Sed rate, or erythrocyte sedimentation rate (ESR) SUDDEN increase

[irishponies]

Hello,

I want to thank everyone that shared their personal insights replying to my post "ANCA MPO and Systemic sclerosis positive - Sudden ESR 93". Your comments are invaluable and I appreciate every word. Thank you,

This post is focused on ESR. This is copied directly from the Mayo Clinic web site:

"Sed rate, or erythrocyte sedimentation rate (ESR), is a blood test that can reveal inflammatory activity in your body. A sed rate test isn't a stand-alone diagnostic tool, but it can help your doctor diagnose or monitor the progress of an inflammatory disease."

I have researched and cannot find reports regarding a SUDDEN elevation in an ESR when the inflammatory disease is in aggressive treatment with Rituxan infusions, the disease is NOT showing a corresponding increase in blood markers, and the ESR has previously been zero (ESR - 0) for more than a year.

ESR Labs: 07/22 through 09/01/22 - "0"

September 20, 2022 - 4; October 15, 2022 - 65;

November 29, 2022 - 93 markedly elevated ("markedly elevated" is the comment from the lab report)

Has anyone experienced a SUDDEN elevation in their ESR or can refer me to a website for more information?

Thank you.

[PMRpro]

ESR is not specific to any particular disease so it will rise with many things including the common cold and even injuries. Values above 100 are considered worthy of concern and potentially indicating serious disease such as cancer but lower than that are regarded as "normal" responses to the presence of inflammation.

Another potential confounder is that the blood sample was badly treated during phlebotomy or transport to the lab, It should also be evaluated within 4 hours max of being taken. Delays can affect the result.

If a value is high, the correct procedure is to repeat it after a week or so to establish if there is a trend,

That isn't really a sudden increase - it's over an extended period of time and suggests there is SOMETHING chronic going on but impossible to say what, It is the sort of thing you would see in severe untreated PMR for example,

Rituxan is a monoclonal antibody and they are extremely specific in what they target, Rituxan is a chimeric monoclonal antibody against the protein CD20, which is primarily found on the surface of immune system B cells. When it binds to this protein it triggers cell death However, many inflammatory conditions do not involve B-cells at all so Rituxan will not have a role in managing them. The example I used, PMR, responds to a different class of MABs, the IL-6 antagonists so Rituxan would have no effect.

[irishponies in reply to PMRpro]

Thank you!