Red Blood Cell Sedimentation Rate: A Disease Diagnosis Technique

//So here is the promised scientific journal review I made. 

The Erythrocyte Sedimentation Rate

Jonathan S. Olshaker, MD, and David A. Jerrard, MD

Division of Emergency Medicine, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland

Reprint Address: Jonathan S. Olshaker, MD, Division of Emergency Medicine, Department of Surgery

University of Maryland Medical Center, 419 W. Redwood Street, Suite 280, Baltimore, MD 212011

Introduction:

The erythrocyte sedimentation rate (ESR) has been used in the clinical lab from predicting severity of sickness to general sickness assessment. Specifically, it measures the body’s reaction to inflammation and infection.  The concept of the ESR originated from the Greeks, who first discovered the relation between the sedimentation of red blood cells and fibrinogen. In 1918, the German scholar Fahraeus discovered that erythrocytes sedimentation in pregnant women is more rapid compare to non-pregnant women. Since then, with minor modifications, the ESR has been used in the evaluation of a variety of diseases.  

However, we don’t encounter ESR in usual clinical tests because its use is based on medical myths. This article examines the use of ESR in the medical laboratory as a tool for predicting both disease likelihood and severity.  The ESR is a measure how fast is the red blood cell aggregation and the setting of a column of erythrocytes within one hour. The standard method of measuring the ESR is based on Westergren’s technique. The test includes anticoagulated blood being diluted with sodium citrate and being placed in an upright tube, known as a Westergren tube. Then the rate at which the red blood cells fall is measured and reported in mm/h.

On the contrary, there is another method that requires no dilution which is called the Wintrobe method. It is more sensitive compare to Westerner method at normal ranges of ESR but at higher ranges this methods may give erroneous results. The article gathered results from laboratory tests in order to find out the utility of ESR in disease diagnosis.

The results give the conclusion that ESR is not a myth in disease diagnosis. It is beneficial in certain diagnosis such as septic arthritis, osteomyelitis and many others. It is helpful in classifying patients into low or high risk groups. However, ESR does not give specific disease diagnosis because it only suggests various conditions. That’s why a diagnosis is still in need of investigation regardless of ESR.

Summary of the results:

Since the journal article is more of a descriptive journal article. There are no tables or figures included in the journal. However it gathered results of disease diagnostics in relation to the erythrocyte sedimentation rate.

Low ESR usually indicated abnormal plasma protein. Monitoring ESR can also be used in the assessment of the activities of collagen vascular disease. Patients with collagen vascular disease have higher ESR.  Pregnant women normally have high ESR. Patients with cancer usually have normal ESR however when ESR do elevate, it means that metastases are present. 
Specific uses of ESR in the emergency department include the diagnosis of temporal arteritis, septic arthritis, osteomyelitis, pelvic inflammatory disease and the evaluation of intravenous drug users.

Critique of the Result

The accuracy of the data depends on the results the researchers gathered from laboratories. It did not indicate what method was actually used in obtaining lab results. It did not also tell how many are the respondents so we cannot tell if the number of surveys can represent a significant sample of the population.

Recommendations

The results could be tabulated so that it is easier to comprehend the results and compare the diagnosis. The researchers could do their own experiments on ESR so as to prove the findings. Undergraduates can also do thesis by proving the findings too and improving the methodology of the work.