What is the evidence of increased ESR in a child?

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What might a high child’s OB result indicate? Could a high ESR result be a sign of the development of serious underlying diseases? Which specialist should I go to in case of elevated ESR? The question is answered by the drug. Katarzyna Darecka.

What might an elevated ESR result in my baby’s blood indicate?

Hello. My question concerns my son, who is now six years old. Recently, I did a preventive examination for him, in which he developed an increased ESR. In this connection, I would like to ask what it shows elevated ESR in a child? I know that an increased ESR in a child is usually associated with some diseases or infections, but in the last weeks or even months, my son was completely healthy.

I have not noticed any symptoms that could be cause of increased ESR in the childsuch as fever, cough or runny nose. Hence my concerns about whether the child’s increased ESR may indicate some more serious, hidden diseases? Other morphology indicators are normal, and the only deviation is OB above normal. I would be grateful if you could point out possible causes of the child’s increased ESR. I also do not know what to do, because my son is feeling well and I would not necessarily want to drag him to the doctors for no reason, if he is okay. However, due to the increased ESR in my child, should I consult a doctor?

The doctor indicates possible causes of increased ESR in the child

ESR, i.e. the Biernacki test or the erythrocyte sedimentation rate (ESR), is one of the tests that may indicate an inflammatory reaction in the body. Usually erythrocytes fall off freely, and if there is inflammation, they fall faster.

The reference value for men is <3-15 mm / h, for women it is 1-10 mm / h. After the age of 65, normal ESR values ​​are <20 mm / h. The reference value for a newborn is 0-2 mm / h, for children (from infancy to adolescence) 3-13 mm / h.

Depending on the laboratory performing the tests, the standards may vary. OB is a very nonspecific test, increased values ​​may indicate:

  1. bacterial, viral, fungal infection (acute or chronic),
  2. systemic connective tissue disease, e.g., rheumatoid arthritis, gout, reactive arthritis, systemic lupus erythematosus, polymyositis, rheumatic polymyalgia;
  3. malignant tumors;
  4. anemia (hemolytic, iron deficiency, aplastic);
  5. macroglobulinemia;
  6. hypergammaglobulinemia;
  7. cryoglobulinemia;
  8. as a result of surgery or trauma;
  9. thyroid dysfunction;
  10. nephrotic syndrome.

The test should always be performed on an empty stomach, and the previous day’s meal should be eaten by 18.00 at the latest. Depending on the level of ESR and the patient’s symptoms, abnormalities in the physical examination, the doctor may order additional laboratory, imaging or microbiological tests, such as morphology, CRP (acute phase protein), procalcitonin, urinalysis, urine culture, TSH and free thyroid hormones.

Although an ESR result can help diagnose a disease, an abnormal result does not mean that you have a specific disease. Further diagnosis is always required.

Reduction of ESR may occur in such diseases as: congestive heart failure, hypofyrbynogenemia, low amount of plasma protein (in the course of kidney disease), polycythemia, sickle cell anemia.

ESR decreases very slowly after the onset of an inflammatory stimulus, and this can take weeks or even months. Therefore, its increased result may be caused by a recent infection, so the test should be repeated after a few weeks – perhaps then the result will be correct.

– Lek. Katarzyna Darecka

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