Why shouldn't we determine the erythrocyte sedimentation rate?

Area of Science:

• Clinical chemistry
• Hematology
• Inflammation markers

Background:

• The erythrocyte sedimentation rate (ESR) is a widely used laboratory test for assessing inflammation.
• It has been utilized for nearly a century in clinical practice.
• ESR is employed to monitor inflammatory processes in conditions like infections, autoimmune diseases, and cancers.

Purpose of the Study:

• To evaluate the clinical utility of the erythrocyte sedimentation rate (ESR) test.
• To assess the impact of non-specific factors on ESR measurements.
• To determine if the ESR test's widespread use is justified given its limitations.

Main Methods:

• Literature review of studies on erythrocyte sedimentation rate (ESR) methodology and clinical application.
• Analysis of factors influencing ESR results beyond the intended inflammatory markers.
• Critical appraisal of the diagnostic and prognostic value of ESR in various diseases.

Main Results:

• The ESR test is influenced by numerous factors unrelated to the specific inflammatory process it aims to quantify.
• The nonspecificity of ESR compromises its ability to accurately reflect the degree of inflammation.
• Existing evidence suggests significant limitations in the clinical usefulness of ESR.

Conclusions:

• The erythrocyte sedimentation rate (ESR) test's clinical utility is severely compromised by its lack of specificity.
• Numerous confounding factors limit the reliability of ESR as a marker of inflammation.
• Healthcare providers should exercise caution when interpreting ESR results and consider alternative, more specific inflammatory markers.