ESR

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Erythrocyte sedimentation rate; Sed rate; Sedimentation rate

Adults (Westergren method):

• Men under 50 years old: less than 15 mm/hr
• Men over 50 years old: less than 20 mm/hr
• Women under 50 years old: less than 20 mm/hr
• Women over 50 years old: less than 30 mm/hr

Children (Westergren method):

• Newborn: 0 to 2 mm/hr
• Neonatal to puberty: 3 to 13 mm/hr

Note: mm/hr. = millimeters per hour

An increased ESR rate may be due to:

• Anemia
• Endocarditis
• Kidney disease
• Osteomyelitis
• Pregnancy
• Rheumatic fever
• Rheumatoid arthritis
• Syphilis
• Systemic lupus erythematosus
• Thyroid disease
• Tuberculosis
• Other inflammatory conditions

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Very high ESR levels occur with:

• Body-wide (systemic) infection
• Giant cell arteritis
• Hyperfibrinogenemia (increased fibrinogen levels in the blood)
• Multiple myeloma
• Macroglobulinemia - primary
• Necrotizing vasculitis
• Polymyalgia rheumatica

Lower-than-normal levels occur with:

• Congestive heart failure
• Hyperviscosity
• Hypofibrinogenemia (decreased fibrinogen levels)
• Low plasma protein (due to liver or kidney disease)
• Polycythemia
• Sickle cell anemia

Additional conditions that may affect test results:

• Allergic vasculitis
• Atrial myxoma
• Autoimmune hepatitis
• Endometritis
• Eosinophilic fasciitis
• Erysipelas
• Juvenile rheumatoid arthritis
• Legionnaire's disease
• Osteomyelitis
• Pelvic inflammatory disease
• Pericarditis after a heart attack
• Retroperitoneal fibrosis
• Skin lesion of blastomycosis
• Subacute thyroiditis
• Scleroderma

Review Date: 05/07/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).