ESR - elevation

The ESR should not be used to screen asymptomatic patients for the presence of disease.

The ESR increases with age, in pregnancy and, to a lesser extent, in anaemia; values of >30 mm in one hour should be evaluated clinically and/or investigated as appropriate to the clinical context.

Review clinical findings; FBC, blood film; CRP; albumin, protein (total), protein electrophoresis.

An elevated ESR is a non-specific indicator of disease including bacterial infection, malignancy, connective tissue disease and other inflammatory disorders.

If cause not apparent, consider occult inflamation, infection or malignancy.