Soe in a child of 1 month is normal. Why can a child's ESR be higher or lower than normal? Reasons for low values

To do this, you should pay attention to factors such as:

1. Blood is taken on an empty stomach, so it is important that the sampling takes place in the first hours after waking up. For infants and infants in the first year of life, the last meal should be 3-5 hours before blood sampling, otherwise false readings cannot be avoided.
2. The night before, you should sleep well and relax, minimizing any physical activity that provokes an increase in the release of protein into the blood.
3. In the presence of the use of medicines on an ongoing basis, the laboratory assistant should be informed and an appropriate note should be made.
4. It is not recommended to donate blood during menstruation, as it will be oversaturated with fibrinogen, which will eventually lead to accelerated ESR.

It is important to pay attention to nutrition, excluding the use of sweet confectionery and fatty meat foods, especially fast food, for 3-5 days.

Ask your question to the doctor of clinical laboratory diagnostics

Anna Poniaeva. She graduated from the Nizhny Novgorod Medical Academy (2007-2014) and residency in clinical laboratory diagnostics (2014-2016).

Medicine does not stand still - every day new diagnostic techniques appear and are introduced to identify the causes of changes occurring in the human body and leading to diseases.

Despite this, the definition of ESR has not lost its relevance and is actively used for diagnosis in adults and young patients. This study is mandatory and in all cases is indicative, whether it is a visit to a doctor due to a disease or a medical examination and preventive examination.

This diagnostic test is interpreted by a doctor of any specialty, and therefore belongs to the group of general blood tests. And, if the ESR blood test is elevated, the doctor must determine the cause.

What is soe?

ESR is a term formed from the capital letters of the full name of the test - the erythrocyte sedimentation rate. The simplicity of the name does not conceal any medical background, the test really determines the very erythrocyte sedimentation rate. Erythrocytes are red blood cells that, when exposed to anticoagulants, settle at the bottom of a medical test tube or capillary for a certain time.

The time of separation of the taken blood sample into two visible layers (upper and lower) is interpreted as the erythrocyte sedimentation rate and is estimated by the height of the plasma layer obtained as a result of the study in millimeters per hour.

ESR refers to non-specific indicators, but has a high sensitivity. By changing the ESR, the body can signal the development of a certain pathology (infectious, rheumatological, oncological and other) even before the appearance of an obvious clinical picture, i.e. during a period of imaginary prosperity.

The erythrocyte sedimentation rate in the blood helps:

• differentiate the diagnosis, for example, angina pectoris and myocardial infarction, and osteoarthritis and rheumatoid arthritis, etc.
• determine the body's response during treatment for tuberculosis, Hodgkin's disease, disseminated lupus erythematosus, etc.
• to state a latent disease, however, even a normal ESR value does not exclude a serious disease or malignant neoplasm

Diseases accompanied by high ESR

The erythrocyte sedimentation rate is of great diagnostic and medical importance if a disease is suspected. Of course, not a single doctor refers to the ESR alone when making a diagnosis. But together with the symptoms and the results of instrumental and laboratory diagnostics, he occupies a significant position.

The erythrocyte sedimentation rate is almost always increased in most acute bacterial infections. The localization of the infectious process can be the most diverse, but the picture of peripheral blood will always reflect the severity of the inflammatory reaction. ESR also increases with the development of an infection of viral etiology.

In general, diseases in which an increase in ESR is a typical diagnostic sign can be divided into groups:

• Diseases of the liver and biliary tract (see);
• Purulent and septic diseases of an inflammatory nature;
• Diseases in the pathogenesis of which is the destruction and necrosis of tissues - heart attacks and strokes, malignant neoplasms, tuberculosis;
• - anisocytosis, sickle anemia, hemoglobinopathies;
• Metabolic diseases and pathological changes in the endocrine glands - diabetes mellitus, obesity, thyrotoxicosis, cystic fibrosis and others;
• Malignant transformation of the bone marrow, in which red blood cells are defective and enter the bloodstream unprepared to perform their functions (leukemia, myeloma, lymphoma);
• Acute conditions leading to an increase in blood viscosity - diarrhea, bleeding, intestinal obstruction, vomiting, condition after surgery;
• Autoimmune pathologies - lupus erythematosus, scleroderma, rheumatism, Sjögren's syndrome and others.

