Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Elevated ESR Levels?
Question:
ELEVATED ESR 65 MM/HR
the question is related to my 35 year old wife.
past medical history ;-
"3 miscarriages within 3 months of pregnancy.
c-section delivery 4 years ago.
gall bladder removed due to stones 2 years ago.
otherwise generally healthy".
question :-
1. a month ago my wife had an upset stomach which she often has due to indigestion. she also had cold, runny nose, headache in right eye cavity, cough. so i got her check up on 30 august 2015. REPORTS OF THE DATE ENCLOSED. her reports were normal except except low haemoglobin and her ESR which was 80 MM / hr.
2. eventually a cross check from other lab was done on 6 september and this time the ESR was 65 MM/hr. REPORTS OF THE DATE ENCLOSED. the urine test showed acidic and epithelial cells 6-7 hpf.
3. on 7 september 2015 allopath physician was consulted who diagnosed MAXILLARY SINUSTIS and prescribed antibiotics and other drugs
for ten days. PRESCRIPTION ENCLOSED.
4. after 10 days of drugs all the sinusitis symptoms subsided . my wife felt generally good and active. today on 27 september again we did some tests to ensure the improvements but ESR level is still at 65 MM/ HR. urine epithelial cells XXXXXXX to 12-14 . REPORTS enclosed for today i.e. 27 September. for last 15 days she has increased her fruits intake along with more liquids.
5. for now she has no joint pain, no body aches, eats well, sleeps well, goes to her job. the only issue she seems to face is occasional headache on right side if she stays in sun for too long and at times feel tired and fatigue if their is extra work pressure. i m also trying to get her into yoga. meanwhile she has a cancer awareness camp in her school where CBC and mammography was done and she was told everything OK.
the question is why is her ESR so high ? how to find the cause behind her elevated ESR. what tests can help me find the root cause ? what methods like foods or exercises help in lowering ESR ? What questions i need to ask my local physician ? can a person have high ESR and still be healthy ?i googled but it gave nothing except anxiety.
ELEVATED ESR 65 MM/HR
the question is related to my 35 year old wife.
past medical history ;-
"3 miscarriages within 3 months of pregnancy.
c-section delivery 4 years ago.
gall bladder removed due to stones 2 years ago.
otherwise generally healthy".
question :-
1. a month ago my wife had an upset stomach which she often has due to indigestion. she also had cold, runny nose, headache in right eye cavity, cough. so i got her check up on 30 august 2015. REPORTS OF THE DATE ENCLOSED. her reports were normal except except low haemoglobin and her ESR which was 80 MM / hr.
2. eventually a cross check from other lab was done on 6 september and this time the ESR was 65 MM/hr. REPORTS OF THE DATE ENCLOSED. the urine test showed acidic and epithelial cells 6-7 hpf.
3. on 7 september 2015 allopath physician was consulted who diagnosed MAXILLARY SINUSTIS and prescribed antibiotics and other drugs
for ten days. PRESCRIPTION ENCLOSED.
4. after 10 days of drugs all the sinusitis symptoms subsided . my wife felt generally good and active. today on 27 september again we did some tests to ensure the improvements but ESR level is still at 65 MM/ HR. urine epithelial cells XXXXXXX to 12-14 . REPORTS enclosed for today i.e. 27 September. for last 15 days she has increased her fruits intake along with more liquids.
5. for now she has no joint pain, no body aches, eats well, sleeps well, goes to her job. the only issue she seems to face is occasional headache on right side if she stays in sun for too long and at times feel tired and fatigue if their is extra work pressure. i m also trying to get her into yoga. meanwhile she has a cancer awareness camp in her school where CBC and mammography was done and she was told everything OK.
the question is why is her ESR so high ? how to find the cause behind her elevated ESR. what tests can help me find the root cause ? what methods like foods or exercises help in lowering ESR ? What questions i need to ask my local physician ? can a person have high ESR and still be healthy ?i googled but it gave nothing except anxiety.
Brief Answer:
High ESR
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
The erythrocyte sedimentation rate (ESR) is an indirect measure of the acute-phase response of inflammation.
The ESR changes relatively slowly, and its measurement more often than weekly usually is not useful.
Although ESR is sensitive indicators of inflammation, it is not very specific. An extremely elevated ESR (>100 mm/h) has a 90% predictive value for a serious underlying disease.
Your wife has just recovered from presumably upper respiratory tract infection (sinusitis).
Out of Infectious diseases -Tuberculosis & Urinary tract infection can cause very high ESR.
Out of Inflammatory diseases,Rheumatoid arthritis & Systemic lupus erythematosus (SLE), particularly in female can be cause of high ESR but you have mentioned that she does not have any joint pain or bodyache.
Severe anemia i.e. very low hemoglobin can cause high ESR but you have not mentioned her exact hemoglobin level.
