Increased ESR in the blood of a child Komarovsky. Why is the child’s ESR increased? Why does ESR change?

When parents receive the test result in their hands, they cannot always decipher the result correctly. What the ESR value indicates is worth understanding in order to take timely measures.

What does an increased level of ESR (erythrocyte sedimentation rate) in a child’s blood indicate, what does this mean and what are the reasons, how to lower the high level? Let's find out!

Erythrocyte sedimentation rate

The full medical name for the outpatient term is erythrocyte sedimentation rate. 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 are separated into two visible layers. The time spent on this is the desired speed in mm/hour.

A similar process occurs in the human body. Red blood cells settle on the walls of blood vessels during the process of agglomeration over a certain period of time.

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

Red blood cell speed helps doctors diagnose certain conditions:

• identify hidden diseases (but not all diagnoses are accompanied by an increase in ESR);

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How to get tested

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

The analysis is not carried out immediately after a rectal examination, physical therapy sessions, or x-rays. They may inflate the figure.

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

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

The 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 it is believed that the second method is more informative. If he gave an overestimated indicator, a retake is not required, except for laboratory errors.

In laboratories equipped with modern equipment, automatic counters are used to calculate ESR. The process completely eliminates the human factor, which reduces the likelihood of error to a minimum.

Normal for up to one year and older

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

• newborn babies – 0.2-2.8 mm/hour;

Too “nimble” red blood cells do not always indicate inflammatory processes. To determine an accurate diagnosis, other outpatient blood tests and examinations are required.

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

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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.

An increased ESR in a child’s blood may also indicate non-infectious diagnoses:

• injuries;

Important Factors

Why else can ESR be elevated in a child’s blood? Sometimes the rise is associated with the physiological characteristics of the baby.

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

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

• decrease in hemoglobin;

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

In girls, the speed of red blood cells is affected by the time of day, the reason is hormones. For example, a morning analysis will show that the ESR level is normal, and a lunchtime analysis will show that it is increased.

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

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When to go to the doctor

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

If the red blood cell speed exceeds the norm by 10 points, you need to go to the doctor. This is a sign of an infectious focus.

A corpuscular velocity level of 30 to 50 mm/hour indicates an acute stage of the disease, which will require immediate and long-term treatment.

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

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

How to downgrade

There is no effective way to reduce it. It is more expedient to identify the reason for the increase in this indicator and eliminate it. Moreover, it is unreasonable to ask such a question when it comes to the health of a child.

Drug treatment of diagnoses that provoke an increase in ESR can be supplemented with alternative medicine recipes:

• anti-inflammatory herbal decoctions (chamomile, lungwort, coltsfoot, linden) - take several spoons a day;

An increase in ESR levels should not frighten parents. Most often this is a sign of minor physiological changes in the child’s body.

However, the possibility of serious pathology cannot be ruled out. If you receive an alarming result, undergo the necessary examinations.

The speed of blood cells is a significant indicator, so you should not ignore it.

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What are the norms for ESR in a child?

The ESR rate in children indicates the optimal erythrocyte sedimentation rate. This is a general indicator that is determined in a blood test. It shows the rate at which cells stick together. To obtain results, health care workers draw venous or capillary blood.

Erythrocyte sedimentation rate (ESR)

This indicator is very important. It is impossible to determine from it what disease the baby is developing. But it is possible to identify pathological changes at the initial stage of development, when symptoms have not yet appeared. The pediatrician will tell you what this means and what numbers you should pay attention to.

There is no primary therapy as such to cure ESR abnormalities in children. The indicator will recover on its own when the patient recovers. If, for example, a child has an ESR of 20, this means that there are serious abnormalities in his body. The disease must be identified and treated.

Acceptable parameters of ESR in the blood

These parameters are different for each person. They depend on whether it is a newborn, a one-year-old baby or an adult. For all, ESR standards are set within certain limits. In addition, ESR is determined by the gender of the patient.

How old, gender

Erythrocyte sedimentation rate, mm/h

Newly born baby

Babies up to 6 months.

If the ESR is within the normal range, this does not mean that the child is healthy. In many situations, this indicator does not rise above 20 mm/h, even if the patient has been diagnosed with a malignant tumor. But significantly increased numbers indicate that an infectious pathological process or inflammation is most likely developing in the patient’s body.

The level of ESR in adults and children is different. Doctors rely on this data to prescribe additional examinations for the patient. In addition, children of different ages have different erythrocyte sedimentation rates.

ESR norms in children:

1. Newborns - from 2 to 4 mm/h.
2. Infant up to 1 year - from 3 to 10 mm/h.
3. Children from 1 year to 5 years - from 5 to 11 mm/h.
4. Child aged 6 to 14 years (girls) - from 5 to 13 mm/h. From 6 to 14 years (boys) - from 4 to 12 mm/h.
5. From 14 and older (girls) - from 2 to 15 mm/h. Boys over 14 years old - from 1 to 10 mm/h.

Changes occur with age, and also depending on the individual characteristics of each child. Violations may be minor, i.e. the indicator almost corresponds to how much ESR should be in a child’s body.

If all other tests are normal, then there is no cause for concern. Most likely, the child has temporary deviations or individual manifestations in the body. But if the doctor recommends additional studies, you should take tests and undergo tests. This way you can make sure that there are no pathological processes.

The ESR value rises to 25 units if serious disorders develop in the human body without visible symptoms. Or when the norm is too high by at least 10 mm/h.

The decision on further actions is made only by the doctor.

If the ESR level reaches 30 mm/h, it means that the child’s body is developing a chronic disease or pathological processes are at an advanced stage.

The doctor prescribes mandatory treatment after making an accurate diagnosis, which may take a couple of months.

If the ESR is 40, then the child has global health problems. It is necessary to detect the source of the disease and begin immediate treatment.

Why does ESR increase in children?

As a result of a different ratio of blood cells, an inflammatory process develops and the ESR increases. This is because in the blood the concentration of those proteins that are formed after tissue destruction or against the background of inflammation in the body increases.

An increased ESR in a child’s blood indicates the presence of pathological processes, but where exactly they occur is impossible to determine. Abnormalities indicate various diseases, but this is not the main method of diagnosis. An increase in standard norms indicates that an infectious inflammatory process is occurring in the child’s body.

In addition, such a test can show high numbers even when a person is completely healthy. Therefore, experts recommend conducting additional studies to determine the development of the disease at the initial stage.

There are certain pathologies that cause an increase in ESR in children:

1. Bacterial infections. This is tuberculosis or pneumonia, meningitis.
2. Diseases of viral origin. Sore throat, scarlet fever or herpes.
3. Aggravated pathological processes in the intestines. Cholera, typhoid fever or salmonella.
4. Immunopathological diseases. Rheumatism or nephrotic syndrome, vasculitis.
5. Pathological processes associated with the kidneys. Colic or pyelonephritis.
6. Anemia, burn, injury or complications after surgery.

The main indicator that doctors pay attention to is the magnitude of the disorder. Test results will help you understand that serious disorders are occurring in a child’s body.

The ESR level rises by more than 10 units. As a rule, after complete recovery, the erythrocyte sedimentation rate in children remains at a high level even after a couple of months. Therefore, tests should be taken periodically.

A blood test to determine the level of C-reactive protein will help you accurately and quickly find out what ESR a patient has. This parameter can determine the stage of development of the disease, as well as its expressed indicators. If it is high, then the ESR will be increased.

Reasons for low ESR

As a rule, a reduced ESR level does not cause much concern to doctors. But that doesn't mean everything is fine. A reduced result indicates that the baby has an unbalanced diet and his body does not have enough protein. In addition, the ESR may be low as a result of dehydration, such as after severe diarrhea or vomiting.

