Blood Test

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In a Blood test report what is ESR ?

It is the Erythrocyte Sedimentation Rate, that means, the velocity of your red
blood cells to "fall down" in a suspension. This parameter reflects a systemic
inflammatory process trough your body, it does not have to be necessarily an
infection but that's very probable.

An erythrocyte sedimentation rate diagnoses inflammation in the body. An elevated


sed rate doesn't tell the dr where the inflammation is or what is causing it, it
just lets him know that it's there.

ESR is the erythrocytes (Red Blod cells) sedimentaion rate. It is increased in


certain physiological conditions. Grossly abnormal in certain diseases and low in
certain conditions. In certain conditons and diseases there is no increase.
a) Its estimation is valued in diagnosis ( of little value ) -(i) To distinguish
functional from organic diseases. (ii)In most of the arthritis conditions it is
increrased, (iii) The rate is increased in pelvic inflammation but not in
unruptured ectopic gestation (iv) The rate is always rapid in malignant pelvic
tumours and not in simple pelvic tumours.
b) In prognosis and Treament: In fevers a rising ESR suggests the progress of the
disease or onset of complications (ii) In rheumatic fever it is a specially
sesnsitive index of persistant rheumatic infection (iii) In acute nephritis the
rate remains high in patients pasing to chronic stage.

The sed rate, or erythrocyte sedimentation rate, is another method for measuring
swelling and inflamma-
tion of the muscles. Doctors use the sed rate to watch the progress of the muscle
inflammation. This test
is not specific to a particular disease but to the presence of the inflammation.

For this test, technicians mix red blood cells from the blood sample in a prepared
test tube. They
measure the length of time it takes these cells to settle to the bottom of the
tube. For males, the normal
rate falls between 0 and 15 millimeters per hour; females, 0 to 20 millimeters per
hour. The sed rate will
be higher with more inflammation. (The sed rate may be slightly higher if you are
older or pregnant.)

Blood Tests to Detect Inflammation

ESR and CRP are blood tests that detect inflammation. Thses are useful tests to
help diagnose and monitor the activity of certain diseases.

Inflammation and blood proteins

If you have inflammation in a part of your body then extra protein is often
released from the site of inflammation and circulates in the bloodstream. The CRP
and ESR blood tests are commonly used to detect this increase in protein, and so
are 'markers' of inflammation.

ESR and CRP blood tests

Erythrocyte Sedimentation Rate (ESR)


A blood sample is taken and put in a tube that contains a chemical to stop the
blood from clotting. The tube is left to stand upright. The red blood cells
(erythrocytes) gradually fall to the bottom of the tube (as a 'sediment'). The
clear liquid plasma is left at the top. The ESR measures the rate at which the red
blood cells separate from the plasma and fall to the bottom of a test tube. The
rate is measured in millimetres per hour (mm/hr). This is easy to measure as there
will be a number of millimetres of clear liquid at the top of the red blood after
one hour.

If certain proteins cover red cells, these will stick to each other and cause the
red cells to fall more quickly. So, a high ESR indicates that you have some
inflammation, somewhere in the body.

C Reactive Protein (CRP)


This is sometimes called an 'acute phase protein'. This means that the level of CRP
increases when you have certain diseases which cause inflammation. CRP can be
measured in a blood sample.

What conditions affect the ESR and CRP level?

The ESR and CRP level are raised many inflammatory conditions. For example:

* Certain infections (mainly bacterial infections)


* Abscesses
* Certain types of arthritis
* Various other muscular and connective tissue disorders
* Tissue injury and burns
* Cancers
* Crohn's disease
* Rejection of an organ transplant
* Heart attack

Some conditions lower the ESR. For example, heart failure, polycythaemia, sickle-
cell anaemia, and cryoglobulinaemia.

When are these tests used?