The highest rates of ESR (more than 100 mm/h) are typical for infectious processes:

• SARS, influenza, sinusitis, bronchitis, pneumonia, tuberculosis, etc.
• urinary tract infections (pyelonephritis, cystitis)
• viral hepatitis and fungal infections
• for a long time, high ESR can be in the oncological process.

It should be noted that during infectious processes, this indicator does not increase immediately, but one or two days after the onset of the disease, and after recovery for some time (up to several months), the ESR will be slightly increased.

ESR - norm and pathology

Since this indicator is normalized, there are physiological limits that are normal for various population groups. For children, the ESR rate varies depending on age.

Separately, such a condition of a woman as pregnancy is considered, in this period an increased ESR up to 45 mm / h is considered normal, while a pregnant woman does not need additional examination to detect pathology.

Methods for determining the ESR and interpretation of the results

In medical diagnostics, several different methods for determining ESR are used, the results of which differ from each other and are not comparable with each other.

The essence of the Westergren method, widely practiced and approved by the International Committee for Standardization of Blood Research, is the study of venous blood, which is mixed with sodium citrate in a certain ratio. The erythrocyte sedimentation rate is determined by measuring the tripod distance - from the upper border of the plasma to the upper border of the settled erythrocytes 1 hour after mixing and placing in a tripod. If it turns out that Westergren's ESR is increased, the result is more indicative for diagnosis, especially if the reaction is accelerated.

The Wintrob method consists in the study of undiluted blood mixed with an anticoagulant. The ESR is interpreted by the scale of the tube into which the blood is placed. The disadvantage of the method is the unreliability of the results at a rate above 60 mm / h due to clogging of the tube with settled erythrocytes.

Panchenkov's method consists in the study of capillary blood diluted with sodium citrate in a quantitative ratio of 4:1. Blood settles in a special capillary with 100 divisions. The result is evaluated after 1 hour.

Westergren's and Panchenkov's methods give the same results, but with increased ESR, Westergren's method shows higher values. Comparative analysis of indicators is presented in the table (mm/h).

It is worth noting that automatic counters for determining the erythrocyte sedimentation rate are now actively used, which do not require human participation in diluting a portion of blood and tracking the results. For a correct interpretation of the results, it is necessary to take into account the factors that determine the variations in this indicator.

In civilized countries, unlike Russia (with backward methods of diagnosis and treatment), ESR is no longer considered as an informative indicator of the inflammatory process, since it has a lot of both false positive and false negative results. But the CRP indicator (C-reactive protein) is an acute phase protein, an increase in which indicates a non-specific response of the body to a wide range of diseases - bacterial, viral, rheumatic, inflammation of the gallbladder and ducts, abdominal processes, tuberculosis, acute hepatitis, injuries, etc. .- is used very widely in Europe, it has practically replaced the ESR indicator, as more reliable.

Factors affecting this indicator

Many factors, both physiological and pathological, affect the ESR, among which the key ones are distinguished, i.e. most important:

• the ESR indicator in the female half of humanity is higher than in the male, which is due to the physiological characteristics of female blood;
• its value is higher in pregnant women than in non-pregnant women, and ranges from 20 to 45 mm / h;
• women taking contraceptives have an increased rate;
• people suffering from anemia have a high ESR;
• in the morning, the erythrocyte sedimentation rate is slightly higher than in the daytime and evening hours (typical for all people);
• acute-phase proteins lead to an acceleration of the erythrocyte sedimentation rate;
• with the development of an infectious and inflammatory process, the result of the analysis changes a day after the onset of hyperthermia and leukocytosis;
• in the presence of a chronic focus of inflammation, this indicator is always slightly increased;
• with increased blood viscosity, this indicator is below the physiological norm;
• anisocytes and spherocytes (morphological variants of erythrocytes) slow down the erythrocyte sedimentation rate, and macrocytes, on the contrary, accelerate the reaction.

If the ESR in the blood of a child is increased - what does this mean?

