ERYTHROCYTE SEDIMENTATION
RATE
INTRODUCTION
• When anticoagulated blood allowed to
stand undisturbed for a period of time the
rbc's tend to sink to bottom displacing the
plasma towards top.
STAGES OF SEDIMENTATION
• AGGREGATION :
15 MIN
• SEDIMENTATION
:40 MIN
• PACKING : 10 MIN
METHODS
• WINTROBES
• WESTERGREN
• MICRO ESR
• AUTOMATION
• ZETA SEDIMENTATION
WINTROBES
• Fill pasteur pipette
• Pipette out in tube top mark 0/100
• Vertical position
•
•
•
•
ADVANTAGES
Simple
both PCV & ESR
Buffy coat smear
ERROR
Air bubble
Hemolysed sample
WESTERGRENS
• Pipette open at both ends
• 0 to 200mm
• Measure the height of plasma after
1 hour
• ADVANTAGE
sensitive and accurate because if
bigger column
• NORMAL RANGE
Adult male :0 - 7 mm
Adult femles 0- 14 mm
Children 0-14 mm
Factors affecting ESR
• Physioligical
Plasma factors : fibrinogen globulin and
cholestrol (increase)
albumin (decrease)
Number of cells
Laboratory
 Temperature
 Time
 Anticoagulants
 The length of tube
 Inclination of the tube
 Movement or agitation of the tube
PATHOLOGICAL CONDITION
• INCREASED
TB, RF,RA,SLE
MM,
• DECREASED
Polycythemia rubra
vera
sickle cell
Hypofibrinogemia in
liver disease