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Causes of increased and decreased erythrocyte sedimentation rate (ESR)
Medical expert of the article
Last reviewed: 06.07.2025
Along with leukocytosis and corresponding changes in the leukocyte formula, an increase in ESR serves as a reliable sign of the presence of infectious and inflammatory processes in the body. In the acute period, as the infectious process progresses, ESR increases, during the recovery period, ESR decreases, but somewhat more slowly compared to the rate of decrease in the leukocyte reaction. In autoimmune diseases, measuring ESR allows you to determine the stage of the disease (exacerbation or remission), assess its activity and the effectiveness of treatment. Normal ESR excludes the presence of an inflammatory process.
Diseases and conditions accompanied by changes in ESR
Increased ESR |
Decrease in ESR |
Pregnancy, postpartum period, menstruation Inflammatory diseases of various etiologies Paraproteinemia Tumor diseases (carcinoma, sarcoma, acute leukemia, lymphogranulomatosis, lymphoma) Diseases of connective tissue Glomerulonephritis, renal amyloidosis, occurring with nephrotic syndrome, uremia Severe infections Immunodeficiencies Hypoproteinemia Anemia Hyper- and hypothyroidism Internal bleeding Hyperfibrinogenemia Hypercholesterolemia Hemorrhagic vasculitis Rheumatoid arthritis Side effects of drugs (morphine, dextran, methyldopa, vitamin A) |
Erythremia and reactive erythrocytosis Severe manifestations of circulatory failure Epilepsy Sickle cell anemia Hemoglobinopathy C Hyperproteinemia Hypofibrinogenemia Viral hepatitis and mechanical jaundice (presumably due to the accumulation of bile acids in the blood) Taking calcium chloride, salicylates, etc. |
At the same time, an increase in ESR is not a specific indicator for any particular disease. However, often in pathology, its changes have diagnostic and prognostic value and can serve as an indicator of the effectiveness of the therapy. Determination of ESR should not be used as a screening method in asymptomatic patients.