There are situations when the ESR rate in a child’s blood decreases due to hereditary diseases. And also because of pathological processes that affect the circulatory system. But other parameters obtained after a detailed blood test will also tell about this.

For diagnosis, ESR parameters in children and adults are of great importance. But this is just a helper method. He tells the specialist in which direction to look for the disease, as well as whether he has prescribed the right treatment for his patient.

There are certain factors as a result of which a child’s ESR falls below that established by standards:

• diarrhea that lasts for a long period;
• severe vomiting;
• loss of large amounts of fluid by the body;
• viral hepatitis;
• serious heart disease;
• chronic disorders affecting the circulatory system.

In addition, low ESR levels are observed in a child in the first 2 weeks of his life after birth. If the baby feels well, but the indicators are underestimated, you should not leave the situation without action. It is better to go to the hospital and do additional research.

False ESR test results

It is not always possible to obtain accurate analysis data. In medicine there is such a thing as a false positive result. The data from such a test cannot be considered reliable. They cannot indicate the development of pathology in the patient’s body.

There are certain reasons why ESR results are considered false positive:

• anemia not accompanied by morphological changes;
• increased concentrations of all proteins in plasma, with the exception of fibrinogen;
• insufficient kidney function;
• hypercholesterolemia;
• the onset of pregnancy;
• overweight;
• patient's age;
• hepatitis B vaccine;
• intake of vitamin A.

The cause may also be technical violations made during diagnostics. This is incorrect exposure of the material, temperature, insufficient amount of anticoagulants for testing.

Methods for restoring ESR in children

A doctor cannot make an accurate diagnosis using only the erythrocyte sedimentation rate results. If there are deviations from the standard norm, then he prescribes additional research methods:

After all additional examinations, only the doctor makes decisions; he knows how much ESR is normal for the child. If there are deviations, he refers the patient to other tests. Taking into account all the indicators, as well as the disease that will be detected, the children are prescribed appropriate medications.

As a rule, to restore ESR, the pediatrician prescribes medications to his patients to stop the inflammatory process. These are antibiotics, antiviral drugs, and antihistamines.

There are alternative medicine methods that help normalize the level of erythrocyte sedimentation rate. For example, herbal decoctions that have an anti-inflammatory effect. These include chamomile and linden.

You can drink tea with raspberries, add honey and lemon. In addition, the doctor recommends eating foods with a lot of fiber and natural protein foods.

Red beets have a positive effect on the erythrocyte sedimentation rate. But before using traditional medicine to treat a child’s body, you should consult a doctor.

You cannot make decisions on your own and give your child any means.

Effective treatment not only helps the little patient get better, but also normalizes the ESR level. This is not so easy to achieve; time must pass (at least one month) from the moment the child gets sick.

How is the analysis carried out?

As a rule, the material is taken in the hospital in the morning, from a finger, a vein, or, if it is a newborn, then from the heel. The tests are not dangerous for a child; they only require a few drops. The pad is lubricated with cotton wool and alcohol. The skin is pierced, the first blood is wiped off to prevent impurities from getting into the material. Collection is carried out in a special vessel.

Important! The blood should flow out on its own. You cannot press, otherwise it will mix with the lymph. Then the results will not be accurate enough.

In order for the blood to come out on its own, the child’s hand should be warmed, for example, with warm water or near a radiator. If the material is taken from a vein, then a tourniquet is tied on the baby’s forearm. They ask him to work with his fist. This is necessary so that the doctor can accurately hit the vein with a needle.

Each procedure is painful in its own way. But children can also be capricious because they are afraid of people in white coats or the sight of blood. They get scared out of ignorance, not understanding what will be done to them. Many clinics allow parents to be present during the collection of material.

This makes the baby much calmer. In addition, the child must be explained that the analysis is necessary to make an accurate diagnosis.

Many children do not tolerate the procedure very well. After it, nausea and dizziness occur. In this case, you can give the child something sweet, such as juice, tea or chocolate. An unpleasant moment can be left in the past if you distract your child with a pleasant event.

Analysis of ESR is carried out at any age. A standard procedure prescribed to healthy or sick people. For example, it is used if the body temperature rises, other complaints appear, or if a child has bronchitis. The doctor always prescribes a general blood test, including ESR.

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Normal ESR in the blood of children and what to do if the value is elevated

Thanks to a child's blood test, you can determine whether the baby is healthy or has any diseases. This is especially important if the disease is hidden. To identify such hidden pathologies, all children are routinely sent for tests at a certain age. And increased attention is paid to blood tests in children.

One of the important indicators determined in the laboratory during blood testing is ESR. Seeing this abbreviation on a blood test form, many parents do not know what it means. If, in addition, the analysis revealed an increased ESR in the child’s blood, this causes worry and anxiety. To know what to do with such changes, you need to understand how ESR analysis is carried out in children and how its results are deciphered.

What is ESR and how is its value determined?

The abbreviation ESR abbreviates the “erythrocyte sedimentation rate,” which is found during a clinical blood test. The indicator is measured in millimeters per hour. To determine it, blood combined with an anticoagulant (it is important that it remains liquid) is left in a test tube, allowing its cells to settle under the influence of gravity. After one hour, the height of the upper layer is measured - the transparent part of the blood (plasma) above the blood cells that have settled down.

Table of norm values

When a blood test is deciphered, all indicators are compared with standards, which depend on the age of the children. This also applies to the sedimentation rate of red blood cells, because the ESR immediately after birth will be the same, at the age of 2-3 years or 8-9 years the indicator will be different.

The normal ESR results are:

In a newborn in the first days of life

In an infant up to one year old

An increase in the rate between the 27th day of life and two years is considered normal. In children of this age, ESR can reach mm/h. In adolescence, the results differ for girls (an indicator of up to 14 mm per hour is considered normal) and for boys (an ESR of 2-11 mm per hour is considered normal).

Why is it below normal?

Deviations of ESR from the norm are often manifested by an increase in this indicator, and a decrease in the rate at which red blood cells are deposited is observed much less frequently. The most common cause of such changes is increased blood viscosity.

A lower ESR occurs when:

• Dehydration, for example due to acute intestinal infection.
• Heart defects.
• Sickle anemia.
• Acidosis (lowering blood pH).
• Severe poisoning.
• Sharp weight loss.
• Taking steroid medications.
• An increase in the number of blood cells (polycythemia).
• The presence in the blood of red blood cells with an altered shape (spherocytosis or anisocytosis).
• Pathologies of the liver and gallbladder, especially manifested by hyperbilirubinemia.

Reasons for increasing ESR

A high ESR in a child does not always indicate health problems. This indicator can change under the influence of various factors, sometimes harmless or temporarily affecting the child. However, quite often an increase in ESR is a sign of illness, and sometimes very serious.

Non-hazardous

For such reasons, a slight increase in ESR is typical, for example, domm/h. This ESR indicator can be detected:

• During teething.
• With hypovitaminosis.
• If your child is taking retinol (vitamin A).
• In case of strong feelings or stress, for example, after a baby has been crying for a long time.
• During a strict diet or fasting.
• When taking certain medications, such as paracetamol.
• For obesity.
• If there is an excess of fatty foods in the diet of a baby or a nursing mother.
• After vaccination against hepatitis B.

In addition, the so-called Elevated ESR Syndrome can be detected in childhood. With it, the indicator is high, but the child does not have any complaints or health problems.

Pathological

In diseases, the ESR increases much more than normal, for example, domm/hour and higher. One of the main reasons for faster erythrocyte sedimentation is an increase in the amount of protein in the blood due to an increase in the level of fibrinogen and the production of immunoglobulins. This condition occurs during the acute phase of many diseases.

