MICRO-BIOLOGY: ERYTHROCYTE SEDIMENTATION TEST (ESR)

It is carried out as part of routine blood panels. An ESR test is a type of test that
measures how fast the red blood cells (RBCs) in your blood settle down inside a
test tube. RBCs typically have a slow settling rate. However, if your tests show a
high settling rate, i.e., high ESR levels, they may indicate a diseased state in your
body, which appears as high ESR symptoms.

Before we understand what causes high ESR levels, let’s know what an ESR test is
and how it is useful.

What is an ESR Test?

ESR is an abbreviation for “Erythrocyte Sedimentation Rate.” ESR blood test is

also commonly called a “Sed rate test.” ESR tests calculate how fast the
erythrocytes, or red blood cells, in your blood settle down in a test tube. It
indirectly measures the level of specific proteins that facilitate the settling down
of blood cells. These protein levels provide information about the state of
inflammation in your body.

What Do High ESR Levels Mean?

When the body is diseased or infected, the immune system triggers a response to
fight the infection, and in doing so, the level of these proteins increases in the
body. As these proteins increase, they cause clumping of the RBCs together,
which increases their settling rates. (Tishkowski, K. et al., 2022) Therefore, high
levels of ESR usually mean that the body is currently fighting a disease or
infection.

For certain chronic disorders, like

Inflammatory diseases

Autoimmune diseases

Chronic kidney diseases

Arthrits,

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ESR tests are used to monitor the stages of disease and development.

However, the Erythrocyte Sedimentation Rate/ESR test is not diagnostic for any
specific disease. It is combined with other tests and symptoms to determine
whether there is increased inflammation in the body and, consequently, disease.

When Does The Doctor Recommend an ESR Test?

If your doctor suspects you have an infection, they may recommend the ESR test.
However, ESR tests are typically part of routine blood panel screenings, so they do
not need to be ordered separately.

What are The Symptoms of High ESR Levels?

Since ESR levels are determinants of disease and infection, high ESR symptoms
typically show up in following as symptoms associated with symptoms & illnesses
such as:

Headache, Fever, Joint/muscle pain or stiffness, Loss of appetite, Abnormal

weight loss/weight gain and Anaemia.

This list of symptoms is not exhaustive. High ESR symptoms can appear different
and are best evaluated by a physician.

What is The Normal Range for ESR Levels?

High ESR levels correspond to high protein levels in the blood that cause faster
clumping of RBCs.

The ESR test measures in millimetres (mm) the distance between the clear liquid
(plasma) at the top of the tube and your red blood cells after an hour. The normal
range is:

0 to 15 mm/hour in men whose age is <50 years

0 to 20 mm/hour in men >50 years of age

0 to 20 mm/hour in women <50 years of age

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0 to 30 mm/hour for women above 50 years of age

What Can Cause High ESR Levels?

High ESR levels can be due to several conditions. Most of them are inflammatory
diseases, which heighten the immune system’s response and cause high ESR
symptoms. Some of them include:

Inflammatory infections that have invaded the blood, i.e., systemic inflammatory
infections. These include infections affecting the bone, heart, skin, lungs, etc.

Tissue injury or ischemia (tissues suffering from lack of blood supply)

Traumatic events or accidents

Certain types of cancer like leukaemia, myeloma, lymphoma, etc.

Diabetes, Heart disease, Kidney disease, Vascular diseases like atherosclerosis,

high blood pressure, etc.

Obesity

Thyroid disease, Rheumatic fever. Autoimmune disorders like lupus, arthritis, etc.

This list of conditions is not exhaustive. High ESR symptoms can also be caused by
other conditions depending on gender, medical history, and overall health.

Medicines like birth control pills, vitamin A supplements, cortisone, methyldopa,

quinine, and theophylline may also affect your ESR test results.

Some conditions, like pregnancy, advanced age, and even anaemia, can result in
high ESR levels. Therefore, it is not always necessary that high ESR symptoms are
due to any disease or infection.

What Do I Do if I Have High ESR Levels?

The best thing to do after receiving a report showing high ESR levels is to wait for
your physician to make an accurate diagnosis based on your other tests, gender,

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age, and overall health. Just because you have high ESR levels is not an accurate
assessment of an underlying disease or condition in your body.

For the doctor to make an accurate assessment, it is imperative to provide correct

information about your medical history and any medicines you are on - as certain
supplements can affect your ESR levels. The normal range of ESR levels is subject
to change based on the labs, the tested person, and gender.

Not just that, a moderate ESR level may be an indicator of pregnancy or

menstruation rather than an inflammatory disease, making it necessary for the
physician’s diagnosis rather than just the ESR levels. Your physician may also
consider ordering more tests to make an accurate diagnosis.

PCV Test, PCV Test-Uses, PCV Test-Results

What is a PCV Test?

A PCV (Packed Cell Volume) Test is done to diagnose anemia or polycythemia in

patients. It is generally done along with a full blood count test that is conducted
to estimate the need for any blood transfusions and monitor the response to the
blood transfusion treatment.

Blood is a mix of plasma as well as cells. The PCV test can measure how much of
the blood consists of cells. If the PCV results show a reading of 50%, it denotes
that 50 ml of cells is present in exactly 100 ml of blood. If the RBC (Red Blood Cell)
number increases, then the total reading of the PCV will also be up. This number
can also increase due to dehydration.

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What is the PCV test used for?

