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What does an abnormal sed rate finding mean?
The main reason for an elevated sed rate is an increase in erythrocyte aggregation (the clumping together of red blood cells that is necessary for blood clotting). Unless the red blood cells are clumping together because of anemia (a lack of red blood cells), this aggregation is due to abnormally high levels of plasma proteins.
Plasma proteins are chains of amino acids -- the building blocks of all body cells. When too many plasma proteins (e.g., fibrinogen or beta globulin) adhere to the surface of red blood cells, they are more likely to clump together. These groups of aggregated cells are heavier, so they fall out from plasma more quickly than single red blood cells. Therefore, an elevated sed rate is a sign of an excess of plasma proteins in the blood, which could be caused by a number of different diseases.
Unfortunately, the sed rate cannot determine which disease is present. For this reason, a sed rate test is often performed in conjunction with other blood tests, including the following (please click on the link for more information):
Total serum protein test (to assess the levels of different plasma proteins)
Complete blood count
Waste product test
In general, slightly elevated sed rate with no other indicators of disease will not result in extensive investigation into the cause. The patient will likely be retested after several months. Elevations greater than 100 millimeter per hour are usually due to an apparent cause such as infection, cancer or other serious illness.
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Is regular sed rate testing needed?
Sed rate tests are generally used as a screening tool for disease, and most patients will not require regular testing. However, sed rate tests can also be used to monitor several chronic diseases, including Hodgkin disease and other cancers. Therefore, some patients will have regular sed rate tests to provide an early warning of a relapse in their condition.
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How is sed rate analysis performed?
The ESR test is performed in a laboratory by placing whole blood in a solution at a ratio of 4:1. A small amount of the mixture is then transferred to a tube at least 200 millimeters high. After an hour, the distance that the erythrocytes (mature red blood cells) travel down through the plasma (the liquid part of blood in which cells are suspended) is measured. That distance is the erythrocyte sedimentation rate.