"The erythrocyte sedimentation rate (ESR) is the most common examination method to determine indications of inflammation in the body due to blood cell clumping, however further examination is still needed to determine the type of infection that is occurring"

Erythrocyte sedimentation rate (ESR) is a measure of how quickly the red blood cells in a particular blood sample settle to the bottom of a test tube over a certain period of time. The rate of blood sedimentation is determined by the structure of blood cells. When an infection occurs, blood cells tend to clump together which settle more quickly because their mass is heavier. The presence of aggregation or clump in the blood is an indicator of inflammation or infection in the body.

 Figure 1. Blood clots due to infection in the blood vessels

Until now, ESR especially the Westergren method, has been determined by the International Committee for Standardization in Hematology (ICSH) and the Clinical and Laboratory Standards Institute (CLSI) to be the gold standard for methods used for initial diagnosis to look for indications of certain diseases because it is cheap and easy to carry out by medical staff. and analyst.

Blood sedimentation rate (ESR) examination has several important functions:

1. Recognize the Presence of Inflammation: ESR is used to detect and confirm the presence of inflammation in the body. When inflammation occurs, proteins in the blood can change the sedimentation rate, so test results can provide clues to the presence of an inflammatory condition.
2. Disease Diagnosis and Monitoring: The ESR test is often performed along with other tests to aid in the diagnosis of certain diseases related to inflammation, such as autoimmune diseases, infections, or other conditions that cause inflammation.
3. Evaluation of Response to Treatment: In the treatment of diseases involving inflammation, the ESR test is used as a monitoring tool to see how well the body is responding to treatment. Changes in ESR results can help doctors assess the effectiveness of the treatment given.
4. Identify Unclear Causes of Fever: The ESR test can help in identifying unclear or undiagnosed causes of fever by showing the presence of inflammatory processes that may be occurring in the body.
5. Detection of Arthritis and other Symptoms: ESR examination is also useful in identifying certain types of arthritis as well as symptoms affecting the muscles, aiding in the diagnosis and monitoring of these conditions.

The normal ESR range for adult men (under 50 years) is around 0-15 millimeters per hour (mm/hour) as well as for adult women (under 50 years is around 0-20 millimeters per hour (mm/hour). Test results ESR must be assessed by a doctor along with clinical symptoms and other tests to make a correct diagnosis.Very high ESR values (>100 mm/hour) can indicate the presence of chronic infection, lymphoplasmacytic lymphoma, heart disease, local brain inflammation, arthritis, as well as melanoma skin cancer.

Usually doctors will recommend an LED examination in patients with the following symptoms:

1. Fever and pain in the joint area
2. Pain in the shoulders, neck or hips
3. Sudden and significant weight loss
4. Experiencing digestive disorders such as blood in the stool

Reference:

1. Kevin Tishkowski, National Center for Biotechnology Information. (2023). Erythrocyte Sedimentation Rate
2. International Committee for Standardization in Haematology (ICSH). (2011). ICSH recommendations for modified and alternate methods measuring the erythrocyte sedimentation rate
3. US National Library of Medicine. (2022). ESR (erythrocyte sedimentation rate)