A PCV or Packed Cell Volume Test, is a general blood screening done to diagnose
dehydration (low body fluids or blood volume), polycythemia (high level of red
blood cells), or anemia (low levels of red blood cells) in certain patients. PCV

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estimates the portion of blood made up of cells and is prescribed by a medical
professional after noticing the patient's condition and symptoms.

Understanding the test results of PCV (Packed Cell Volume) test

A lower number of the PCV means that the red blood cell count is less, which can
be due to many reasons such as blood loss, cell destruction, and less bone
marrow production. An increased PCV generally means that the person is
dehydrated, and there is a higher number of RBC production.

Why do I need a PCV test?

The PCV test is a part of the full blood count and estimates the percentage or
fraction of cells in the blood. If your doctor suspects that you have anemia, i.e.
low level of red blood cells, polycythemia, i.e. high level of red blood cells, or
dehydration, i.e. low body fluids or blood volume, they may advise this test.

What happens during a PCV Test?

A blood sample is taken with the help of a needle, generally from a vein in your
arm. The site may feel tender to you for some time, but there are no long-term
effects, and you'll be able to do your normal activities afterwards.

What is packed cell volume (PCV) in a blood test?

The packed cell volume is a measurement of the proportion of blood that is made
up of cells. The value is expressed as a percentage. For example, a PCV of 40%
means that there are 40 millilitres of cells in 100 millilitres of blood.

What is normal PCV in a blood test?

The PCV test value is either expressed as a percentage or fraction. A normal PCV
range in a blood test is:

Males: 38.3 to 48.6%

Females: 35.5 to 44.9%

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The above values indicate the proportion of cells in the blood. For example, 38.3%
to 48.6% means 40 ml of cells in 100 ml of blood.

Is 30 PCV normal for pregnant women?

The normal PCV range in pregnant females is 33-38%. This lower than average
PCV range in pregnancy is due to high fluid levels in the blood during pregnancy.
In some cases, the PCV value of 30% (mild anemia) is also observed.

Why is PCV lower in females?

The human blood comprises cells and plasma. In adolescent females, the level of
mean hemoglobin concentration/blood cells is lower as compared to males. This
is the reason why the value of PCV is lower in females.

What happens if PCV is low?

A low PCV implies that the patient has a low number of red blood cells and is
suffering from anemia. The doctor may need further test reports of the patient to
know the underlying causes of anemia so that the treatment can be given
accordingly.

Is PCV 34 normal?

A normal range of PCV generally depends on the person taking the test. In
females, the normal range is 35.5 to 44.9%. In males, 38.3% to 48.6% is the
normal PCV range. For pregnant females, the normal PCV is 33-38%. In some
cases of pregnancy, the PCV is 30% as well.

References:

https://medlineplus.gov/lab-tests/hematocrit-test/

https://pubmed.ncbi.nlm.nih.gov/11092458/

What is a Blood Group Test used for?

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A blood group test determines your unique blood type. This blood type is not the
same for every person. Whenever there is a requirement for a blood transfusion,
only people of the same blood group can transfer blood to those in need.

Understanding the test results of the Blood Group Test

It is extremely simple to interpret the test results. There are two major parts to
the report: Blood grouping and Rh typing. The blood group will tell you what type
of blood you have (A, B, O, and AB). Additionally, Rh typing will determine
whether you have Rh antigen. Accordingly, your final blood group will either be
positive or negative (A+, A-, etc).

Why do I need a Blood Group Test?

The most important reason to identify your blood group is in the event of a
medical emergency. If you require a blood transfusion, you will need a compatible
blood type. An incompatible blood type can cause blood cells to clump together,
which can be lethal.

What happens during the Blood Group Test?

A blood group test involves the collection of a blood sample. With the help of a
lancet, only a few drops of your blood are taken for this test. Any diagnostic
centre with a laboratory will be able to do the test, but it is always advisable to
consult with a recognized lab.

What are the different blood group types?

The four primary blood types are determined by whether or not antigens A or B
are present. The ABO Blood Group System is what doctors refer to it as. These
blood groups are:

Group A

Group B

Group AB

Group O

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The Rh factor is the third kind of antigen. If you have this antigen, your blood type
is ‘Rh+’ or ‘positive,’ and if you don't, your blood type is ‘Rh-’ or ‘negative.’

Do I need to fast before the test?

A blood group test is a fairly simple test. There is no special preparation needed
before taking this test. You do not fast before taking this test.

Can blood type be determined without drawing blood?

Because of the presence of antigens A and B in the saliva of 80% of people, a

saliva test can determine blood group type. However, it is important to note that
this method does not necessarily indicate the presence or absence of the Rh
factor. The idea of a blood group type is better served through a blood test. So, it
is always advisable to take a blood group test to find your blood type.

Will my blood group be the same as my parents?

Just like the colour of your eyes or hair, your blood type is inherited from your
parents too. But you may not always have the same blood group as your parents.
A child born of parents with type A and type B blood could have A, B, AB, or O
blood groups.

Will I need to do anything to prepare for the test?

A blood group test is a fairly simple test and does not require any special
preparation.

Are there any risks to the test?

A blood group test usually does not involve any risk. As it is a simple test and only
involves a prick. However, you might feel some discomfort at the time of pricking.
In rare cases, there may be bleeding or infection at the site of the puncture.

References:

AABB. Blood FAQ. Available online at

http://www.aabb.org/tm/Pages/bloodfaq.aspx.

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The American National Red Cross. Understanding Your Blood Type. Available
online at https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-
blood-donations/blood-types.html.

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