The ESR is the acronym for the erythrocyte sedimentation rate (ESR) . When we find a high ESR it indicates the existence in the blood of some element that accelerates the erythrosedimentation, that is, the time it takes to precipitate the erythrocytes in a test tube is accelerated.
The high ESR is used as a marker of inflammation, infection, tumor processes in autoimmune in nature, among many other processes.
Some time ago it was used more frequently and it was important to reflect alterations of both functional and organic nature. But nowadays due to its low specificity, and with the appearance of new markers, such as PCR , something more specific is losing importance, although it is still determined in routine blood tests.
Should we worry about high VSG level?
The truth is that a high ESR is not very specific, both to indicate what type of process is taking place and to determine the severity, since even without pathology it can be altered upwards.
We can find high ESR levels from inflammatory processes, such as rheumatoid arthritis, even by the mere fact of being menstruating.
That is why, in isolation does not indicate alteration in itself, only tells us that there is a process in the body that promotes the precipitation of erythrocytes in the test tube, due to both physiological and pathological processes.
High ESR has to be contextualized
From what we have said, high ESR has to be contextualized, therefore, a series of signs and symptoms must be added, which may be supported by this determination. On the other hand, before a diagnosis, it can be used along with other markers, in monitoring the effectiveness of a treatment or a disease.
This is why, in many cases, the only thing that predicts an isolated elevation of the ESR is the fear that it will generate in the patient when the ESR is marked with an asterisk in the routine analysis.
Use of ESR and CRP values in the follow-up of inflammatory diseases.
What is more common, is the combined use of these two inflammatory markers, ESR and CRP , in pathological processes already defined, and therefore in the context of the follow-up of inflammatory diseases .
For example; the follow-up and evaluation of the inflammatory activity of rheumatoid arthritis , it being true that PCR is better valued than ESR , but both can be used.
What makes the VSG high at the molecular level?
What happens for the accelerated precipitation of erythrocytes? That is, a high ESR in the molecular field, beyond its involvement in inflammatory phenomena.
It is known that the load of the red blood cells is negative and that is what causes it to be dissolved, in dispersion, purely physical, by which the same charges repel each other. But due to the molecules found in the liquid medium that surround the red blood cells, their charge has to be maintained.
Therefore, an internal balance must be maintained for the good behavior of the loads, and in the event that the balance is broken, it will tend to increase the globulin factor, producing absorption on the surface of the erythrocyte of albuminoid bodies, triggering a rapid discharge, increasing the agglomeration and therefore the precipitation.
We have to take into account that the temperature, number of erythrocytes, viscosity and other factors influence the ESR .
We could say that when the electrostatic balance in the blood components is broken, it modifies its behavior in the dispersion, giving rise to precipitation. It is therefore high ESR , an alteration in the balance of the internal environment .
We must bear in mind that the internal environment must be understood as a manifestation of the function of the whole. The plasma is in intimate relation with all the organs and tissues and that is why it can produce an alteration of the charges of the erythrocytes by any cause that produces ionic modifications, elevating the ESR .
Both Claude Bernard and René Quinton saw in the internal environment a fundamental element in the regulation of the organism.
This marine aquarium that imbibes the cells of the organism is fundamental to maintain its electrochemical balance, and when this electrochemical medium is modified, alterations between its interactions take place, as the elevation of the ESR well demonstrates .