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High ESR rate in a blood test

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High ESR rate in a blood test
Last update: 27/04/2021

What is high ESR called?

  • ESR high

What is the normal rate of ESR in a blood test?

If you need to know which are the ESR reference rates or you require more information about ESR in a blood test, you can visit normal ESR rate in a blood test

What does a high ESR mean?

The ESR (Erythrocyte Sedimentation Rate) is the rate at which erythrocytes settle out of anticoagulated blood in 1 hour.

A high ESR rate is not specific as a general screening test because it may occur in many diseases. A high ESR rate should be studied along other blood tests to give a clue about the possible diagnosis.

A pathologic reason for an increased ESR rate is usually an inflammation, an infection or a tissue injury. An increased ESR rate is also common is some types of cancer (lymphoma, multiple myeloma) or in autoimmune diseases (lupus, arthritis).

The ESR should not be used to screen asymptomatic patients for disease because many times the reason for a high ESR in not clear.

When there are symptom related it might be useful to diagnose the following diseases:

  • Polymyalgia rheumatica.
  • Rheumatoid arthritis.
  • Giant cell arteritis (temporal arteritis).

In pregnant women or in elderly people ESR normal rates are higher than normal.

  • Mild ESR increase (15 - 50 mm/h in adult men and 20 - 50 mm/h in adult women):

    A mild ESR increase is not usually a matter for concern. The most common causes are anemia, inflammation or bacterial infection.

    If you do not have any related symptoms, you should not be worried about it. It is probable that ESR rate will return to normal range in future blood tests.

    Normal ESR rates are higher in people over 50 years old. Rates up to 20mm/h in men and 30 mm/h are considered in the normal range.

  • Moderate ESR increase (50 - 100 mm/h in adults):

    A moderate ESR increase may be due to several reasons such as an infection, an autoimmune disease (arthritis), a kidney disorder or various types of cancer. ESR is not very high, but a visit to your doctor is recommended.

    If you are over 50 years old and suffer pain or stiffness in more than one joint, it may be due to rheumatoid arthritis or polymyalgia rheumatica. Discuss both possibilities with your doctor.

    The ESR may be very high (up to 60 mm/hr) in apparently healthy women aged 70 to 89 years.

  • Severe ESR increase (> 100 mm/h in adults):

    A severe ESR increase is a matter of concern. You should visit your doctor to study the possible causes and get a diagnosis.

    The most common causes are:

    • Autoimmune diseases (lupus, rheumatoid arthritis, etc.).
    • Infections (rheumatic fever, syphilis, etc.).
    • Cancer (lymphoma, multiple myeloma, Waldenström's macroglobulinemia, colon cancer, breast cancer, etc.).

    For ESR rates greater than 100 mm (in the nonpregnant client, of course), the most likely causes are in this order infections, malignant tumors, or autoimmune diseases.

    If you are over 50 years old and have headaches and vision problems, it may be due to a disease called temporal arteritis.

Which factors can raise the ESR in a blood test?

There are some health circumstances or drugs than can raise your ESR rate in a blood test:

  • Pregnancy
  • Infections
  • Menstruation
  • Drugs
    • Antiarrhythmic agents
      • Procainamide
      • Quinidine
    • Anticoagulants
      • Heparin
    • Oral Contraceptives
    • Antiepileptic drugs
    • Aspirin
    • Corticosteroids
      • Dexamethasone
    • Dextran
    • Immunosuppressive drug
      • Ciclosporin

Which diseases can raise your ESR in a blood test?

The most common diseases why the ESR rate can be higher than normal are:

  • Anemia
  • Rheumatoid arthritis
  • Lupus
  • Polymyalgia rheumatica
  • Temporal arteritis
  • Tuberculosis
  • Syphilis
  • Rheumatic fever
  • Vasculitis
  • Myocardial infarction
  • Kidney failure
  • Lymphoma
  • Multiple myeloma
  • Waldenström's macroglobulinemia
  • Kawasaki disease
  • Pneumonia
  • Pelvic inflammatory disease
  • Nephrotic syndrome
  • Gout
  • Breast cancer
  • Colorectal cancer
  • Hyperfibrinogenemia
  • Septic arthritis
  • Osteomyelitis

What can I do to lower the ESR?

The only way to lower the ESR rate is trying to reduce the inflammatory or infectious process that is causing it.