An increase in ESR is observed when:

• Infectious diseases. An increased rate is often diagnosed with bronchitis, ARVI, scarlet fever, sinusitis, rubella, cystitis, pneumonia, mumps, as well as tuberculosis and other infections.
• Poisoning, for example, caused by toxins in food or salts of heavy metals.
• Helminthiasis and giardiasis.
• Anemia or hemoglobinopathies.
• Injuries of both soft tissues and bones. ESR also increases during the recovery period after surgery.
• Allergic reactions. ESR increases both during diathesis and anaphylactic shock.
• Joint diseases.
• Tumor processes, for example, with leukemia or lymphoma.
• Endocrine pathologies, for example, diabetes mellitus or thyrotoxicosis.
• Autoimmune diseases, in particular lupus.

ESR in infections

It should be remembered that to diagnose an infection, not only changes in the blood are taken into account, but also the clinical picture and anamnesis. In addition, it is important to note that after recovery, the ESR remains elevated for several months.

For information about the ESR norm and the reasons for increased indicators, see the following video.

Symptoms

In some cases, nothing bothers the child at all, and changes in ESR are detected during a routine examination. However, often a high ESR is a sign of illness, so babies will also have other symptoms:

• If red blood cells settle faster due to diabetes, the child will experience increased thirst, increased urination, weight loss, skin infections, thrush, and other signs.
• If the ESR increases due to tuberculosis, the child will lose weight, complain of malaise, cough, chest pain, and headaches. Parents will notice a slight increase in temperature and poor appetite.
• With such a dangerous cause of increased ESR as cancer, the baby’s immunity will decrease, lymph nodes will increase, weakness will appear, and weight will decrease.
• Infectious processes in which ESR increases most often will be manifested by a sharp rise in temperature, increased heart rate, shortness of breath and other signs of intoxication.

What to do

Since most often a high ESR signals the doctor about the presence of an inflammatory process in the child’s body, a change in this indicator should not go unnoticed by the pediatrician. In this case, the actions of doctors are determined by the presence of any complaints in the child.

If the child does not have any manifestations of the disease, and the ESR in the blood test is high, the doctor will refer the child for additional examination, which will include a biochemical and immunological blood test, chest x-ray, urinalysis, ECG and other methods.

If no pathologies are detected, and an increased ESR, for example, 28 mm/h, remains the only warning symptom, after some time the pediatrician will refer the baby to retake a clinical blood test. The child will also be recommended to determine C-reactive protein in the blood, which is used to judge the activity of inflammation in the body.

If an increase in ESR is a symptom of a disease, the pediatrician will prescribe medication. As soon as the child recovers, the indicator will return to normal values. In case of an infectious disease, the child will be prescribed antibiotics and other medications; in case of allergies, the child will be prescribed antihistamines.

How to get tested

To avoid a false positive result (an increase in ESR without the presence of inflammation in the body), it is important to get a correct blood test. ESR is influenced by quite a few factors, so when taking the test it is recommended to do it on an empty stomach and in a calm state.

• You should not donate blood after an X-ray, eating, crying for a long time, or physical therapy.
• It is advisable that the child eats no later than 8 hours before blood sampling.
• In addition, two days before the examination, very high-calorie and fatty foods should be excluded from the child’s diet.
• The day before the test, the child should not be given fried or smoked foods.
• Immediately before taking blood, the baby needs to be calmed down, because whims and worries provoke an increase in ESR.
• It is not recommended to come to the clinic and immediately donate blood - it is better for the child to rest for a while after the street in the corridor and be calm.

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Soe 20 in a child

The results of a blood test, when the erythrocyte sedimentation rate is elevated, will frighten the patient, especially in the absence of signs of the disease. Should I worry? What does this indicator mean and what is its normal value? In order not to succumb to panic, it is advisable to navigate this issue.

This is the designation for one of the blood test indicators – erythrocyte sedimentation rate. More recently there was another name - ROE. It was deciphered as the erythrocyte sedimentation reaction, but the meaning of the study did not change. The result indirectly shows that there is inflammation or pathology. Deviation of parameters from the standard requires additional examinations to establish a diagnosis. The indicator is influenced by:

The body is healthy - and all blood components: platelets, leukocytes, red blood cells and plasma are balanced. Changes are observed during the disease. Erythrocytes - red blood cells - begin to stick to each other. During analysis, they settle and form a layer of plasma on top. The speed with which this process occurs is called ESR - normally this indicator indicates a healthy body. An analysis is prescribed for the purpose of:

• diagnostics;
• medical examination;
• prevention;
• monitoring the outcome of treatment.

It’s good when the ESR is normal. What do its high and low values ​​mean? An increase in the standard - accelerated erythrocyte sedimentation syndrome - indicates the likelihood of having:

• purulent inflammation;
• liver diseases;
• metabolic disorders;
• autoimmune pathologies;
• viral, fungal infections;
• oncology;
• hepatitis A;
• bleeding;
• stroke;
• tuberculosis;
• heart attack;
• recent injuries;
• high cholesterol levels;
• period after surgery.

Low values ​​are no less dangerous. A value that is 2 units less than what the ESR should be according to the norm is a signal to look for a problem. The following reasons can reduce the erythrocyte sedimentation rate:

• poor flow of bile;
• neuroses;
• hepatitis;
• epilepsy;
• vegetarianism;
• anemia;
• hormone therapy;
• circulatory problems;
• low hemoglobin;
• taking aspirin, calcium chloride;
• starvation.

An increased value of an analysis result does not always indicate inflammation or the presence of pathologies. There are situations when ESR is not the norm, but a high or low indicator, but there is no threat to human health. This is typical for the following circumstances:

• pregnancy;
• recent fractures;
• condition after childbirth;
• period;
• following a strict diet;
• a rich breakfast before tests;
• starvation;
• hormone therapy;
• period of puberty in a child;
• allergies.

To get reliable readings when deciphering a general blood test, you need to be prepared. This requires:

• eliminate alcohol one day before;
• come for testing on an empty stomach;
• stop smoking one hour before;
• stop taking medications;
• eliminate emotional and physical overload;
• do not exercise the day before;
• do not undergo x-rays;
• stop physical therapy.

In order to determine whether the ESR level in the body corresponds to the required parameters, there are two verification methods. They differ in the method of collecting material and equipment for research. The essence of the process is the same, you need:

• take blood;
• add an anticoagulant;
• stand vertically for an hour on a special device;
• evaluate the result based on the height of the plasma in millimeters above the settled red blood cells.

The Westergren method involves taking blood from a vein. Sodium citrate is added in certain proportions to a test tube with a 200 mm scale. Place vertically and leave for an hour. In this case, a layer of plasma forms on top, and red blood cells settle down. A clear division appears between them. The erythrocyte sedimentation rate is the measurement in millimeters of the difference between the upper boundary of the plasma and the apex of the red blood cell zone. The total indicator is mm/hour. Under modern conditions, special analyzers are used that determine parameters automatically.

The Panchenkov research method differs in the collection of capillary blood for analysis. When comparing indicators with the Westergren method, the norm of clinical ESR coincides in the range of normal values. With increasing readings, the Panchenkov method gives lower results. The parameters are determined as follows:

• take a capillary on which 100 divisions are applied;
• take blood from a finger;
• dilute it with sodium citrate;
• place the capillary vertically for an hour;
• measure the height of the plasma layer above the red blood cells.

The norm of ESR in the blood of women is associated with physiological characteristics. It is taller than men. Hormonal changes during menstruation, pregnancy, puberty, and menopause contribute to this. The increase in indicators is influenced by the use of contraceptives and excess weight. What should the ESR be for women of different ages? The following indicators are accepted – mm/hour:

During the period of waiting for a child, the ESR indicator is a norm that is specifically specified. It is increased compared to normal levels and changes during the period; two weeks before birth, its growth is possible. ESR in pregnant women also depends on body type. The following indicators are observed – mm/hour:

• dense constitution – first half – 8-45, second part of the term – 30-70;
• thin figure - up to the middle - 21-63, in the subsequent period of time - 20-55.

