ERYTHROCYTE

SEDIMENTATION
RATE
DEFINITION
THE RATE AT WHICH RED CELLS FALL
WHEN ANTICOAGULATED BLOOD IS
ALLOWED TO SETTLE UNDER THE
INFLUENCE OF GRAVITY IS CALLED
ERTHROCYTE SEDIMENTATION RATE.
OCCURS DUE TO ROULEAU
FORMATION OF RBC’S.
FACTORS AFFECTING ESR
SIZE OF THE ROULEAUX
PLASMA FACTORS:-
FIBRINOGEN
ACUTE PHASE REACTANTS
GLOBULIN
VISCOSITY
SHAPE OF THE RBC’S
TECHNICAL AND MECHANICAL FACTORS
TEMPERATURE
POSITION
 METHODS OF
DETERMINATION
WESTERGEN METHOD
APPARATUS REQUIRED:-
WESTERGEN’S TUBE
WESTERGEN’S RACK
REAGENT USED:-
3.8% SODIUM CITRATE
PROCEDURE:-
BLOOD OBTAINED BY VENUPUNCTURE IS
MIXED WITH THE REAGENT IN THE RATIO 4 :1.
FILL THE TUBE UPTO THE ‘0’ MARK..
KEEP IT IN THE RACK PROPERLY.
READ AFTER ONE HOUR.
PRECAUTIONS
CONCENTRATION OF THE REAGENT SHOULD
BE CORRECT.
BLOOD SHOULD BE PROPERLY MIXED WITH
THE REAGENT.
PIPETTE SHOULD BE CLEAN AND DRY.
BLOOD SHOULD BE FILLED EXACTLY TO THE
‘0’ MARK.
TUBE SHOULD BE PLACED IN THE VERTICAL
POSITION.
ESR TO BE READ STRICTLY AFTER ONE
HOUR.
SOURCES OF ERROR
IF THE REAGENT CONCENTRATION IS
HIGH,FALSE RESULTS WILL BE
OBTAINED.
TAKING THE HALF HOUR READING
AND MULTIPLYING BY 2.
WHEN THE SAMPLE IS NOT AT ROOM
TEMPERATURE.
TILTING OF THE WESTERGEN’S TUBE.
WINTROBE’S METHOD
NOT THE PROCEDURE OF CHOICE.
APPARATUS REQUIRED:-
WINTROBE TUBE.
WINTROBE RACK.
PASTEUR PIPETTE.
REAGENT USED:-
AMMONIUM POTASSIUM OXALATE.
PROCEDURE:-
BLOOD MIXED WITH THE REAGENT(2mg OF THE
REAGENT /ml OF BLOOD).
SUCK IT IN THE PIPETTE AND PUT INTO THE
WINTROBE’S TUBE.
TUBE IS THEN PLACED IN THE RACK.
READ AT END OF 1 HOUR.
NORMAL RANGE

WESTERGEN’S METHOD:-
MALES:-0-5 mm/Hr.
FEMALES:-5-12 mm/Hr.

WINTROBE’S METHOD:-
MALES:- 0-9 mm/Hr.
FEMALES:-0-20 mm/Hr.
ADVANTAGES

WESTERGEN’S WINTROBE’S
METHOD:- METHOD:-
SINCE THE TUBE IS ESR AS WELL AS
LONGER THE VALUE PCV CAN BE
OBTAINED IS MORE MEASURED IN THE
ACCURATE. SAME SAMPLE.
DISADVANTAGES
WESTERGEN’S METHOD:-
THE REAGENT USED CAN
1) DILUTE THE RBC’S AND INCREASE THE ESR.
2) DILUTE THE PLASMA FIBRINOGEN AND
GLOBULIN,THEREBY DECREASING THE ESR.

WINTROBE’S METHOD:-
SINCE THE TUBE IS SHORTER AND THE SAMPLE
VOLUME IS LESS,THE ACCURACY IS LOW.
PHYSIOLOGICAL VARIATIONS
AGE:-
LOW IN INFANTS.INCREASES UPTO PUBERTY AND
DECREASES TILL OLD AGE AFTER WHICH IT AGAIN
INCREASES.
SEX:-
GREATER IN FEMALES.
PREGNANCY:-
INCREASES UPTO THE 3 rd MONTH AND THEN
RETURNS TO NORMAL,ABOUT 3-4 WEEKS AFTER
DELIVERY.
ALTITUDE:-
ESR DECREASES AS THE ALTITUDE INCREASES.
AFTER MEALS:-
ESR INCREASES.
PATHOLOGICAL INCREASE
I. ALL INFECTIONS.
II. ACUTE EPISODE OF CHRONIC
INFECTIONS.
III. ALL MALIGNANCIES.
IV. COLLAGEN DISEASES.
V. ANAEMIA.
PATHOLOGICAL DECREASE

POLYCYTHEMIA OF ANY ETIOLOGY.

DECREASED LEVELS OF
FIBRINOGEN.
DISORDERS OF RBC SHAPE:-
FOR Eg:-
1. SICKLE CELL DISEASE.
2. HERIDETARY SPHEROCYTOSIS.
CLINICAL SIGNIFICANCE
NOT A DIAGNOSTIC TEST.
INDEX OF INFLAMMATORY ACTIVITY.
GIVES CLUE REGARDING THE
PROGRESS OF THE DISEASE AND
ALSO THE RESPONSE TO TREATMENT.
SINCE IT IS NORMAL IN FUNCTIONAL
DISORDERS IT CAN BE USED TO RULE
OUT ORGANIC DISEASES.