An increased ESR in the blood of a child most likely indicates an infectious-inflammatory process, which is determined not only by the result of the analysis. At the same time, other indicators of the general blood test will also be changed, and in children, infectious diseases are always accompanied by disturbing symptoms and a deterioration in the general condition. In addition, ESR may increase with non-communicable diseases in children:

• autoimmune or systemic diseases - rheumatoid arthritis, bronchial asthma, systemic lupus erythematosus
• with metabolic disorders - hyperthyroidism, diabetes mellitus, hypothyroidism
• with anemia, hemoblastoses, blood diseases
• diseases accompanied by tissue breakdown - oncological processes, pulmonary tuberculosis and extrapulmonary forms, myocardial infarction, etc.
• injury

It should be remembered that even after recovery, the increased erythrocyte sedimentation rate normalizes rather slowly, approximately 4-6 weeks after the illness, and if there is any doubt, in order to make sure that the inflammatory process has stopped, you can take an analysis for C-reactive protein (in a paid clinic) .

If a significant elevated ESR is found in a child, the reasons most likely lie in the development of an inflammatory reaction, therefore, in the case of pediatric diagnostics, it is not customary to talk about its safe increase.

The most harmless factors of a slight increase in this indicator in a child can be:

• if the ESR is slightly increased in the baby, this may be the result of a violation of the diet of a nursing mother (an abundance of fatty foods)
• taking medicines ()
• the time when the baby is teething
• vitamin deficiency
• helminthiases (see,)

Statistics on the frequency of increased ESR in various diseases

• 40% are infectious diseases - upper and lower respiratory tract, urinary tract, pulmonary tuberculosis and extrapulmonary forms, viral hepatitis, systemic fungal infections
• 23% - oncological diseases of the blood and any organs
• 17% - rheumatism, systemic lupus erythematosus
• 8% - anemia, cholelithiasis, inflammatory processes of the pancreas, intestines, pelvic organs (salpingoophoritis, prostatitis), diseases of the ENT organs (sinusitis, otitis media, tonsillitis), diabetes mellitus, trauma, pregnancy
• 3% - kidney disease

When is an increase in ESR considered safe?

Many people know that an increase in this indicator, as a rule, indicates some kind of inflammatory reaction. But this is not a golden rule. If an elevated ESR in the blood is found, the causes can be quite safe and do not require any treatment:

• allergic reactions, in which fluctuations in the initially increased erythrocyte sedimentation rate make it possible to judge the correct anti-allergic therapy - if the drug works, then the indicator will gradually decrease;
• a hearty breakfast before the study;
• fasting, strict diet;
• menstruation, pregnancy and the postpartum period in women.

Causes of false positive ESR tests

There is such a thing as a false positive analysis. The ESR test is considered false positive and does not indicate the development of infection in the presence of the following causes and factors:

• anemia, in which there is no morphological change in red blood cells;
• an increase in the concentration of all plasma proteins, except for fibrinogen;
• kidney failure;
• hypercholesterolemia;
• severe obesity;
• pregnancy;
• advanced age of the patient;
• technical errors in diagnostics (incorrect blood exposure time, temperature above 25 C, insufficient mixing of blood with an anticoagulant, etc.);
• the introduction of dextran;
• vaccination against hepatitis B;
• taking vitamin A.

What to do if the causes of increased ESR are not identified?

There are frequent cases when the reasons for the increased erythrocyte sedimentation rate are not found, and the analysis consistently shows high ESR in dynamics. In any case, in-depth diagnostics will be carried out in order to exclude dangerous processes and conditions (especially oncological pathology). In some cases, some people have such a feature of the body when the ESR is increased, regardless of the presence of the disease.

In this case, it is enough to undergo a preventive medical examination with your doctor once every six months, but if any symptoms occur, you should visit a medical institution in the near future. In this case, the phrase "God saves the safe" is an excellent motivation for an attentive attitude to one's own health!

If a child is unwell for no apparent reason, the doctor will definitely check the level of ESR in the blood - this is an indicator of the presence of hidden inflammatory processes.

When receiving the result of the analysis in their hands, parents cannot always decipher its result correctly. What does the value of ESR mean - it is important to understand in order to take action in time.

What does the increased content of ESR (erythrocyte sedimentation rate) in the blood of a child indicate, what does this mean and what are the reasons, how to lower the high level?

Sedimentation rate of erythrocytes

The full medical name of the outpatient term is sedimentation rate of erythrocytes. It fully reflects the essence of the test, which measures the speed of red cells under the influence of anticoagulants.

In a test tube, they separate into two visible layers.. The time spent on this is the desired speed in mm / h.

A similar process occurs in the body. Erythrocytes settle on the walls of blood vessels in the process of agglomeration for a certain period of time.

The ESR indicator does not apply to specific, but it is very sensitive to the slightest physiological changes - the initial development of various pathologies before the manifestation of a clear clinical picture.

