Erythrocyte Sedimentation Rate (ESR) (WB-EDTA Blood)

A high erythrocyte sedimentation rate (ESR) indicates increased inflammation in the body. It’s a nonspecific marker seen with infections, autoimmune diseases (like rheumatoid arthritis), certain cancers, tissue injury, and chronic inflammatory conditions. Results must be interpreted with clinical context and other tests because age, pregnancy, and anemia can also raise ESR. Further evaluation helps identify the underlying cause and guide treatment.

ESR (erythrocyte sedimentation rate) measures how quickly red blood cells settle in a tube over one hour and is a non‑specific marker of inflammation or infection. EDTA (a chelating anticoagulant used in blood collection tubes) prevents clotting for haematology tests; however, EDTA is not the preferred anticoagulant for ESR measurement (sodium citrate is commonly used) because EDTA can alter sedimentation results.

A low erythrocyte sedimentation rate (ESR) usually reflects reduced red-cell aggregation or low plasma fibrinogen. Causes include high hematocrit/polycythemia, sickle-cell or spherocytic disorders, hypofibrinogenemia, hyperviscosity, steroid therapy, or pre-analytical/technical issues. It’s rarely diagnostic alone; clinicians interpret a low ESR with symptoms and other tests (for example CRP and CBC) to assess clinical significance.

Normal ESR values vary by age and sex. Typical ranges: men under 50: 0–15 mm/hr; men over 50: 0–20 mm/hr; women under 50: 0–20 mm/hr; women over 50: 0–30 mm/hr; children: 0–10 mm/hr. Labs and individual factors (pregnancy, anemia, infections) can affect results, so interpret ESR with clinical context. Ask your clinician for interpretation.

An elevated ESR can occur with many cancers, most commonly hematologic malignancies (Hodgkin and non‑Hodgkin lymphoma, multiple myeloma, leukemia) and advanced or metastatic solid tumors — especially lung, breast, prostate, kidney (renal) and ovarian cancers. ESR is a nonspecific inflammatory marker: it rises with tumor burden, necrosis or secondary infection and must be interpreted with clinical findings and specific diagnostic tests.

An elevated ESR isn’t treated directly; care focuses on the underlying cause. Treat infections with appropriate antimicrobials; manage autoimmune or inflammatory conditions with NSAIDs, corticosteroids, disease‑modifying agents or biologics; address anemia or malignancy per specialist advice; and monitor response with repeat testing. Symptomatic relief and specialist referral help guide definitive therapy.