A child with illness has more vivid symptoms than adults. A blood test is done to confirm the inflammatory process. ESR is a norm that depends on age. The indicators are affected by vitamin deficiency, the presence of helminths, and medications. ESR norms by age – mm/hour:

The test results for men are lower than those for women. Increased results indicate inflammation and pathologies of the body; they can be reduced only by eliminating the cause. What is the normal ESR level in the blood of men? It is determined according to age and is of increased importance during puberty. Normal ESR is – mm/hour:

Testing a child's blood for ESR: reasons for prescribing and interpretation of results

The abbreviation ESR is well known to every doctor, because for more than a hundred years this indicator has been helping to diagnose many diseases - from infections to tumors. We are talking about the erythrocyte sedimentation rate - one of the characteristics of a general blood test, which is prescribed for both adults and children. It is useful for every patient to navigate the results of such a test, but this skill is especially useful for young parents who are often worried about the health of their baby. Therefore, in this article we will talk about how to correctly decipher the results of a blood test for ESR in children.

What does “ESR” mean on a child’s blood test result form?

Red blood cells are the most numerous blood cells, and they account for the bulk of the “weight” of the main fluid of our body. If you add a small amount of a substance that prevents clotting (anticoagulant) to a test tube of blood, then after some time its contents will separate into two clearly visible layers: a red erythrocyte sediment and transparent plasma with the rest of the formed elements of the blood.

At the beginning of the last century, a Swedish scientist named Robert Sanno Foreos first drew attention to the fact that the rate of red blood cell precipitation differs between pregnant and non-pregnant women. Later, doctors found out that there are a lot of conditions in which red blood cells sink to the bottom of the test tube faster or slower than normal. Therefore, with the help of such an analysis, doctors draw conclusions about the processes occurring in the human body. This indicator is especially important in pediatrics, because a child, especially at an early age, cannot tell in detail about the symptoms of illness.

The essence of the phenomenon on which the ESR measurement is based is that under certain physiological and pathological conditions, the concentration of special proteins in the blood increases, capable of gluing red blood cells together. As a result, red blood cells take on the appearance of coin columns (if examined under a microscope). Grouped red blood cells become heavier, and the rate of blood separation into fractions increases. If for some reason there are fewer cells than normal, then the ESR in the analysis will be reduced.

No competent doctor will make a diagnosis based solely on changes in the erythrocyte sedimentation rate. For this reason, in most cases, ESR testing is prescribed as part of a general or detailed blood test.

There is no need to worry if your child's doctor orders a blood test that includes ESR. This is a standard procedure that allows you to monitor a person’s health status at any age - both in the presence of complaints and in their absence. Therefore, even if children feel well, it is worth donating blood for ESR at least once a year.

The most common reason for visiting a pediatrician is childhood infections. And ESR always changes during the inflammatory process that accompanies the fight of the immune system against bacteria and viruses. For this reason, the doctor will definitely prescribe a general or detailed blood test, including ESR, if the child complains of a sore throat and runny nose, as well as if his body temperature has risen. This test is also performed in cases where symptoms suggest a serious problem: appendicitis, internal bleeding, allergies or a malignant tumor.

How to prepare for the procedure and what is it like?

Preparation for manipulation plays a significant role in the reliability of the ESR assessment results. The fact is that proteins appear in the blood not only during inflammation, but also in some physiological situations - for example, immediately after eating, physical activity, and as a result of stress.

Depending on the method used to determine ESR, the nurse will take a blood sample from a finger or a vein (or, in infants, from the heel). If the analysis is carried out using the Panchenkov method, then several milliliters of blood will be required. To get them, a specialist will prick the pad of the ring finger with a small needle or scarifier (it has fewer nerve endings than other fingers), and then quickly collect the escaping blood into a special tube. After completing the procedure, apply a cotton swab with a disinfectant solution to the wound for 5 minutes.

In the laboratory, the resulting blood sample will be combined with a four-to-one sodium citrate solution and then filled into a clear vertical capillary with the mixture. After an hour, using a special scale, it will be possible to determine how much time the red blood cells have settled and calculate the ESR.

If the child’s ESR analysis is performed using the Westergren method, then blood will need to be taken from a vein. If this manipulation is performed by an experienced nurse, the pain will be as insignificant as with an injection into the finger. She will apply a tourniquet to your child's arm and then insert a needle into a vein on the inside of the arm near the elbow. Then the tourniquet will be removed, and the required amount of blood will be drawn into the placed test tube in just a few seconds. If you are near your child at this moment, try to distract his attention so that he does not see what is happening and is not afraid. At the end of the procedure, the nurse will press a cotton swab onto the wound and stick a strip of adhesive tape on top. This bandage can be removed after half an hour.

During the analysis using the Westergren method, venous blood is also mixed with an acetic acid derivative and sodium citrate, and the resulting solution is filled into a test tube with a special division scale. As with the Panchenkov method, ESR is assessed an hour after the start of the analysis.

The Westergren method is considered more sensitive to an increase in ESR, so doctors often insist that venous blood be taken from the child for analysis.

Decoding the results of a study of ESR in children

Interpretation of ESR analysis is an individual process. In different situations, the results obtained may indicate normality or pathology, so the doctor will make a conclusion based on the general clinical picture and medical history of the child.

Normal ESR in newborns is 2.0–2.8 mm/hour, in children up to two years old - 2–7 mm/hour, from 2 to 12 years old - 4–17 mm/hour, and after 12 years old - 3– 15 mm/h.

In infants under 6 months of age, ESR may briefly increase to 12–17 mm/h, which is associated with changes in blood composition, and in some cases, with the period of eruption of the first teeth. And in girls, the erythrocyte sedimentation rate is always slightly higher than in boys - this disproportion persists in adults.

The reasons why ESR may be higher than normal are divided into physiological and pathological. The former include stress, daily changes in blood composition (in the afternoon the ESR is slightly higher), the state of recovery after an infectious disease (this indicator returns to normal with some delay), taking certain medications, dietary or drinking habits, the effects of physical activity, and others .

However, more often the ESR analysis is elevated due to an inflammatory process in the body. Changes in the indicator are caused by:

• infectious disease (sore throat, pneumonia, meningitis, tuberculosis, rubella, chickenpox, ARVI, herpes, etc.);
• pathology of immunity (rheumatoid arthritis, systemic lupus erythematosus, glomerulonephritis, etc.);
• endocrine diseases (thyroid pathology, diabetes mellitus, adrenal gland diseases);
• blood loss and other anemia;
• pathology of red bone marrow, bone fractures;
• allergy;
• oncological diseases.

As already mentioned, an increase in ESR, which is not accompanied by any other changes in the child’s blood test or changes in his well-being, is not a reason for concern and, especially, a reason for prescribing medications. Most likely, if you receive such a result, the doctor will advise you to repeat the analysis in 2-3 weeks, following all the rules for preparing for the procedure. If the ESR value again exceeds the norm, do a biochemical blood test, check the level of C-reactive protein and a stool test for helminths.

Some children experience elevated ESR syndrome, a condition in which the erythrocyte sedimentation rate remains above 50 mm/h for a long time without any apparent reason. As a rule, in such cases, doctors try to conduct a thorough diagnosis in case there is a hidden serious disease. But if tests and examinations do not reveal deviations from the norm, then no treatment is prescribed for the syndrome of elevated ESR, recognizing it as an individual feature of the body.

Usually, a low ESR in children does not cause concern to doctors. However, such an analysis result may be a sign of an unbalanced baby’s diet with a lack of protein or dehydration (due to diarrhea or vomiting). Also, erythrocyte sedimentation slows down in some hereditary blood diseases and disorders in the circulatory system, but this is accompanied by changes in many indicators of a detailed blood test in a child.