RBC rate helps doctors diagnose some conditions:

How to take an analysis

Blood is taken from a finger on an empty stomach(at least 8-9 hours after the last dose). A couple of days before going to the laboratory, it is better to exclude fatty and fried foods from the usual diet.

Before diagnosis, the child must be calm. If he is taking any medication, be sure to tell the doctor.

Analysis is not carried out immediately after rectal examination, physiotherapy sessions, radiography. They may overestimate.

After taking the blood, the laboratory assistant will place it in a test tube. Under the influence of gravity, the red bodies will begin to rapidly settle. Two methods are used to determine their speed:

Panchenkov's method- the biological fluid is placed on the glass, located vertically.

Westergan method- conditions similar to the processes of the human body are recreated (for this, venous blood is taken).

Ideally, both results should match.. But the second method is considered more informative. If he gave an overestimated indicator, a retake is not required, with the exception of laboratory errors.

In laboratories equipped with modern equipment use automatic counters to calculate ESR. The process completely eliminates the human factor - this reduces the likelihood of error to a minimum.

Norm up to a year and older

There are physiological limits to ESR. Each group of patients has their own:

• newborn babies - 0.2-2.8 mm / hour;
• 1 month - 2-5 mm / hour;
• 6-12 months - 3-10 mm / hour;
• from 1 year to 5 years - 5-11 mm / hour;
• 6-14 years old - 4-12 mm / hour;
• over 14 years old - 1-10 mm / hour (boys), 2-15 mm / hour (girls).

Too "nimble" erythrocytes do not always indicate inflammatory processes. To determine the exact diagnosis, other outpatient blood tests and examinations are required.

In developed countries, the level of ESR is no longer considered as an indicator of the presence of inflammatory processes, since there are too many factors that provoke a false positive or negative result.

It was replaced by the PSA indicator - C-creative protein, reflecting the body's response to pathological conditions (various infections, inflammation, tuberculosis, hepatitis, trauma).

Reasons for the increase

If there is an inflammatory focus in the child's body, then the changes will also affect other blood parameters. Acute infections are accompanied by other characteristic symptoms.

Elevated ESR in the blood of a child may also indicate non-infectious diagnoses:

If the cause of the increased ESR in the blood in children is still an inflammatory process, then even after recovery from the disease, the indicator will be higher than normal for 6 weeks.

If there is any doubt about the victory over the diagnosis, will have to retake the analysis several times.

Doctors keep their statistics on the increase in ESR under various conditions in children. A high ESR level in a child's blood may have the following reasons:

• infectious diseases - 40%;
• oncological diseases of the blood, systemic organs - 23%;
• lupus erythematosus, rheumatism - 17%;
• kidney pathology - 3%;
• other diagnoses (ENT diseases, anemia, cholelithiasis) - 8%.

Important Factors

Why else can the ESR in the blood of a child be increased? Sometimes lifting is associated with the physiological characteristics of the baby..

If a thorough examination did not reveal any pathologies and signs of inflammation, parents can calm down - this is the same case.

There are factors that give a false positive or false negative result:

• decrease in hemoglobin;
• taking some vitamins;
• decrease in red blood cells;
• vaccinations against hepatitis;
• obesity.

If the child's condition does not cause concern, and the analysis still showed an increased ESR in the child's blood, then the reason is in other factors.

It could be:

• laboratory error;
• child's fear of analyses;
• the impact of stress;
• taking certain medications;
• vitamin deficiency;
• teething;
• an abundance of spicy and fatty foods in the daily diet.

In young children, the ESR may jump- this is typical for the age from 27 days to 2 years. This is more of a norm than a pathology.

In girls, the time of day affects the rate of red blood cells The reason is hormones. For example, a morning analysis will show that the ESR level is normal, and a lunch one will show its increase.

With accelerated ESR syndrome the indicator does not fall below 60 mm / h for a long time. Diagnosis requires a thorough examination of the body. If no pathologies are identified, then this condition does not require separate treatment.

When to go to the doctor

You received the test results in your hands and found that the ESR level of the child is slightly higher than normal, but the child is full of energy. Then don't worry, just retake the test later.

If the rate of erythrocytes exceeds the norm by 10 points you need to go to the doctor. This is a sign of an infectious focus.

The speed level of bodies from 30 to 50 mm/hour signals about the acute stage of the disease, which requires immediate and long-term treatment.

