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Erythrocyte Sedimentation Rate: A Physics-Driven Characterization in a Medical Context
Published on: March 24, 2023
Predictive value of erythrocyte sedimentation rate and C-reactive protein in Behcet's disease activity and
Amirhossein Parsaei1, Soroush Moradi1, Maryam Masoumi2
1Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels are associated with active Behcet's disease (BD) and its manifestations. These markers can predict active BD and vascular involvement, aiding in disease management.
Area of Science:
- Rheumatology
- Clinical Immunology
- Internal Medicine
Background:
- Behcet's disease (BD) is a chronic inflammatory disorder affecting multiple organ systems.
- The predictive value of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) for active BD manifestations remains debated.
Purpose of the Study:
- To assess and compare ESR and CRP values in patients with active versus inactive BD.
- To determine the predictive value of ESR and CRP for disease activity and specific manifestations.
Main Methods:
- Studied 514 drug-naïve BD patients, recording ESR, CRP, disease activity, and manifestations from their last two visits.
- Utilized Mann-Whitney U test for associations and binomial logistic regression for predictive value analysis.
- Employed ROC curves to determine sensitivity, specificity, and AUC, with multiple regressions for BD activity score prediction.
Main Results:
- Active oral, genital, joint, and dermal manifestations correlated with higher ESR and CRP levels (p < 0.05).
- ESR predicted active BD (AUC=0.79) and vascular manifestations (AUC=0.85). CRP predicted active vascular manifestations (AUC=0.86).
- Optimal ESR thresholds (≥10.5 and ≥42.5) predicted active BD and vascular manifestations with 71-83% sensitivity and specificity.
Conclusions:
- ESR and CRP are linked to active BD and its manifestations.
- These inflammatory markers demonstrate predictive value for active BD and active vascular manifestations.
- Further research is recommended to validate these findings.
Background:
Behcet's disease (BD) as a chronic inflammatory condition that affects the eyes, skin, central nervous system, gastrointestinal tract and vessels. According to the literature, the exact value of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in predicting active manifestations of BD remains controversial. In this study, we aim to assess and compare values of ESR and CRP between BD patients with active/inactive BD and active/inactive manifestations of the disease. Moreover, we try to determine the predictive value of ESR and CRP for disease activity.
Methods:
Participants (n = 514) were drug-naïve BD patients; Based on last two visits, ESR and CRP values, disease activity, and active manifestations were recorded. The Man-Whitney U test measured the associations, and the binomial logistic regression evaluated the predictive value of ESR and CRP for active disease and each active manifestation. The sensitivity and specificity and the area under the curve (AUC) for each model were determined using receiver operating characteristic curves (ROC). Multiple regressions were run to predict BD activity score from ESR and CRP.
Result:
Patients with active oral, genital, joint and dermal manifestations had higher ESR and CRP values (Mann-Whitney U test, p < 0.05 for all). Binomial logistic regressions showed that ESR had valuable predictive value for active BD (OR = 1.09 [1.04-1.13], AUC = 0.79 [0.74-0.83], p < 0.001) and active vascular manifestations (1.03 [1.01-1.05], AUC = 0.85 [0.79-0.92], p < 0.001). CRP had good predictive value for active vascular manifestations (OR 1.98 [1.45-2.72], AUC = 0.86 [0.8-0.91], p < 0.001). The optimal value of ESR ≥ 10.5 and ESR ≥ 42.5 could predict active BD and active vascular manifestations with sensitivity, specificity = 71%, 75% and = 81%, 83% respectively.
Conclusions:
ESR and CRP are both associated with active BD and most manifestations of the diseases. They can be used for the prediction of active BD and active vascular manifestations in BD patients. Further studies can help to confirm the findings of the current research.
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