Journal of Medical Biochemistry (Jan 2010)
The ESR test: An old test with new contents
Abstract
The erythrocyte sedimentation rate (ESR) remains one of the most widely used laboratory tests. Its clinical usefulness and interpretation are in the monitoring of inflammatory diseases, in particular rheumatoid arthritis, temporal arteritis and polymyalgia rheumatica. At present, the reference method for measuring the ESR proposed by the International Committee for Standardization in Haematology (ICSH) utilizes EDTA-anticoagulated-undiluted blood to perform the test using the method described by Westergren in 1921. Current interest in the methodology focuses on the development of an automated closed system that allows the determination of the sedimentation rate with selected working methods, using a single sample for more than one haematological test, improving the bio-hazardous aspects of the testing procedures. As a consequence, standardization becomes necessary. ESR results should be reliable, despite the increased number of different methods and testing variables. Control materials and External Quality Assurance Schemes are now available, and should be used. In conclusion, innovative techniques may improve the appropriateness and usefulness of ESR in clinical practice, but in addition, they need to guarantee the traceability of results in comparison to the reference method in order to ensure comparability of results among different clinical laboratories.
