What Causes Elevated ESR (Erythrocyte Sedimentation Rate)?

An elevated ESR (erythrocyte sedimentation rate) often indicates the presence of inflammatory lesions in the body. In some cases, this elevation is physiological and does not require treatment. However, when the ESR elevation is pathological, appropriate measures should be taken based on the type of disease identified to help the body recover to a healthy state as soon as possible.

ESR, or erythrocyte sedimentation rate, measures the rate of sedimentation of red blood cells by observing their descent distance at the end of the first hour. Elevated ESR can be divided into two main types: physiological elevation and pathological elevation.

Physiological elevation is mainly observed during menstruation, pregnancy after the third month, and in individuals over 60 years old. This increase may be associated with physiological anemia, gradually increasing fibrinogen levels, placental detachment, childbirth injuries, and other factors.

Pathological elevation is primarily seen in various acute inflammatory conditions such as acute bacterial infections, subacute endocarditis, tuberculosis, as well as systemic lupus erythematosus, rheumatic fever, tumors, tissue trauma, and hypercholesterolemia.

The C-reactive protein (CRP) is a commonly used marker for systemic inflammation. Compared to CRP, ESR elevation reacts slower and may persist even when CRP levels have returned to normal. Therefore, ESR elevation can provide longer-term and slower-reacting insights into inflammatory processes.