The pediatrician identifies the root cause of the increase in ESR in the blood of the child, based on an accurate diagnosis, therapy is prescribed.

If the cause is inflammation, then antibiotics and antiviral drugs cannot be avoided.

How to downgrade

There is no real way to reduce. It is necessary to identify the cause of the increase in this indicator and eliminate it. Moreover, it is unreasonable to ask such a question when it comes to the health of the child.

Do not self-medicate by giving antibiotics and anti-inflammatory dietary supplements without consulting a doctor. This can worsen the condition of the baby, harm his health.

Drug treatment of diagnoses provoking an increase in ESR can be supplemented alternative medicine recipes:

• anti-inflammatory herbal decoctions (chamomile, lungwort, coltsfoot, linden) - take a few tablespoons a day;
• natural antibacterial products (honey, citrus fruits);
• a decoction of raw beets - drink 50 ml in the morning before breakfast.

Increasing the level of ESR should not scare parents. Most often, this is a sign of minor physiological changes in the child's body.

However, the possibility of a serious pathology cannot be ruled out. If you get an alarming result, go through the necessary examinations.

The speed of blood cells is one of the significant indicators so don't ignore it.

In contact with

Dear Oksana!

The erythrocyte sedimentation rate (ESR) is an indicator that indicates how quickly erythrocytes - red blood cells - stick together, i.e. settle down. If the ESR indicator is outside the norm for age, this indicates that there is a reason that influenced this process. Usually, experts analyze the big picture, because ESR in itself cannot indicate the development of any particular disease and cannot be a symptom of pathology. However, it cannot be excluded from the overall clinical picture.

ESR norms in children

The normal level of ESR in the blood of a child depends on age:

• Newborns - 0 - 2 mm / h, maximum - 2.8 mm / h;
• 1 month - 2 - 5 mm/h;
• 2 - 6 months - 4 - 6 mm/h;
• 6 - 12 months - 3 - 10 mm/h;
• 1 - 5 years - 5 to 11 mm/h;
• 6 to 14 years - from 4 to 12 mm / h;
• Over 14 years old: girls - from 2 to 15 mm / h, boys - from 1 to 10 mm / h.

Reasons for increasing ESR

If a child has an increase in ESR, then most often experts suggest the presence of some kind of infectious and inflammatory process. At the same time, other indicators in the results of a general blood test should also be changed. The behavior of the child should also change, because any infection is accompanied by alarming symptoms and poor health.

In addition, the erythrocyte sedimentation rate increases in some non-communicable diseases. It can be:

• Autoimmune or systemic diseases (rheumatoid arthritis, bronchial asthma, systemic lupus erythematosus);
• Endocrine diseases (hyper- and hypothyroidism, diabetes mellitus);
• Blood diseases, anemia, hemoblastosis;
• Oncological diseases, tuberculosis of the lungs and other organs, myocardial infarction, etc.;
• Injuries.

It should be noted that the erythrocyte sedimentation rate normalizes rather slowly after the child's recovery, only after 4-6 weeks. Remember if your child had colds or other infectious or inflammatory diseases at the age of 1.5 - 2 months? If the answer is yes, then in order to make sure that the inflammation has passed, you can take a blood test for C-reactive protein, because. the factor of unresolved infection in the case of pediatric diagnostics is most likely.

There are other, less dangerous reasons for increasing ESR. For example, if you are breastfeeding, then fatty foods or certain medications, such as paracetamol, may have affected the blood test. ESR also increases during teething in children. It can also indicate a lack of vitamins or infection with worms. With an allergic reaction in children or dense feeding before testing, the erythrocyte sedimentation rate may also increase.

If we talk about statistics, then infectious diseases are responsible for an increase in ESR by 40%, oncological diseases by 23%, systemic diseases by 17%, anemia, inflammation of the gallbladder or pancreas, intestines, ENT organs, etc., by 8%. .d., 3% - kidney disease.

What to do?

First of all, it is necessary to exclude a false result. Take a blood test again. If high ESR rates are observed in dynamics, then you need to immediately consult a doctor, because. the child may need in-depth diagnostics in order to exclude dangerous diseases. However, do not worry ahead of time. Sometimes, although rarely, in some children there is a certain individual feature, manifested in an increase in ESR against the background of normal indicators of other blood components.

Sincerely, Xenia.