ESR rate is only an indirect parameter and high rates suggest possible underlying diseases, but do not cause any symptoms by itself.

Where can I find more information about the ESR in a blood test?

You can visit our pages about:

Which values are considered a high ESR rate in a blood test?

The following rates are considered to be above the normal range:

IMPORTANT: These rates are expressed in mm/h (millimeter/hour). They are an example of a healthy man of about 40 years old with no known disease and not taking any medication. The rates can be different depending on the laboratory or on your personal circumstances.

ESR
Mild ESR increase
16 mm/h17 mm/h18 mm/h19 mm/h20 mm/h21 mm/h22 mm/h23 mm/h
24 mm/h25 mm/h26 mm/h27 mm/h28 mm/h29 mm/h30 mm/h31 mm/h
32 mm/h33 mm/h34 mm/h35 mm/h36 mm/h37 mm/h38 mm/h39 mm/h
40 mm/h41 mm/h42 mm/h43 mm/h44 mm/h45 mm/h46 mm/h47 mm/h
48 mm/h49 mm/h50 mm/h     
Moderate ESR increase
51 mm/h52 mm/h53 mm/h54 mm/h55 mm/h56 mm/h57 mm/h58 mm/h
59 mm/h60 mm/h61 mm/h62 mm/h63 mm/h64 mm/h65 mm/h66 mm/h
67 mm/h68 mm/h69 mm/h70 mm/h71 mm/h72 mm/h73 mm/h74 mm/h
75 mm/h76 mm/h77 mm/h78 mm/h79 mm/h80 mm/h81 mm/h82 mm/h
83 mm/h84 mm/h85 mm/h86 mm/h87 mm/h88 mm/h89 mm/h90 mm/h
91 mm/h92 mm/h93 mm/h94 mm/h95 mm/h96 mm/h97 mm/h98 mm/h
99 mm/h100 mm/h      
Severe ESR increase
101 mm/h102 mm/h103 mm/h104 mm/h105 mm/h106 mm/h107 mm/h108 mm/h
109 mm/h110 mm/h111 mm/h112 mm/h113 mm/h114 mm/h115 mm/h116 mm/h
117 mm/h118 mm/h119 mm/h120 mm/h121 mm/h122 mm/h123 mm/h124 mm/h
125 mm/h126 mm/h127 mm/h128 mm/h129 mm/h130 mm/h131 mm/h132 mm/h
133 mm/h134 mm/h135 mm/h136 mm/h137 mm/h138 mm/h139 mm/h140 mm/h
141 mm/h142 mm/h143 mm/h144 mm/h145 mm/h146 mm/h147 mm/h148 mm/h
149 mm/h150 mm/h151 mm/h152 mm/h153 mm/h154 mm/h155 mm/h156 mm/h
157 mm/h158 mm/h159 mm/h160 mm/h161 mm/h162 mm/h163 mm/h164 mm/h
165 mm/h166 mm/h167 mm/h168 mm/h169 mm/h170 mm/h171 mm/h172 mm/h
173 mm/h174 mm/h175 mm/h176 mm/h177 mm/h178 mm/h179 mm/h180 mm/h
181 mm/h182 mm/h183 mm/h184 mm/h185 mm/h186 mm/h187 mm/h188 mm/h
189 mm/h190 mm/h191 mm/h192 mm/h193 mm/h194 mm/h195 mm/h196 mm/h
197 mm/h198 mm/h199 mm/h200 mm/h    
Medically reviewed by our Medical staff on 27/04/2021

Bibliography

  • Concise Book of Medical Laboratory Technology: Methods and Interpretations. 2nd Edition. 2015. Ramnik Sood. ISBN: 978-93-5152-333-8. Pag. 220.
  • Hemograma. Manual de interpretación. Renato Failace. 5ª Edición. Editorial médica Panamericana 2011 ISBN: 978-85-363-2556-9.
  • A Manual of Laboratory and Diagnostic Test. 9th edition. Frances Fischbach. Marshall B. Dunning III. 2014. Pag 106. ISBN-10: 1451190891.
  • Laboratory tests and diagnostic procedures with nursing diagnoses (8th ed), Jane Vincent Corbett, Angela Denise Banks, ISBN: 978-0-13-237332-6, Pag. 45.

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