Many of us disregard ESR by saying its non specific test

ESR;
Many of us disregard ESR by saying its non specific test, As its very simple test and not very costly,It’s very useful test if used in proper clinical context especially if we are practicing in countries with limited resources.

If ESR is normal , it helps excluding many chronic infections & autoimmune disorders especially when thinking about possible d/d of an undifferentiated chronic disease.
Normal ESR is most of the time against diagnosis of TB, SLE, RA, Abscess, lymphoma, Myeloma,leukemia etc. however this must be interpreted in whole clinical context. ESR alone can’t include or exclude any of the above but helps to do so.

Elevated ESR especially above 60-70 is very useful marker to ring the bell about ongoing chronic infection/ autoimmune or some of the malignancies like Lymphoma, Myeloma to be suspected.

ESR isn’t a good test to assess any acute pathology like acute infections etc, where CRP or Procalcitonin is better test.

ESR can be elevated in many non inflammatory causes too like Renal failure, anemia, fracture in old age, etc. usually every 10 gm/L ( 1gm/DL) drop in Haemoglobin will cause 5 unit rise in ESR. This is a rough estimate.

Some disease will high ESR but normal CRP like SLE etc. So when there is infection in such conditions CRP is used as a marker. Mostly ESR and CRP are elevated simultaneously in majority of the disease.

ESR has prognostic role too & is used to monitor disease such as Vasculitis & other rheumatological conditions.

I can elaborate more if any question is there but remember every test is non specific if not used in proper clinical context.

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