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    VSH Crescu1

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    Cristina Prijilevschi
    This document discusses the erythrocyte sedimentation rate (ESR) test, which is useful for diagnosing and monitoring conditions involving collagen diseases, rheumatoid arthritis, and polymyalgia rheumatica. It provides normal and abnormal ESR values associated with various medical conditions, such as infections, inflammatory diseases, cancers, tissue damage, and physiological factors like menstruation and pregnancy. Extremely high ESR values over 100 mm/h can indicate metastases, kidney diseases, or severe infections. Many medical factors can influence the ESR, including medications, anemia, blood storage conditions, and abnormal red blood cells.

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    VSH Crescu1

    Uploaded by

    Cristina Prijilevschi
    48 views3 pages
    This document discusses the erythrocyte sedimentation rate (ESR) test, which is useful for diagnosing and monitoring conditions involving collagen diseases, rheumatoid arthritis, and polymyalgia rheumatica. It provides normal and abnormal ESR values associated with various medical conditions, such as infections, inflammatory diseases, cancers, tissue damage, and physiological factors like menstruation and pregnancy. Extremely high ESR values over 100 mm/h can indicate metastases, kidney diseases, or severe infections. Many medical factors can influence the ESR, including medications, anemia, blood storage conditions, and abnormal red blood cells.

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    VSH crescut

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    VSH crescu1

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    This document discusses the erythrocyte sedimentation rate (ESR) test, which is useful for diagnosing and monitoring conditions involving collagen diseases, rheumatoid arthritis, and polymyalgia rheumatica. It provides normal and abnormal ESR values associated with various medical conditions, such as infections, inflammatory diseases, cancers, tissue damage, and physiological factors like menstruation and pregnancy. Extremely high ESR values over 100 mm/h can indicate metastases, kidney diseases, or severe infections. Many medical factors can influence the ESR, including medications, anemia, blood storage conditions, and abnormal red blood cells.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    48 views3 pages

    VSH Crescu1

    Uploaded by

    Cristina Prijilevschi
    This document discusses the erythrocyte sedimentation rate (ESR) test, which is useful for diagnosing and monitoring conditions involving collagen diseases, rheumatoid arthritis, and polymyalgia rheumatica. It provides normal and abnormal ESR values associated with various medical conditions, such as infections, inflammatory diseases, cancers, tissue damage, and physiological factors like menstruation and pregnancy. Extremely high ESR values over 100 mm/h can indicate metastases, kidney diseases, or severe infections. Many medical factors can influence the ESR, including medications, anemia, blood storage conditions, and abnormal red blood cells.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    of 3

    VSH crescut

    Boli de colagen; este cel mai util test pentru diagnosticul si monitorizarea arteritei temporale, artritei
    reumatoide si polimialgiei reumatice.

    Infectii, pneumonii, sifilis, tuberculoza, endocardita bacteriana subacuta.

    Boli inflamatorii: boala inflamatorie pelvina acuta, guta, artrita, nefrita, nefroza.

    Boli neoplazice.

    Cresterea imunoglobulinelor serice, mielom multiplu, macroglobulinemie Waldenström.

    Intoxicatii acute cu metale grele.

    Distructii tisulare/celulare, infarct miocardic acut, postoperator (valorile crescute se pot mentine pana la
    1 luna).

    Toxemie, hipotiroidism, hipertiroidism.

    Anemia acuta sau din bolile cronice.

    ! Un VSH moderat crescut trebuie intotdeauna investigat2;5.

    2. VSH normal:

    Policitemie vera.

    Anemie feripriva.

    Infectii virale necomplicate, mononucleoza infectioasa.

    Insuficienta cardiaca congestiva, boala renala activa cu insuficienta cardiaca.

    Alergie acuta.

    Ulcer peptic.

    ! Un VSH normal nu exclude o boala organica non-inflamatorie, disfunctie de organ/neoplazie2;4.

    Valori critice – cresteri extreme ale VSH apar in limfoame, carcinoame maligne de colon/san, mielom
    multiplu si artrita reumatoida2.

    VSH >100 mm/h apare in: metastaze, boli renale (in special cele cu azotemie), infectii severe
    (osteomielita, endocardita bacteriana subacuta), polimialgie reumatica4.

    Limite si interferente

    1. Variatii fiziologice:
    Menstruatia: VSH-ul creste in timpul ciclului menstrual, atingand nivelul maxim in faza premenstruala si
    scazand in timpul menstruatiei4.

    Sarcina: VSH-ul creste continuu incepand cu a 4-a saptamana de sarcina pana in a 3-a saptamana
    postpartum2 si atinge un nivel maxim de pana la 45 mm/h in prima saptamana postpartum4.

    Nou-nascuti: VSH-ul este scazut datorita hematocritului crescut si nivelului scazut de fibrinogen4.

    Femei varstnice (70-89 ani) aparent sanatoase pot avea un VSH foarte mare (pana la 60 mm/h)2.

    2. Factori care determina VSH crescut:

    Sange refrigerat2.

    Anemia: datorita numarului scazut de eritrocite; in anemia feripriva cresterea VSH nu corespunde
    numarului de eritrocite deoarece microcitoza concomitenta incetineste sedimentarea hematiilor.

    Macrocitoza.

    Medicamente: contraceptive orale, dextrani (datorita absorbtiei pe suprafata eritrocitelor),


    anticonvulsivante, aspirina, carbamazepina, cefalotin, ciclosporina A, dexametazona, etretinat,
    fluvastatin, hidralazina, indometacin, isotretinoin, lomefloxacin, metisergid, misoprostol, ofloxacin,
    procainamida, propafenona, quinina, sulfametoxazol, zolpidem2;4.

    3. Factori care scad VSH-ul:

    Temperaturi >20-24°C4.

    Hiperglicemia2.

    Hiperlipoproteinemia (in special chilomicronii)4.

    Hipofibrinogenemia.

    Policitemia.

    Hiperleucocitoza2.

    Prezenta de eritrocite anormale: microcite, drepanocite, echinocite, poichilocite, stomatocite,


    acantocite, sferocite (prin scaderea suprafetei necesare pentru agregarea hematiilor)3.

    Casexia5.

    Medicamente: aspirina, aur, corticotropin, ciclofosfamida, glucocorticoizi, hidroxiclorochina, metotrexat,


    antiinflamatorii nesteroidiene, penicilamina, sulfasalzina, tamoxifen, trimetoprim2.

    Bibliografie
    1. DeMott W, Tilzer L. Hematology. In Laboratory Test Handbook, 3rd Edition, Hudson (Cleveland), 1994,
    599-600.

    2. Fischbach F, Dunning III M. Blood Studies: Hematology and Coagulation. In A Manual of Laboratory
    and Diagnostic Tests, Philadelphia, 8 Ed, 2009, 110-111, 1237.

    3. Laborator Synevo. Referintele specifice tehnologiei de lucru utilizate. 2010. Ref Type: Catalog

    4. Thomas L. Tests for the Diagnosis of Inflammation. In Clinical Laboratory Diagnostics, First Edition,
    Frankfurt/Main, 1998, 698-699.

    5. Wallach J. Interpretarea testelor de diagnostic, Ed VII, Trad Ionescu R, Dragomir M, Ed Stiintelor


    Medicale, Buc, 115-117.

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