ESR in a child is a useful parameter, which, however, has only an auxiliary value in diagnosis, indicating to the doctor the direction of search or the correct action in treating a particular disease. Compliance with all the pediatrician's instructions and regular testing will help you protect your child's health from serious dangers, as well as get rid of unnecessary worry.

In which laboratory diagnostic center can you donate blood for ESR analysis?

Assessment of ESR is an obligatory component of a general and detailed blood test, even in cases where they are performed in an abbreviated form for efficiency. You can find out this indicator in any medical institution that has the appropriate equipment - in a clinic, hospital, private clinic or independent laboratory.

However, taking into account the fact that the result of ESR analysis in children can vary depending on various physiological factors, it is important to carry out such manipulation in a comfortable environment, and entrust the blood sampling procedure to professionals who are able to find an approach to even the most capricious baby. Specialists from the INVITRO network of independent laboratories understand how important it is for parents to be confident in the well-being of their child and to receive the most accurate information about his condition. Therefore, to assess ESR, the Westergren method is used here, recognized by the world community as the most accurate, and a blood sample, if necessary, will be taken even at home. The results of analyzes carried out by INVITRO are recognized by all medical institutions in Russia. The consistent quality of the laboratory’s work is confirmed by the company’s 20 years of experience, to which thousands of patients trust every day to take care of their health and the health of their families.

Analysis of ESR in children is an important diagnostic parameter that allows identifying inflammatory processes and infectious diseases.

Erythropoietin is the hormone responsible for the formation of red blood cells. An increase or decrease in its level may indicate the development of a serious disease.

Determination of erythrocyte sedimentation rate is most often included in a general blood test.

Make an appointment for a free appointment with a doctor. A specialist will conduct a consultation and interpret the test results.

In order for the test results to be as reliable as possible, it is necessary to properly prepare for their delivery.

Comfort is above all! Get tested without leaving your home or choose the laboratory that is most conveniently located.

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ESR (ROE, erythrocyte sedimentation rate): norm and deviations, why it increases and decreases

Previously, it was called ROE, although some still habitually use this abbreviation, now they call it ESR, but in most cases they apply the neuter gender to it (increased or accelerated ESR). With the permission of the readers, the author will use the modern abbreviation (ESR) and the feminine gender (speed).

ESR (erythrocyte sedimentation rate), together with other routine laboratory tests, is considered one of the main diagnostic indicators in the first stages of the search. ESR is a nonspecific indicator that increases in many pathological conditions of completely different origins. People who had to go to the emergency room with a suspicion of some kind of inflammatory disease (appendicitis, pancreatitis, adnexitis) probably remember that the first thing they do is take a “two” (ESR and leukocytes), which after an hour allows us to clarify a little picture. True, new laboratory equipment can perform analysis in less time.

The normal ESR level in the blood (where else could it be?) primarily depends on gender and age, but is not particularly diverse:

• In children under one month old (newborn healthy babies), ESR is 1 or 2 mm/hour; other values ​​are rare. Most likely, this is due to high hematocrit, low protein concentration, in particular its globulin fraction, hypercholesterolemia, and acidosis. The erythrocyte sedimentation rate in infants under six months of age begins to differ sharply in mm/hour.
• In older children, the ESR levels out somewhat and is 1-8 mm/h, corresponding approximately to the ESR norm of an adult male.
• In men, ESR should not exceed 1-10 mm/hour.
• The norm for women is 2-15 mm/hour, its wider range of values ​​is due to the influence of androgenic hormones. In addition, at different periods of life, the ESR in women tends to change, for example, during pregnancy, from the beginning of the 2nd trimester (4th month), it begins to grow steadily and reaches a maximum by childbirth (up to 55 mm/h, which is considered absolutely normal). The erythrocyte sedimentation rate returns to its previous values ​​after childbirth in about three weeks. Probably, the increased ESR in this case is explained by an increase in plasma volume during pregnancy, an increase in the content of globulins, cholesterol, and a decrease in the level of Ca 2++ (calcium).

An accelerated ESR is not always a consequence of pathological changes; among the reasons for an increase in the erythrocyte sedimentation rate, other factors that are not related to pathology can be noted:

1. Starvation diets and limited fluid intake will likely lead to the breakdown of tissue proteins, and, consequently, an increase in fibrinogen, globulin fractions and, accordingly, ESR in the blood. However, it should be noted that eating will also speed up ESR physiologically (up to 25 mm/hour), so it is better to go for analysis on an empty stomach, so as not to worry in vain and not donate blood again.
2. Some medications (high molecular weight dextrans, contraceptives) can accelerate the erythrocyte sedimentation rate.
3. Intense physical activity, which increases all metabolic processes in the body, will most likely increase the ESR.

This is approximately what the change in ESR looks like depending on age and gender:

The erythrocyte sedimentation rate accelerates, first of all, due to an increase in the level of fibrinogen and globulins, that is, the main reason for the increase is considered to be a protein shift in the body, which, however, may indicate the development of inflammatory processes, destructive changes in connective tissue, the formation of necrosis, and the onset of a malignant neoplasm , immune disorders. A long-term unreasonable increase in ESR to 40 mm/hour or more acquires not only diagnostic, but also differential diagnostic significance, since in combination with other hematological indicators it helps to find the true cause of high ESR.

If you take blood with an anticoagulant and let it stand, then after a certain period of time you will notice that the red blood cells have sank down, and a yellowish transparent liquid (plasma) remains on top. How far red blood cells travel in one hour is the erythrocyte sedimentation rate (ESR). This indicator is widely used in laboratory diagnostics, which depends on the radius of the red blood cell, its density and plasma viscosity. The calculation formula is a wildly twisted plot that is unlikely to interest the reader, especially since in reality everything is much simpler and, perhaps, the patient himself will be able to reproduce the procedure.

The laboratory technician takes blood from a finger into a special glass tube called a capillary, places it on a glass slide, and then draws it back into the capillary and places it in a Panchenkov stand to record the result an hour later. The column of plasma following the settled red blood cells will be their sedimentation rate, it is measured in millimeters per hour (mm/hour). This old method is called ESR according to Panchenkov and is still used by most laboratories in the post-Soviet space.

The definition of this indicator according to Westergren is more widespread on the planet, the original version of which differed very little from our traditional analysis. Modern automated modifications for determining ESR according to Westergren are considered more accurate and allow you to get results within half an hour.

The main factor accelerating ESR is rightfully considered to be a change in the physicochemical properties and composition of the blood: a shift in the protein A/G (albumin-globulin) coefficient towards a decrease, an increase in the pH value, active saturation of red blood cells (erythrocytes) with hemoglobin. Plasma proteins that carry out the process of erythrocyte sedimentation are called agglomerins.

An increase in the level of the globulin fraction, fibrinogen, cholesterol, and an increase in the aggregation abilities of red blood cells occurs in many pathological conditions, which are considered the causes of high ESR in a general blood test:

1. Acute and chronic inflammatory processes of infectious origin (pneumonia, rheumatism, syphilis, tuberculosis, sepsis). Using this laboratory test, one can judge the stage of the disease, the subsidence of the process, and the effectiveness of therapy. The synthesis of “acute phase” proteins in the acute period and the enhanced production of immunoglobulins at the height of “military operations” significantly increase the aggregation abilities of erythrocytes and the formation of coin columns by them. It should be noted that bacterial infections give higher numbers compared to viral lesions.
2. Collagenosis (rheumatoid polyarthritis).
3. Heart damage (myocardial infarction - damage to the heart muscle, inflammation, synthesis of “acute phase” proteins, including fibrinogen, increased aggregation of red blood cells, formation of coin columns - increased ESR).
4. Diseases of the liver (hepatitis), pancreas (destructive pancreatitis), intestines (Crohn's disease, ulcerative colitis), kidneys (nephrotic syndrome).
5. Endocrine pathology (diabetes mellitus, thyrotoxicosis).
6. Hematological diseases (anemia, lymphogranulomatosis, myeloma).
7. Injury to organs and tissues (surgeries, wounds and bone fractures) - any damage increases the ability of red blood cells to aggregate.
8. Lead or arsenic poisoning.
9. Conditions accompanied by severe intoxication.
10. Malignant neoplasms. Of course, it is unlikely that the test can claim to be the main diagnostic sign for oncology, but its increase will one way or another create many questions that will have to be answered.
11. Monoclonal gammopathies (Waldenström's macroglobulinemia, immunoproliferative processes).
12. High cholesterol levels (hypercholesterolemia).
13. Exposure to certain medications (morphine, dextran, vitamin D, methyldopa).

