What is ESR

[tourdefrance]

Can someone please explain, in words of one syllable, specifically what ESR means. For example mine has just trebled to 18 after 6 months at 6 or below. Please explain exactly what that means.

Thank you

[iforget]

Raised ESR is simply a sign that there is some degree of inflammation present in the body. It does not show where the inflammation is or what is causing it.

[PMRpro Ambassador]

ESR is erythrocyte sedimentation rate - how fast the red blood cells settle to the bottom of a tube (like mud settling to the bottom of a bucket). A sample of whole blood is poured into a tube and then left to stand for an hour, the distance in millimetres the top of the red cells part of the blood has fallen in an hour is the ESR. The speed is influenced by the presence of proteins on the outside of the red blood cells - they make the cells stick to each other and so they fall faster.

Inflammation in the body causes increased production of these proteins, they attach to the outside of the blood cells and so make them fall further in the given time and the figure for the ESR increases.

So an increased ESR suggests there is inflammation somewhere in the body and that is why it is raised in about 80% of people with PMR/GCA. It is very non-specific though - and increases for many other reasons including certain infections (mainly bacterial infections), abscesses, certain types of arthritis, various other muscular and connective tissue disorders - for example, polymyalgia rheumatica or GCA, tissue injury and burns, cancers, heart attack and even pregnancy.

The fact your ESR has gone up suggests that either your PMR/GCA inflammation is flaring - either because you have reduced your pred too far or because the underlying autoimmune disorder has become more active - or because you have another infection or injury. However - an increase in the ESR shouldn't lead to a knee-jerk reaction of increasing your pred dose unless you also have a return of symptoms of PMR/GCA.

Sorry - couldn't manage words of one syllable but does that help?

[tourdefrance in reply to PMRpro]

Thank you so much. Makes sense as I have both shoulders partially frozen and both elbows with mild tennis elbow (a bonus to the PMR) plus some arthritis now appearing.

Going to ignore pregnancy and a couple of others!!!

Thank you again.

Kind regards

[piglette in reply to tourdefrance]

Your ESR is still pretty low in fact. Mine was 127 when first diagnosed with PMR. I think the rheumatologist was quite impressed. It has gone down since then, but has had ups and downs along the way. It is currently 52 but has been down to 30.