Contents
In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
Biernacki’s test (ESR) is a little specific marker of inflammation. This means that its increased level indicates the presence of inflammation, but it does not allow to determine its location or the causative agent (bacteria, viruses, parasites). ESR determination is also one of the most frequently performed blood laboratory tests. They are usually performed simultaneously with the morphology.
Biernacki’s reaction – what is it?
The Biernacki test (ESR) is a test that determines the speed at which, within one hour, red blood cells sink to the bottom of a dedicated vessel. This study was developed in 1897 by the Polish physician Edmund Biernacki. OB is, in addition to the reactive protein C (CRP), an indicator of the presence of inflammation in the body. However, ESR levels do not rise or fall as rapidly as CRP levels. This means that in the event of an infection starting, we will notice an increase in the level of the C-reactive protein faster. The same is true when the infection subsides – the level of CRP decreases first.
Biernacki’s test is extremely useful at the initial diagnostic stage and during the monitoring of patients’ health. This is because erythrocyte sedimentation rate shows high sensitivity to changes of an inflammatory nature in the body. The rate at which red blood cells fall is influenced by their number and volume, as well as by the concentration of fibrinogen, globulins, albumin, nucleoproteins, lecithin, and cholesterol. The change in the level of the above-mentioned factors is usually related to the deterioration of health. In women, it may also indicate hormonal changes related to menstruation or pregnancy.
Do you want to perform the OB test in a package with other tests and receive an interpretation of the results? Order a package of preventive laboratory tests with home blood sampling now.
ESR is performed during preventive blood tests. OB standards depend on the age and sex of the examined person. The lowest norm occurs in newborns, while the highest in women over 60 years of age.
OB – indications for the study
The ESR test is a blood test that tells you if your body is inflamed. The test itself evaluates the sink rate of red blood cells in non-clotting blood over one hour. The test unit is millimeters per hour (mm / h). The doctor may order the measurement of Biernacki’s reaction when there is a suspicion of autoimmune or cancerous diseases, inflammatory changes of a different nature (e.g. rheumatic), infectious diseases or tissue necrosis.
It is recommended to test Biernacki’s reaction at least once a year.
Biernacki’s test and lipid profile should be performed at least once a year as preventive examinations. ESR can be performed by virtually anyone, as only a blood sample is required for analysis. Though OB test result does not indicate any specific disease, a three-digit result is considered dangerous, which suggests that the body is suffering from a serious disease with an inflammatory component (infection, neoplastic process, autoimmune process).
OB testing is part of testing packages for both women and men. It helps you judge if there is any inflammation in your body. You can buy packages safely and conveniently on Medonet Market:
- Woman’s health check – diagnostic blood tests,
- Prophylactic blood tests for men,
- A package of preventive examinations – blood tests,
- Oncology package for men – diagnostic tests,
- Neoplastic diseases – risk assessment for women.
How to prepare for the OB measurement?
ESR should be performed on an empty stomach, so no less than 12 hours have elapsed since the last meal. For this reason, it is best to plan a visit to the collection point in the morning. The test material is collected once from a vein in the arm. It is recommended that children and people over 60 years of age drink a glass of water 30 minutes before the examination.
Basic screening for men and women is a package that everyone should do at least once a year. Buy quickly and safely at Medonet Market and make it in several hundred locations throughout the country.
OB study – price
The test can be performed completely free of charge, if the doctor has a contract with the National Health Fund and issues a referral and indicates the laboratory where the OB test can be performed. If we decide to use private diagnostics, price OB it will be around PLN 5–14, depending on the price list of a given laboratory.