However, at different periods of the same process or under different pathological conditions, ESR does not change the same:

• A very sharp increase in ESR domm/hour is typical for myeloma, lymphosarcoma and other tumors.
• Tuberculosis in the initial stages does not change the erythrocyte sedimentation rate, but if it is not stopped or a complication occurs, the rate will quickly creep up.
• In the acute period of infection, the ESR will begin to increase only from 2-3 days, but may not decrease for quite a long time, for example, with lobar pneumonia - the crisis has passed, the disease recedes, but the ESR persists.
• It is unlikely that this laboratory test will be able to help on the first day of acute appendicitis, since it will be within normal limits.
• Active rheumatism can last for a long time with an increase in ESR, but without frightening numbers, but its decrease should alert you to the development of heart failure (blood thickening, acidosis).
• Usually, when the infectious process subsides, the total number of leukocytes returns to normal first (eosinophils and lymphocytes remain to complete the reaction), ESR is somewhat delayed and decreases later.

Meanwhile, long-term persistence of high ESR values ​​(20-40, or even 75 mm/hour and above) in infectious and inflammatory diseases of any kind will most likely suggest complications, and in the absence of obvious infections, the presence of some then hidden and possibly very serious diseases. And, although not in all cancer patients the disease begins with an increase in ESR, its high level (70 mm/hour and above) in the absence of an inflammatory process most often occurs in oncology, because the tumor will sooner or later cause significant damage to the tissues, the damage of which will ultimately result. As a result, the erythrocyte sedimentation rate will begin to increase.

The reader will probably agree that we attach little importance to ESR if the numbers are within the normal range, but reducing the indicator, taking into account age and gender, to 1-2 mm/hour will still raise a number of questions for particularly curious patients. For example, a general blood test of a woman of reproductive age, when examined repeatedly, “spoils” the level of erythrocyte sedimentation rate, which does not fit into the physiological parameters. Why is this happening? As in the case of an increase, a decrease in ESR also has its own reasons, due to a decrease or lack of the ability of red blood cells to aggregate and form coin columns.

when ESR decreases, one (or more) components of correct erythrocyte sedimentation are not in order

Factors leading to such deviations include:

1. Increased blood viscosity, which, with an increase in the number of red blood cells (erythremia), can generally stop the sedimentation process;
2. Changes in the shape of red blood cells, which, in principle, due to their irregular shape, cannot fit into coin columns (sickling, spherocytosis, etc.);
3. Changes in physical and chemical blood parameters with a shift in pH downward.

Such changes in the blood are characteristic of the following conditions of the body:

• High levels of bilirubin (hyperbilirubinemia);
• Obstructive jaundice and, as a consequence, the release of large amounts of bile acids;
• Erythremia and reactive erythrocytosis;
• Sickle cell anemia;
• Chronic circulatory failure;
• Decreased fibrinogen levels (hypofibrinogenemia).

However, clinicians do not consider a decrease in erythrocyte sedimentation rate to be an important diagnostic indicator, so the data is presented specifically for particularly inquisitive people. It is clear that in men this decrease is not noticeable at all.

It is definitely not possible to determine whether your ESR has increased without a finger prick, but it is quite possible to assume an accelerated result. Increased heart rate (tachycardia), increased body temperature (fever), and other symptoms indicating the approach of an infectious-inflammatory disease can be indirect signs of changes in many hematological parameters, including the erythrocyte sedimentation rate.

For ARVI and colds in children, the doctor usually prescribes a general blood test. The presence and degree of inflammation makes it possible to determine the erythrocyte sedimentation rate, or ESR.

ESR

ESR is a nonspecific indicator. When conducting a blood test, the rate at which its fractions precipitate is determined, among other things. During inflammation, the ESR is increased due to the increased protein content. Can this help make a diagnosis?

It is impossible to find out what exactly caused this reaction of the body using just one indicator. And yet, the erythrocyte sedimentation rate is determined in almost any disease. It allows you to install:

1. The presence of an inflammatory process.
2. Degree of inflammation.
3. Response to antibacterial or anti-inflammatory therapy.

ESR is only an indirect sign of these conditions, but its practical significance is still great. And many doctors prefer to focus on this value when prescribing or adjusting treatment. So, if the sedimentation rate was increased and began to decrease during therapy, the medicine was chosen correctly.

In children, this indicator can vary to varying degrees.

Changes in ESR in children

ESR norms in childhood are practically no different from those in adults. Up to 8–10 years old, the upper limit of the indicator is considered to be 10–12 mm/hour, for older children – up to 15 mm/hour.

But when assessing a general blood test, you should always focus on the standards of a specific laboratory, which are usually indicated on the result form. In some, an erythrocyte sedimentation rate of 20 mm/hour may also be acceptable.

Most often, doctors encounter an increase in ESR. The reasons for this are as follows:

• Colds, acute respiratory infections.
• Bronchitis, pneumonia.
• Pyelonephritis.
• Arthritis.
• Anemia.
• Autoimmune pathologies.
• Diseases of the blood system.
• Tumors.

In most cases, ESR in children increases due to a cold or viral infection. However, there is no clear correlation between the disease and the degree of growth of the indicator.

A child’s body is capable of reacting violently to an infection, and a doctor can see an ESR of 38–40 mm/hour in an analysis, even with a normal ARVI. This is often observed in children.

But more often, high numbers of indicators are observed with more severe diseases - for example, pneumonia. If the doctor sees a result of 35–45 mm/hour, he is obliged to conduct a detailed examination and prescribe an x-ray.

An ESR above 40–45 mm/hour in a child requires the exclusion of an acute purulent process, autoimmune pathology, blood diseases, and malignant neoplasms.

Mild respiratory infections and colds are not always reflected in this indicator. But more often, the erythrocyte sedimentation rate can be increased to an average of 20–25 mm/hour.

In adults, as a rule, the same patterns of changes in this indicator are observed.

Decrease in ESR

The erythrocyte sedimentation rate may decrease with blood thickening - dehydration due to severe vomiting and diarrhea. Sometimes this happens against the background of severe liver diseases with impaired protein synthesis or heart failure with loss of protein fractions. Such diseases are very rare in children; they are the lot of adult patients.

You should know that low ESR in a newborn is a normal variant. It stays like this for two weeks.

Determination of ESR in acute respiratory viral infections in children and adults, as well as in other pathologies, is widely used in the practice of any doctor. However, the interpretation of this indicator alone is impractical due to its nonspecificity; the erythrocyte sedimentation rate can increase in many pathological processes. It is necessary to take into account the clinical picture of the disease and the data of the entire examination.

What does ESR 25 indicate in a child? Almost all indicators of a general blood test in children differ significantly from adults. This is due not only to the gender and age of children, but also to the characteristics of their body. So the level of ESR also has its differences. It is he who helps to draw attention to the problem in a timely manner and find ways to solve it. For the neonatal period and a slightly older age, the ESR norm is different, so when considering the analysis, you need to keep this in mind. This is the only way to accurately diagnose the body and, if necessary, prescribe additional tests.

