ESR on Westergren - what is it?
Health does not always make us happy. It is in difficult periods of life that it brings. Any of us can begin any pathological processes that affect the state of the whole organism. To find out what's the matter that needs to be treated, we pass the tests. One of the important informative indicators in this case is the erythrocyte sedimentation rate.
The erythrocyte sedimentation rate (ESR) is included in the compulsory research in clinical blood analysis. He points out how cells settle for a certain period of time. In the literal sense of the word, it is estimated how the separation into red blood cells and plasma occurs in a mixture of blood and anticoagulant. According to these data, the doctor can judge the presence of inflammation, cancer, infectious or rheumatological disease. There are three methods for determining the erythrocyte sedimentation rate: Westergren ESR, Winthrob and Panchenkov methods.
Historical background: when they began to explore this figure
Medical experts have long identified the relationship between the rates of erythrocyte sedimentation rate and pathologies in the body. But it was only at the beginning of the twentieth century that they began to register ESR for the purpose of diagnosing diseases. This happened after one Swedish physician, R. Fareus, made a discovery: the erythrocyte sedimentation rate can significantly change with illness and pregnancy. This happened in the 20s of the last century.
There is also evidence that ESR began to be investigated in 1897, after the first experiment of E. Bernatsky. Then in the course was another name - ROE (erythrocyte sedimentation reaction).
After 1925, medical scientists began to develop methods for determining the ESR. They are still used in medical practice.
What are the methods for determining the ESR
Historically, there are several methods for determining ESR. It is important to note that each of them differs significantly from the other; therefore, the norms are different. You can not combine them, otherwise there will be confusion with the results.
The Westergren method is the most popular for determining ESR. He is recognized by leading laboratories and committees for blood research, therefore it is considered essential for analysis. The time to get the result is 60 minutes.Below it will be described in more detail.
Vintrob's method is different in that the blood for the study is taken clean, it is not diluted. Analysis tube length - 100 mm. This is a disadvantage of the method, since distorted results appear when the ESR is greater than 60 mm per hour.
The Panchenkov method is that the blood is diluted with a reagent according to a certain technology. The solution is collected in a test tube with a length of 100 mm, and after an hour the results are noted.
Westergren method for determining ESR
The international committee dealing with the standardization of hematological studies considers the Westergren method to be the most accurate. For the analysis of the patient, venous blood is collected, which is filled with a special cylindrical tube with an anticoagulant — sodium citrate — up to the mark of 200 mm. This container is placed in a tripod and left for 60 minutes.
Anticoagulant does not allow blood to clot, with red blood cells having a density higher than that of plasma, settle to the bottom. How quickly the red blood cells fall down depends on their ability in one or another patient to stick together among themselves.This process is called aggregation. Erythrocyte aggregates will settle faster. This is the basis of the Westergren ESR study method. The surface properties of erythrocytes in human blood and the protein content in his plasma are taken into account. If the number of acute-phase compounds increases, which is characteristic of the inflammatory process, the aggregation potential of the red blood cells also increases. Record the result by estimating the number of erythrocytes deposited in the column.
How does this method differ from others?
In addition to the ESR, in Westergren, the Panchenkov technique is widespread in our country. To this end, a reagent (5% sodium citrate) diluted with whole blood is placed in a special capillary. After sixty minutes, measure the height of the settled plasma.
Indicators of ESR according to the method of Westergren and Panchenkov at normal values are the same. But with the acceleration of erythrocyte sedimentation, the data according to the first method are reflected in higher numbers.
There is also the Vintroba method. It is considered less accurate than the first two, so it is rarely used.In modernized laboratories, automatic analyzers are often used, which also provide the result of ESR including.
What diseases can refer to the pathological results of ESR on Westergren?
Erythrocyte sedimentation rates may deviate from the norm in one direction or another. When is the ESR in Westergren elevated? As already mentioned, this occurs in infectious, inflammatory, rheumatic and oncological diseases. Most often suspected diseases of the heart and blood vessels, pathological processes in the blood and kidneys. A high ESR result (up to 60 mm / hour) is also observed with a significant increase in the amount of acute phase proteins, such as C-reactive protein, seromucoid, fibrinogen, ceruloplasmin. This may indicate a malignant neoplasm.
ESR (Westergren's method is considered by us in this case as well) can increase during pregnancy and the use of certain medications. Autoimmune processes and acute septic conditions also lead to the acceleration of erythrocyte sedimentation. Faster fall down red blood cells with active chronic liver diseases, collagen diseases and myocardial infarction.
The decreased result of ESR in Westergren is observed with an increase in protein fractions, erythremia, a significant increase in the number of leukocytes, a change in erythrocyte structure, and slow-moving hepatitis.
ESR rates for adults
In people of different ages and sex rates of erythrocyte sedimentation rates differ. So, for men who have not reached fifty years of age, an ESR of 0–15 mm per hour is considered good. Results of 0–20 mm per hour are typical for men after a specified age. In each of these cases we are talking about the ESR of Westergren. The blood of women up to fifty years in normal gives the erythrocyte sedimentation rate of 0-20 millimeters per hour. Representatives of the beautiful half of humanity who have reached fifty years old must have an ESR up to 30 mm / h.
ESR on Westergren. Norm for children
For children, there are norms that differ from those of adults. The question of what ESR on Westergren means and what its norms in babies often concern parents. Children of different ages have normally the following indicators:
- for newborns, the erythrocyte sedimentation rate of 2–4 mm per hour is considered characteristic;
- for babies from two months to a year, the ESR rate is 3-10 millimeters per hour;
- children from one to five years - 4-12 mm per hour;
- if a child is six to 14 years old, an ESR of 4-12 mm per hour will be normal for him;
- girls who are 14 years old and older have normal erythrocyte sedimentation rates of 2-15 millimeters per hour; for boys at this age, 1–10 mm per hour is considered the norm.
ESR increased - what does this mean?
If the ESR in Westergren is elevated, you should not puzzle over what it means. It is better to provide this task to the doctor. To decipher the value of an indicator is its direct responsibility. Moreover, it is not necessary to look for the answer in encyclopedias and the Internet.
Sometimes, the erythrocyte sedimentation rate can increase normally when eating fatty foods or after taking Paracetamol. In children, an elevated ESR may result in teething or improper, unbalanced nutrition. ESR may also increase with angina, allergies, blood loss, and anemia.
In people of all ages, except for well-known reasons, the body can individually respond to any changes, which is reflected in blood tests.
So you see in the clinical analysis that the erythrocyte sedimentation rate is increased. You have a question about whether they are normal and what they mean. ESR on Westergren - accelerated or slow - does not always indicate the presence of pathology in the body. But if this figure has increased for some reason, then it must be remembered that it normalizes slowly, not less than a month. An ordinary person will not be able to take into account all the nuances in obtaining results, to determine which deviations from the norm are permissible, and which deviations are not. That is why it is so important that the doctor understood all such cases.