OB – the norm
| Age groups | Standards | What could be the cause of the elevated ESR level? |
| Newborns | 0-2 mm/h | S1,2 inflammations (infectious and non-infectious), cancer, blood proliferative diseases (e.g. leukemia), autoimmune diseases, injuries |
| Babies (up to 6 months) | 12-17 mm/h | — |
| Women <60 years of age | do 12 mm/h | S1,4 inflammatory conditions (infectious and non-infectious), neoplasms, blood proliferative diseases (e.g. leukemia), autoimmune diseases, myocardial infarction, trauma, bone fractures, hypothyroidism and hyperthyroidism, elevated cholesterol levels; an increase in ESR is also common in women in the period just before and during menstruation, during pregnancy and the puerperium (from the 10th-11th week of pregnancy to 6 weeks after delivery), as well as when taking contraceptive pills, dextran, theophylline and vitamin A; a long above normal or steadily increasing level of ESR may be evidence of an increasing field of infection or ineffective treatment. |
| Women> 60 years of age | do 20 mm/h | — |
| Men <60 years of age | do 8 mm/h | — |
| Men> 60 years of age | do 15 mm/h | — |
OB standards may differ depending on the laboratory where the test was performed. Moreover, the norms are very variable and are influenced by the general condition of the patient. For this reason, each result should include the reference range used by the specific laboratory. The Biernacki test result should be interpreted together with other data (CRP, morphology).
Interpretation of OB results
ESR measurement results should not be interpreted on their own, because the test – despite its high sensitivity – is non-specific and does not clearly indicate any specific disease. Biernacki’s reaction should be assessed by a physician, also based on the patient’s medical history as well as other diagnostic tests. If the erythrocyte sedimentation rate is outside the normal range, further tests may be required to accurately identify the cause of the condition. If you need to interpret the results, make an online teleconsultation at haloDoctor.pl.
If ESR results are normal, but the patient reports bothersome symptoms, then further investigation may also be indicated. It should be remembered that Biernacki’s reaction is assessed taking into account the age and sex of the patient, as well as the medications taken by him.
The results of ESR are influenced by hot baths, heavy meals, certain medications, menstruation, and pregnancy.
Reduced OB values
Reduction in ESR values occurs in allergic diseases, sickle cell anemia and in hyperemia. Certain medications, such as aspirin, cortisone, and quinine, also reduce the level of ESR.
The reasons for the decreased ESR can also be:
- chronic circulatory failure,
- polycythemia true,
- problems with clotting caused by deficiency of fibrinogen,
- jaundice,
- malaria,
- some allergies.
Increased OB values
Naturally elevated ESR occurs in pregnant women (from about 10 weeks of pregnancy) and during puerperium and menstruation. Therefore, it does not make sense to perform the analysis in the listed cases, as the result will not be reliable. ESR may also be increased in women using hormonal contraception.
ESR naturally increases during pregnancy. In the second trimester, the result may reach 50 mm / h, while in the third trimester it may reach a three-digit result (up to 100 mm / h).
An increased result of Bernacki’s reaction test may indicate inflammation, but the test result does not indicate what may be the cause of it. Potential inflammation can be caused by:
- thyroid disorders (e.g. hypothyroidism / hyperthyroidism),
- hypercholesterolaemia, i.e. high blood cholesterol,
- liver problems, e.g. cirrhosis of the liver
- tuberculosis,
- syphilis,
- surgical procedures,
- injuries of organs and tissues due to injury or fracture,
- stress,
- nephrotic syndrome,
- pneumonia,
- rheumatic diseases,
- anemia,
- myocardial infarction,
- neoplastic disease (ESR result is sometimes three-digit),
- elevated ESR values in a child are very often a sign of tooth decay.
An OB index above 100 may indicate giant cell arteritis, very often also multiple myeloma, kidney cancer and Hodgkin’s disease.
Given that red blood cells fall very slowly, a high ESR may suggest that inflammation occurred weeks earlier. Therefore, ESR is not recommended in the diagnosis of acute and short-term inflammation.
The test results should always be consulted with a doctor.
Read also:
- Blood morphology – what do you need to know?
- Preventive examinations worth remembering
ESR and other inflammatory markers
Although ESR is an easy-to-measure marker and is routinely recommended to measure it, it can detect chronic or acute inflammation. ESR increases within 24–48 hours of the onset of the inflammatory response. In order to differentiate bacterial and viral infections, the determination of acute phase proteins is used, the concentration of which changes faster than Biernacki’s test. Commonly used indicators include the aforementioned CRP, as well as procalcitonin (PCT).
Internist in your city