Erythrocyte sedimentation rate. From folklore to facts

Area of Science:

• Clinical Chemistry
• Hematology
• Diagnostic Medicine

Background:

• The erythrocyte sedimentation rate (ESR) is a long-standing laboratory test used in clinical practice.
• Criticism exists regarding ESR's lack of specificity and its validity as a "sickness index."

Purpose of the Study:

• To review the physical and chemical factors influencing red blood cell sedimentation.
• To re-evaluate the clinical utility, sensitivity, specificity, and predictive value of ESR.
• To examine the historical and current applications of ESR in diagnosing diseases.

Main Methods:

• Literature review of studies on erythrocyte sedimentation rate.
• Analysis of physical and chemical properties governing red blood cell aggregation.
• Re-evaluation of clinical data regarding ESR's diagnostic performance.

Main Results:

• ESR is influenced by plasma proteins and red blood cell surface charge.
• The test demonstrates variable sensitivity and specificity across different diseases.
• Historical use in infectious, inflammatory, and neoplastic diseases is examined.

Conclusions:

• ESR remains a valuable screening tool despite limitations.
• Understanding the factors affecting ESR is crucial for accurate interpretation.
• Further research is needed to clarify its precise role in modern diagnostics.