ESR (Biernacki test) – when to do the test? OB standards

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The Biernacki test (ESR) is an index of the sedimentation rate of blood cells in the plasma per unit time. It is determined after one, and sometimes two hours. Under physiological conditions, it depends on the specific gravity of blood cells and plasma, and on the size of the falling particles.

ESR (Biernacki’s reaction) – characteristics

ESR, or Biernacki’s Test, is a blood test performed to confirm or rule out the presence of inflammation. The test measures the sink rate of red blood cells in the non-clotting blood (within one hour). Increased level of this parameter requires extended diagnostics. The norm of Biernacki’s reaction depends on age and gender. It will be lowest in newborns (2 mm per hour), and highest in people over 60 (about 30 mm per hour). It is important that the test result is analyzed after taking into account other blood tests and any symptoms. A more detailed study is the CRP test, i.e. an acute-phase protein, thanks to which it is possible to determine the nature of the inflammation occurring in the body. Acute phase protein and ESR testing may even suggest cancer.

OB examination, as well as morphology and lipid profile, should be performed at least once a year. Anyone can undergo the test, because only a blood sample is needed to perform the test. While the ESR result is not disease specific, the three-digit number is cause for concern as there may be a cancerous process in your body.

When do we do the OB test?

We perform OB examination in the following cases.

1. Basic research.

2. Suspicion of inflammation (infectious diseases, systemic connective tissue diseases, neoplastic disease).

3. Monitoring the treatment of inflammatory diseases.

OB material: plasma.

Preparation for the test: on an empty stomach (at least 8 hours).

The course of the OB study: one-time blood sampling from a vein in the arm. Children and people over 60 years of age should drink a glass of water before the examination.

Time to wait for the result: 1 Day.

Standards: less than 10 mm after 1 hour, less than 20 mm after 2 hours.

Comments: Accelerated fall of blood cells indicates a pathological process in the body. However, the diagnosis of a normal fall of blood cells does not exclude the presence of pathology (even inflammation or cancer). It is difficult to monitor the clinical course of the disease with the use of precipitation assessment alone, because changes in ESR occur much slower than changes in acute-phase protein concentrations.

The price of the OB analysis is from 5 to 8 zlotys (private). OB examination may be performed under the National Health Fund, when the doctor issues a referral for it and indicates a laboratory where we can perform it.

OB — norms

OB standards vary by gender and age:

  1. newborns – 0-2 mm / h
  2. infants (both sexes) up to 6 months of age – 2-17 mm / h
  3. children over 6 months of age – from 7 to 8 mm / h (in some laboratories it can be up to 20 mm / h)
  4. women under 50 – from 6 to 20 mm / h
  5. women after the age of 50 – up to 30 mm / h
  6. men before the age of 50 – from 3 to 15 mm / h
  7. men after the age of 50 – up to 20 mm / h.

Important. The standards of Biernacki’s reaction may differ from each other depending on the laboratory in which the test was carried out. In addition, the ESR values ​​are very variable, the general health of the subject is of great importance. For this reason, each testing facility should include a reference range with the results.

Interpretation of the OB examination results

Elevated OB is the natural course of things in pregnant women, during the puerperium, and during menstruation. In such a case, it is not recommended to perform the Biernacki test as the result is unreliable. It has also been observed that increased ESR occurs in women using oral hormonal contraceptives.

Among the causes high OB is listed as:

  1. underactive or overactive thyroid gland
  2. the occurrence of inflammation,
  3. anemia,
  4. too high cholesterol in the blood,
  5. stress,
  6. liver disease,
  7. fractures,
  8. leukemia
  9. injuries,
  10. periodontitis,
  11. rheumatic diseases,
  12. myocardial infarction,
  13. cancer (then the ESR is very high – a three-digit result).
  14. in children – caries and gum disease.

Given that the erythrocyte sedimentation rate is slow to change, a high ESR could mean that inflammation started several weeks earlier. ESR is not suitable for the diagnosis of acute inflammation.

Too low OB is also invalid. Most often it indicates:

  1. jaundice
  2. sickle cell anemia (low ESR in severe cases),
  3. hyperemia,
  4. chronic circulatory failure,
  5. abnormal clotting.

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