightly above the cutoff values. It is important to

also perform the C-reactive protein test as this gives the doctor a

better way to interpret the ESR. Usually these are run together.

In addition, there are cases when there are false positives and

that has to do with how the blood was drawn (traumatic sticks)

and how it was handled in transport and once it got to the lab.

Again, it is common practice to do a repeat test a couple of

weeks after the first abnormal one to verify the result. or to

document an ongoing process of inflammation. Many people

may have a temporary rise in values that are basically harmless.

If that is the case, a repeat test a few weeks later will be normal;

a abnormal one will bear closer investigation. This is the

scenario when there is no urgent clinical presentation. In your

case, seeing that you have signs and symptoms of something

going on, they may opt to do more testing immediately. This may

include the ANA screen (to test for anti-nuclear antibodies) which

can indicate that there is an autoimmune process going on as

well as testing for antibodies to liver tissue, thyroid tissue and

other tests.

A negative ANA does not rule out auto-immune disease as well

as a positive one does not diagnose an autoimmune disease.

There are many " normal " people who have a positive ANA (I am

one of them) and this increases the older the person gets.

Conversely, there are many people with autoimmune disease

that have negative ANAs. So again, interpretation of results has

to be done in the context of a good physical exam and medical

history and other laboratory tests. If it seems that your symptoms

and signs are consistent with a rheumatological autoimmune

disease (there are others like autoimmune hepatitis,

dermatological conditions, thyroid, for example) then you need to

get a rheumatologist as soon as you can as they are uniquely

able to diagnose and treat these diseases in a miraculous way. I

have seen patients when we have thought they have weeks to

live bounce back to amazing health after being diagnosed and

treated by a rheumatologist. I am sure that the same applies to

the other autoimmune specialties.

I answered one of your previous posts entitled " questions " with

my thoughts on the association of pancreatitis with sjogren's

syndrome and lupus so I will not repeat myself here.

I hope this helps some...basically just realize that diagnosing

autoimmune diseases is a very time consuming, frustrating

experience and that patience and knowledge is the key to getting

through the uncertainties and waits.

I hope it all ends up well for you. Feel free to ask me more

questions as this is the area that I have personal experience

with.

Laurie