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Updated: Jul 14, 2026
Erythrocyte Sedimentation Rate: A Physics-Driven Characterization in a Medical Context
Published on: March 24, 2023
Extreme elevation of the erythrocyte sedimentation rate in children
Fuad Idrees Abbag1, Jobran Maree Al Qahtani
1Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia. fuadabbag@yahoo.com
Insights
Extreme elevation in erythrocyte sedimentation rate (ESR) in children is most commonly caused by infection. While a high ESR can indicate significant illness, it is not a reliable screening tool for specific diseases.
Area of Science:
- Pediatric Medicine
- Clinical Pathology
- Immunology
Background:
- Extreme erythrocyte sedimentation rate (ESR) elevation (≥100 mm/hour) often signifies serious underlying conditions.
- This study investigated the clinical significance of markedly elevated ESR in pediatric patients at Aseer Central Hospital.
Purpose of the Study:
- To assess the diagnostic significance of extreme erythrocyte sedimentation rate (ESR) elevation in pediatric patients.
- To identify common causes and associated clinical parameters of high ESR in children.
Main Methods:
- Retrospective review of all pediatric ESR tests performed between September 2001 and December 2002.
- Analysis of medical records for children with ESR ≥100 mm/hr, including diagnoses, hemoglobin (Hgb), and leukocyte counts.
- Comparison with a control group of 145 children with ESR <100 mm/hr.
Main Results:
- Out of 2540 ESR tests, 99 (3.9%) showed extreme elevation (≥100 mm/hr).
- Infection was the most frequent cause (49.5%), followed by connective tissue diseases (CTDs) (26.3%) and malignancy (12.1%).
- Patients with malignancy had the lowest Hgb values; those with CTDs had lower Hgb, and those with mild infections had higher leukocyte counts compared to controls.
Conclusions:
- Infection is the primary cause of extreme ESR elevation in pediatric patients.
- Markedly elevated ESR serves as an indicator of illness severity but is not a specific screening tool for diagnosing diseases.
Background:
Extreme elevation the of erythrocyte sedimentation rate (ESR >or= 100 mm/hour) is usually associated with significant diseases. This study was performed to assess its significance in pediatric patients seen in Aseer Central Hospital.
Methods:
All ESRs performed for children between September 2001 and December 2002 were reviewed. The medical records of those with an ESR>or=100 mm/hr (group 1) were reviewed for age, sex, diagnosis, ESR value, hemoglobin (Hgb) value and leukocyte counts. The diagnoses were divided into seven categories: malignancy, connective tissue diseases (CTDs), tropical infections, mild infections, severe infections, renal diseases and miscellaneous. One hundred forty-five patients with an ESR<100 mm/hr (group 2) were randomly selected for comparison.
Results:
Of 2540 ESRs, 99 were >or=100 mm/hr (3.9%). There were 54 males and 45 females and the mean age was 72+/-48.2 months. Infection was the most common cause (49.5%), followed by CTDs (26.3%), malignancy (12.1%) and renal diseases (8.1%). Malignancy was associated with the lowest Hgb value (8.2 g/dL). A comparison between group 1 and group 2 considering each diagnostic category separately showed that group 1 patients with mild infections had significantly higher mean leukocyte counts and that group 1 patients with CTDs had significantly lower Hgb values than group 2 patients with the same diagnoses, but there were no significant differences between the other diagnostic categories.
Conclusion:
The most common cause of extreme elevation of ESR is infection. This extreme elevation may be used as a sickness index, but not as a screening tool for any disease.
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