Out of Malignancies , Multiple myeloma is the most important cause but your wife does not have any any symptom suggestive of that and urine shows only epithelial cells but no proteinuria (as you have not mentioned).
I feel an x-ray chest PA view and the QuantiFERON-TB Gold ,a blood test for diagnosing Mycobacterium tuberculosis infection (both latent and active tuberculosis disease) won't be out of place as occult tuberculosis remains a possibility in XXXXXXX set-up and needs to be excluded.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
High ESR
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
The erythrocyte sedimentation rate (ESR) is an indirect measure of the acute-phase response of inflammation.
The ESR changes relatively slowly, and its measurement more often than weekly usually is not useful.
Although ESR is sensitive indicators of inflammation, it is not very specific. An extremely elevated ESR (>100 mm/h) has a 90% predictive value for a serious underlying disease.
Your wife has just recovered from presumably upper respiratory tract infection (sinusitis).
Out of Infectious diseases -Tuberculosis & Urinary tract infection can cause very high ESR.
Out of Inflammatory diseases,Rheumatoid arthritis & Systemic lupus erythematosus (SLE), particularly in female can be cause of high ESR but you have mentioned that she does not have any joint pain or bodyache.
Severe anemia i.e. very low hemoglobin can cause high ESR but you have not mentioned her exact hemoglobin level.
Out of Malignancies , Multiple myeloma is the most important cause but your wife does not have any any symptom suggestive of that and urine shows only epithelial cells but no proteinuria (as you have not mentioned).
I feel an x-ray chest PA view and the QuantiFERON-TB Gold ,a blood test for diagnosing Mycobacterium tuberculosis infection (both latent and active tuberculosis disease) won't be out of place as occult tuberculosis remains a possibility in XXXXXXX set-up and needs to be excluded.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
thanks for responding sir....i am here by enclosing reports of her first tests dated 30 august 15. then a follow up cross checkup tests on 6 september 15. then the prescription of doctor dated 7 september 15 diagnosing maxillary sinusitis. after that latest 27 september reports.
when should i expect to see the improvement i.e. when should i perform next test ?kindly go through the reports and advice.
when should i expect to see the improvement i.e. when should i perform next test ?kindly go through the reports and advice.
Brief Answer:
High ESR
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Your wife is having mild anemia and that is not causing high ESR.
You need to repeat ESR on empty stomach (overnight fasting) as food can increase ESR ,after 1 week i.e on or after 02 Oct 15.
Mere presence of epithelial cells in urine is of no clinical significance and contamination is more likely if squamous epithelial cells (which are larger and have single nuclei) are prominent.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
High ESR
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Your wife is having mild anemia and that is not causing high ESR.
You need to repeat ESR on empty stomach (overnight fasting) as food can increase ESR ,after 1 week i.e on or after 02 Oct 15.
Mere presence of epithelial cells in urine is of no clinical significance and contamination is more likely if squamous epithelial cells (which are larger and have single nuclei) are prominent.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
thanks for your reply. The last u saw the report of ESR was done empty stomach in the morning. May be after a month's time i will get it done again. meanwhile while surfing through the questions in your website, a lady physician answered that if there is no symptom then ESR should be ignored as it is non specific. another physician conveyed in another similar question that it takes around 6 months for ESR to get back to normal. what is your opinion sir ? i am attaching the snap shot of that question.
Brief Answer:
ESR
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
After acute infection /inflammation ESR returns to normal slowly as infection or inflammation subsides but no such time frame of 06 months exist .I mean no text book of medicine mentions any specific time frame.In this regard the concerned doctor's opinion is unsubstantiated.
The erythrocyte sedimentation rate (ESR) is a relatively nonspecific test . However, it should be emphasized that the results of ESR are often affected by conditions not associated with inflammation, such as age, gender, and anemia, as well as the shape and size of erythrocytes. For example, the ESR is higher in females and progressively increases with aging; these factors should be considered when interpreting the results. Measurements should be made with a fresh sample, because a delay in performance can decrease the ESR.
Hence the results should always be interpreted in the clinical context.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
ESR
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
After acute infection /inflammation ESR returns to normal slowly as infection or inflammation subsides but no such time frame of 06 months exist .I mean no text book of medicine mentions any specific time frame.In this regard the concerned doctor's opinion is unsubstantiated.
The erythrocyte sedimentation rate (ESR) is a relatively nonspecific test . However, it should be emphasized that the results of ESR are often affected by conditions not associated with inflammation, such as age, gender, and anemia, as well as the shape and size of erythrocytes. For example, the ESR is higher in females and progressively increases with aging; these factors should be considered when interpreting the results. Measurements should be made with a fresh sample, because a delay in performance can decrease the ESR.
Hence the results should always be interpreted in the clinical context.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