ESR norm for children at different ages

Blood for clinical analysis is taken from children, as well as from adults. It is recommended to take it in the morning, but not after physiotherapy procedures or x-rays. This may change the readings.

Children of different ages have their own normal ESR readings:

• neonatal period - 0-2 mm/h;
• up to one year - 3-10 mm/h;
• up to 5 years - 5-10 mm/h;

• up to 12 years - 4-12 mm/h.

During adolescence, the norm for girls and boys will be different. Usually for girls it is 2-15 mm/h, and for boys from 1 to 10. Looking at the norm, you can see that it gradually rises with age. But much depends on the individual characteristics of the children’s body.

Sometimes the ESR in a child’s blood is several units higher than normal or lower. At the same time, the baby feels well and other test parameters are quite normal. In this case, there is no need to panic. Most likely, this phenomenon will be temporary and everything will be restored soon. For some, this phenomenon may be a personal characteristic. In the future, it is possible that this will remain with the child on a permanent basis into adulthood. Such people with an incorrect ESR level, but absolutely healthy, are usually about 5% around the world. Therefore, there should be no cause for concern.

At the age of 10-12 years, the level of ESR in boys and girls may also differ. Since girls begin to mature physiologically several years earlier, their norm is accordingly different.

Usually it is 2-3 units higher than that of boys. This depends on the onset of hormonal changes in the girl’s body, and the difference in norms is not a threat to health.

Why does ESR change?

If a child has an ESR of 25, what does this mean, how to react, and how dangerous is this sign of the disease? Considering the norm of indicators, you can see that this value is overestimated for children of all ages. And the smaller the child, the more panic the parents have. Therefore, not only the erythrocyte sedimentation rate, but also other blood test results should be considered.

Often an increase to 25 mm/h occurs in the presence of a disease. Usually this is an inflammatory process and infectious diseases. Sometimes this happens with chronic diseases in advanced forms and they need to be treated urgently. A higher ESR value will indicate dangerous problems for the child’s health, which can lead to pathological changes.

A clinical blood test alone cannot indicate the disease. Therefore, the doctor must prescribe the necessary tests and conduct an examination. Perhaps the child will have noticeable symptoms that will help determine the diagnosis.

To do this you may need:

• blood biochemistry;
• Analysis of urine;
• bacterial analysis of various body fluids;
• radiography.

It is also possible to be assigned to specialists with a narrow profile, who will examine and study the problem in detail. Thanks to this approach, it is possible to identify diseases in acute and chronic forms, even with their latent development.

What causes the indicator to increase to 25

If, with an increase in ESR, no obvious changes are observed in other indicators of blood results, then the child may be developing a viral or bacterial infection. Over time, the body will respond with changes in almost most indicators, but in the initial stage of the disease they may be insignificant. In the future, this will depend on the course of the disease and its timely treatment. But most often, increased erythrocyte sedimentation indicates the presence of pathologies in the body of children.

Among them are:

• allergic reactions;
• respiratory tract diseases;
• weakening of the immune system;
• relapse of an untreated viral disease;
• problems with the thyroid gland;
• poisoning;
• injuries.

In addition to diseases, a child’s ESR may increase for completely simple and harmless reasons. This usually happens during teething. Not all children experience this change, but it occurs in most cases. Also, poor nutrition and lack of vitamins affect the increase in ESR levels. And those children who take drugs with paracetamol also have impaired performance.

The level of the indicator increases after experiencing stress. In overweight children, the ESR is almost always elevated. In addition, too much weight becomes a problem not only for blood counts. Many organs and joints suffer from this. Therefore, it is not surprising that other blood parameters also change.

After vaccination, with a decrease in hemoglobin or with frequent allergic reactions, the erythrocyte sedimentation rate is always disrupted.

Determining ESR and solving the problem

When children do not have external manifestations of the disease, other studies and analyzes have not shown the presence of diseases, perhaps such an increase in ESR is a physiological feature. It is enough to observe the child for some time, periodically take a general blood test and monitor possible changes. This will help confirm or refute this trait of the body.

In clinics, ESR is most often studied using the Panchenkov method. In some cases it may be incorrect and give false results. But the study largely depends not only on blood, but also on some external conditions. They can increase the sedimentation rate, and every red blood cell will fall under this influence. If the result is in doubt, it is enough to do the analysis again or use a different method.

There are only three of them:

1. Panchenkova.
2. Westergren.
3. Wintroba.

If the ESR is slightly increased, then there is no need to worry. Usually, parents immediately ask the doctor to prescribe all kinds of medications. But in the case when the baby is cheerful, looks healthy, and does not show symptoms of disease, there is no need to treat anything.

When the indicators increase by 12-14 units, it is important to identify the cause and eliminate it. Then the indicators will gradually return to their normal value. It is important to understand that doctors do not treat the tests, but the child. Therefore, improvement in indicators may not occur immediately, but some time after complete recovery.

If you have any concerns about your child's condition, you should consult a doctor. This is especially true for newborn babies who are not suitable for conventional treatment.

It is prohibited to prescribe medications to a child yourself or give medications intended for adults. Only a specialist can talk in detail about the problem of increased ESR and prescribe appropriate treatment.

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ESR is a laboratory indicator that reflects the sedimentation rate of red blood cells (erythrocytes). An increase or decrease in this indicator is a nonspecific sign of inflammatory and infectious diseases. ESR is an integral part of a general clinical blood test, which is performed for symptoms of the disease in children. If the ESR is higher than normal in a child, then the disease should be identified and a treatment regimen should be prescribed.

How to get tested

A general blood test is a mandatory laboratory test. It shows not only ESR. The study determines the number of red blood cells, platelets and leukocytes, hemoglobin level and hematocrit. In order for the test to be accurate, the sick child should prepare to donate blood. The main condition is to refuse food at least 4 hours before donating biological material.

Capillary and venous blood is suitable for research. In the first case, blood is taken from a finger (usually the left hand). The skin is pre-treated with cotton wool moistened with alcohol. Using a special needle, a small puncture (about 2 mm in size) is made, after which the first drops of blood are removed. Then, using a special adapter, blood is taken by gravity from the finger and poured into a test tube.

All materials and instruments used must be sterile. The tubes are labeled and sent to the laboratory. After the manipulation, a cotton ball with an antiseptic is applied to the finger. The technique for collecting capillary blood for children over 1 year of age and adults is the same.

How often do you get your blood tested?

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Only as prescribed by the attending physician 30%, 950 votes

Once a year and I think that’s enough 18%, 554 vote

At least twice a year 15%, 460 votes

More than twice a year but less than six times 11%, 344 vote

I take care of my health and donate once a month 6%, 197 votes

I'm afraid of this procedure and try not to pass 4%, 135 votes

21.10.2019

Venous blood can be taken from the baby. A tourniquet is first applied to the forearm. Its free ends should be directed upward, and its loops - downward. The tourniquet is applied to the fabric (shirt, jacket) so as not to damage the skin. The pulse on the radial artery should be preserved. The puncture site must be wiped with a cotton ball and alcohol. The needle is inserted into the elbow at an angle of 45º, after which the angle is reduced and it is advanced along the blood vessel.

The healthcare worker's index finger should be on the cannula, and the rest should be on top of the cylinder. It is imperative to check the tightness and integrity of the syringe. There should be no air in it. After the needle is inserted, the required amount of blood is collected. The child's fist should be in a clenched position. The nurse removes the tourniquet, removes the needle, applies a cotton ball, and flexes the child's arm at the elbow. She should remain in this position for 5-10 minutes.

