Blood sedimentation
and Eva Rudolf-Müller, doctorEva Rudolf-Müller is a freelance writer in the medical team. She studied human medicine and newspaper sciences and has repeatedly worked in both areas - as a doctor in the clinic, as a reviewer, and as a medical journalist for various specialist journals. She is currently working in online journalism, where a wide range of medicine is offered to everyone.
More about the experts All content is checked by medical journalists.The blood sedimentation rate is also called the rate of sedimentation of the blood cells (BSG or BKS for short). It shows how quickly the red blood cells in a blood sample drop in a special tube within an hour. The ESR value serves primarily as an indication of inflammation in the body. But other diseases also affect blood sedimentation. Read everything you need to know about blood sedimentation here!
What is the blood sedimentation?
The blood sedimentation rate (blood cell sedimentation rate) indicates how fast the red blood cells sink in a blood sample that has been made incoagulable. It is influenced by the number, shape and deformability of the red blood cells.
When is the blood sedimentation determined?
The blood sedimentation serves as a test to rule out inflammatory or malignant diseases. However, it is an unspecific value that does not provide an exact causal diagnosis. It can only indicate general inflammation or malignant disease.
In addition, the doctor can measure the BKS blood level in certain diseases as a control parameter in the further course. Nowadays, however, the C-reactive protein (CRP) is usually determined for this purpose.
What is the normal sedimentation rate?
Age and gender influence the reference range of blood sedimentation. Normal values for women are less than 20 millimeters (mm) after the first hour, for men less than 15 mm. The ESR standard values for patients over 50 years of age are about 10 and 5 mm higher, respectively.
As a rule, the blood sedimentation is only determined after the first hour. Sometimes the doctor also collects the 2-hour value, but this is of no further informative value.
When is the blood sedimentation decreased?
If the sedimentation rate is reduced, this can be for the following reasons, for example:
- Polyglobules (increased red blood cells)
- Polycythemia Vera (disease of the blood-forming cells in the bone marrow)
- Diseases with an altered shape of the erythrocytes, for example sickle cell disease
- Dehydration
If the blood sample was stored too cool before the measurement, the result will be incorrectly low ESR values.
When is the blood sedimentation increased?
In inflammation and cancer, the blood sedimentation is too high. The extent of the ESR increase can provide clues to the underlying disease. A moderate increase of up to 50 mm within the first hour is found in the following cases:
- Anemia
- Increase in lipids in the blood (hypertriglyceridemia)
- Tumor diseases
- Use of hormonal contraceptives
- after menstruation
- during pregnancy
- after an operation
The ESR can also be increased as a result of determination errors such as taking too little blood in the sample tube or storing the sample at over 25 degrees Celsius.
A sharp increase in blood sedimentation to 50 to 100 mm within the first hour can have the following causes:
- Infections
- advanced tumor diseases with metastases
- Leukemias
- Anemia caused by cell breakdown (haemolytic anemia)
- chronic liver disease
- chronic kidney failure
- Tissue necrosis (tissue death)
- Rheumatoid arthritis
- Collagenoses (connective tissue diseases)
- Vasculitis (inflammation of the blood vessels)
If the blood subsidence increases to over 100 mm in the first hour, it is called a fall subsidence. It is often an expression of a serious infection such as sepsis ("blood poisoning") or inflammation of the peritoneum (peritonitis). Fall reduction can also be seen in other diseases such as multiple myeloma (cancer of the blood-forming system), giant cell arteritis (autoimmune disease, also known as polymyalgia rheumatica) or Waldenström's disease (malignant lymphoma).
What to do if the blood sedimentation changes?
If there are no symptoms other than the changed blood sedimentation or if the patient had an infection shortly before, the doctor will check the ESR value again after a week. If the blood sedimentation has shifted back towards the normal range, it is sufficient to wait and carry out another check.
However, if the blood sedimentation continues to increase or if there are other symptoms, further examinations are necessary (such as complete blood count, LDH, transaminases, creatinine, urine status). If necessary, the doctor will also do an ultrasound scan of the abdomen or a chest x-ray.
Tags: Menstruation symptoms nourishment
