IVIG Effects on Erythrocyte Sedimentation Rate in Children

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Erythrocyte Sedimentation Rate: A Physics-Driven Characterization in a Medical Context
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Erythrocyte Sedimentation Rate: A Physics-Driven Characterization in a Medical Context

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Farhad Salehzadeh1, Ahmadvand Noshin1, Sepideh Jahangiri1

  • 1Pediatric Department, Bouali Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil 56157, Iran.

International Journal of Pediatrics
|March 29, 2014
PubMed

Insights

Intravenous immunoglobulin (IVIG) therapy can falsely elevate erythrocyte sedimentation rate (ESR) in pediatric patients. This non-inflammatory rise makes ESR an unreliable marker for monitoring treatment response in patients receiving IVIG.

Area of Science:

  • Pediatric Medicine
  • Clinical Pathology
  • Immunology

Background:

  • Erythrocyte sedimentation rate (ESR) is a common diagnostic tool for inflammatory, infectious, and malignant conditions.
  • Red blood cells settle in plasma due to density differences, forming the basis of ESR measurement.
  • The influence of intravenous immunoglobulin (IVIG) on ESR requires further investigation, particularly across different age groups.

Purpose of the Study:

  • To investigate the effect of IVIG on ESR in pediatric patients.
  • To determine if IVIG administration impacts ESR readings in children of various age brackets.
  • To assess the reliability of ESR as a monitoring tool during IVIG therapy.

Main Methods:

  • Fifty pediatric patients under 12 years old receiving IVIG were enrolled.
  • ESR levels were measured before IVIG infusion and within 24 hours after the final dose.
  • IVIG was administered at a total dose of 2 g/kg, either in single or divided doses.

Main Results:

  • The mean ESR significantly increased from 31.8 ± 29.04 before IVIG to 47.2 ± 36.9 after IVIG (P = 0.05).
  • ESR changes were statistically significant across different pediatric age groups (P = 0.001 to P = 0.025).
  • A notable increase in ESR was observed post-IVIG administration in most pediatric age cohorts.

Conclusions:

  • IVIG therapy can cause a false elevation in ESR, indicating a non-inflammatory rise.
  • ESR may be an unreliable indicator for monitoring treatment response in pediatric patients undergoing IVIG therapy.
  • Caution is advised when interpreting ESR results in pediatric patients who have received IVIG, excluding the neonatal group.

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