To help diagnose diseases


The ESR and CRP are 'non-specific' tests. Basically, a raised level means that
'something is going on', but further tests will be needed to clarify the cause of
the illness. For example, you may be 'unwell' but the cause may not be clear. A
raised ESR or CRP may indicate that some inflammatory condition is likely to be the
cause. This may prompt a doctor to do further tests to find the cause.

To monitor the activity of certain diseases


For example, if you have rheumatoid arthritis, the amount of inflammation and
disease activity can partially be assessed by measuring one of these blood tests.
As a rule, the higher the level, the more 'active' the disease. The response to
treatment may also be monitored as the level of CRP or ESR may fall if the
condition is responding well to treatment.

Both tests are useful. However, changes in the CRP are more rapid. So, for example,
a fall in the CRP within days of starting treatment for certain conditions is a
useful way of knowing that treatment is working. This may be important to know when
treating a serious infection or a severe flare up of an inflammatory condition. For
example, if the CRP level does not fall, it may indicate that the treatment is not
working and may prompt a doctor to switch to a different treatment.

NEUTROPHILS

This granulocyte has very tiny light staining granules (the granules are very
difficult to see). The nucleus is frequently multi-lobed with lobes connected by
thin strands of nuclear material. These cells are capable of phagocytizing foreign
cells, toxins, and viruses.

When taking a Differential WBC Count of normal blood, this type of cell would be
the most numerous. Normally, neutrophils account for 50-70% of all leukocytes. If
the count exceeds this amount, the cause is usually due to an acute infection such
as appendicitis, smallpox or rheumatic fever. If the count is considerably less, it
may be due to a viral infection such as influenza, hepatitis, or rubella.

EOSINOPHIL

This granulocyte has large granules (A) which are acidophilic and appear pink (or
red) in a stained preparation. This micrograph was color enhanced to illustrate
this feature. The nucleus often has two lobes connected by a band of nuclear
material. (Does it looks like a telephone receiver?) The granules contain digestive
enzymes that are particularly effective against parasitic worms in their larval
form. These cells also phagocytize antigen - antibody complexes.

These cells account for less than 5% of the WBC's. Increases beyond this amount may
be due to parasitic diseases, bronchial asthma or hay fever. Eosinopenia may occur
when the body is severely stressed.

BASOPHIL

The basophilic granules in this cell are large, stain deep blue to purple, and are
often so numerous they mask the nucleus. These granules contain histamines (cause
vasodilation) and heparin (anticoagulant).

In a Differential WBC Count we rarely see these as they represent less than 1% of
all leukocytes. If the count showed an abnormally high number of these cells,
hemolytic anemia or chicken pox may be the cause.

LYMPHOCYTE

The lymphocyte is an agranular cell with very clear cytoplasm which stains pale
blue. Its nucleus is very large for the size of the cell and stains dark purple.
(Notice that the nucleus almost fills the cell leaving a very thin rim of
cytoplasm.) This cell is much smaller than the three granulocytes (which are all
about the same size). These cells play an important role in our immune response.
The T-lymphocytes act against virus infected cells and tumor cells. The B-
lymphocytes produce antibodies.

This is the second most numerous leukocyte, accounting for 25-35% of the cells
counted in a Differential WBC Count. When the number of these cells exceeds the
normal amount, one would suspect infectious mononucleosis or a chronic infection.
Patients with AIDS keep a careful watch on their T-cell level, an indicator of the
AIDS virus' activity.

MONOCYTE

This cell is the largest of the leukocytes and is agranular. The nucleus is most
often "U" or kidney bean shaped; the cytoplasm is abundant and light blue (more
blue than this micrograph illustrates). These cells leave the blood stream
(diapedesis) to become macrophages. As a monocyte or macrophage, these cells are
phagocytic and defend the body against viruses and bacteria.

These cells account for 3-9% of all leukocytes. In people with malaria,
endocarditis, typhoid fever, and Rocky Mountain spotted fever, monocytes increase
in number.

All about Lymphomas in this page?


http://www.ehealthmd.com/library/lymphoma/NHL_whatis.html

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