The blood test itself for ESR is carried out in the laboratory. The methods of Panchenkov and Westergren are used. In the first case, an anticoagulant (a substance that prevents blood clotting) is applied to a special glass for determination, after which the child’s blood is added. The resulting mixture is placed in a vertical container and waited for 1 hour. The laboratory technician estimates the height of the plasma (translucent liquid) without sediment in millimeters. In the second method, ESR in the blood of children is assessed after mixing it with an anticoagulant directly in a test tube.

Normal indicators

The level of ESR in the blood largely depends on the age and gender of the child. The normal value for newborns is 0 to 2 mm/hour. At 2-6 months this figure should be 4-6 mm/hour. In children under 1 year of age, an ESR value of 3 to 10 mm/hour is considered normal. At 1-5 years old this figure should be 5-11 mm/hour, and at 6-14 years old it should be 4-12 mm/hour. In adolescent girls over 14 years of age, ESR is normally from 2 to 15 mm/hour, and in boys - 1-10 mm/hour. After 17 years of age, the norms approach those of adults.

Reduced value

If the ESR is below normal, the reasons may be:

• Pathology of the blood system (coagulation disorders due to congenital or acquired deficiency of coagulation factors, anemia).
• Acute and chronic intoxication. often decreases when children use systemic medications without parental knowledge.
• Dehydration (dehydration). The reasons may be increased removal of fluid from the body as a result of intense physical activity, heavy sweating, cholera, acute intestinal infections (dysentery, salmonellosis) and insufficient fluid intake.
• Exhaustion. The reason is malnutrition (lack of proteins, fats and carbohydrates).
• Viral hepatitis.
• Cardiac pathology.
• Epilepsy.
• Repeated vomiting.
• Acute diarrhea.
• Lack of minerals and vitamins in the diet.
• Vegetarianism. Promotes an acute shortage of iron in the body, which is part of the hemoglobin of red blood cells.

The normal ESR rate in children (erythrocyte sedimentation rate) is an indicator of a general blood test that reflects the state of health. In the presence of an inflammatory process in the body, the ESR increases.

What does ESR mean?

One of the important indicators of a general blood test is the erythrocyte sedimentation rate (ESR) within one hour. Previously, it was called ROE (erythrocyte sedimentation reaction). In foreign literature it is designated as Complete Blood Count (CBC), Erythrocyte Sedimentation Rate (ESR), Westergren ESR.

Determination methods

The main methods of determination are: the Westergren and Panchenkov methods. The interpretation of test results obtained using any of these methods is correct. The Westergren method is approved by the International Committee for Standardization of Blood Studies.

Before determining this indicator, an anticoagulant (sodium citrate), a substance that prevents blood clotting, is added to the venous blood. The blood remains liquid, representing blood plasma, in which blood cells float: red blood cells, etc.

The blood is left for an hour, and after this time the height of the transparent layer is measured, i.e. plasma, which is located above the settled blood cells. This value in mm/hour is the ESR. Currently, many medical institutions use automatic devices to determine the indicator.

How is the analysis carried out?

Blood test ESR, and its norm in children depends on the age and state of their health. It reflects the balance between factors that increase erythrocyte sedimentation (eg, fibrinogen) and negatively charged red blood cells. With an increase in fibrinogen, immunoglobulins and other proteins in the blood plasma, red blood cells aggregate to form complexes, the sedimentation of which accelerates under the influence of gravity.

A change in the ESR value can be observed before the onset of symptoms of the disease, or in the absence of any disease, since it is very sensitive to many changes in the body.

The analysis is not carried out after physiotherapeutic procedures, x-rays, prolonged crying of the child and a hearty breakfast. It is carried out in the morning on an empty stomach, while the child should be calm.

ESR in the blood of children

Table - Normal ESR values ​​in children

In newborns, the erythrocyte sedimentation rate is low because their metabolism is still low. ESR in the blood of children under one year of age increases, as it depends on the activation of metabolic processes in the child’s body. The peak of the indicator is observed from 27 to 32 days after birth, then its decrease is observed.

In adolescents, this analysis may depend not only on age, but also on gender. For example, in 14-year-old boys, the erythrocyte sedimentation rate can be 2-11 mm/hour, and in girls of the same age - 2-14 mm/hour. However, these differences are insignificant.

In children, an increased ESR value may be the result of:

• hypovitaminosis;
• stress (prolonged crying);
• taking medication (paracetamol);
• syndrome of increased ESR.

In case of elevated ESR syndrome, it is necessary to do a blood test several times during the year to determine this indicator. If the child has no symptoms of the disease, he feels well, and the erythrocyte sedimentation rate remains elevated, then the pediatrician may additionally recommend a test for C-reactive protein.

Increased value

High ESR in a child can be caused by the following reasons.

• Hyperproteinemia. This is what is called an increased level of total protein in the blood. In the initial period of the disease, which is often called the “acute phase,” the protein composition of the blood plasma begins to change. Illness is always stress for a child’s body, therefore, the content of C-reactive protein, haptoglobin, cryoglobulin, gamma globulins, etc. increases. This leads to an increase in blood viscosity, therefore the rate of erythrocyte sedimentation slows down and the ESR increases.
• Immature red blood cells. Another reason may be the appearance of immature forms of red blood cells. Typically, the indicator already increases 24-30 hours after the onset of the disease, which is characterized by the presence of a focus of inflammation. Prolonged inflammation increases the content of immunoglobulins and fibrinogen.

Possible diseases

The following diseases may be the cause of increased ESR in the blood of children.

In addition, in many pathologies, the rate of erythrocyte deposition can also be increased:

• anemia;
• multiple myeloma;
• leukemia;
• lymphoma;
• thyrotoxicosis;
• diabetes;
• hemoglobinopathies;
• autoimmune diseases (lupus).

For some time after the child’s recovery, the ESR value sometimes remains elevated (1-3 months). In cancer cases, it is high for a long time.

False positive test

There are cases when certain factors cause a long-term rise in this indicator. For example, an increased value may occur when:

• anemia;
• taking vitamin A (retinol);
• obesity;
• renal failure;
• vaccination against hepatitis B;
• hypercholesterolemia;
• hyperproteinemia.

If the child looks healthy, has no complaints or any symptoms of illness, and the ESR is elevated in the child, then the pediatrician may prescribe additional methods for examining the tonsils, lymph nodes, spleen, heart, kidneys, ECG, x-ray of the lungs, blood tests to determine the content total protein, immunoglobulins, platelet and reticulocyte counts.

ESR helps to identify certain data about the child’s health status only in combination with other blood indicators, and, if required, with additional examination methods.

When a full examination does not reveal any reason for the increase in erythrocyte sedimentation rate, then the pediatrician can draw a conclusion about the individual characteristics of the body. Sometimes ESR is elevated when all other blood parameters are normal. In this case, it is necessary to repeat the analysis after some time to make sure that the child is healthy.

Is treatment necessary to normalize ESR?

Usually the indicator returns to normal after recovery. Treatment is determined by the pediatrician, prescribing special medications that are necessary for recovery (antibiotics, antiviral drugs, antihistamines, etc.)

If the increase in the indicator is caused by a reason not related to an infectious disease or a source of inflammation, then the doctor will prescribe other methods for its correction.

There is a direct correlation between the activity of the pathological process and the level of ESR; the stronger and more extensive the inflammatory process, the higher the indicator. With a mild degree of the disease, the indicator returns to normal faster than with a severe one. Therefore, its value reflects the success of the treatment.

If there is a long-term increase in the erythrocyte sedimentation rate, the doctor may recommend a blood test for C-reactive protein (CPR), which is a sensitive indicator of the inflammatory process.

Reduced value

In some cases, the reduced value of the indicator may be less than the established age norm for the child. Most often, with this condition, there is an increase in the number of red blood cells in the blood for various reasons:

A decrease in the erythrocyte sedimentation rate occurs less frequently, however, after some time the analysis must be repeated. The normal ESR level in the blood of children indicates that the child is healthy, so a preventive examination and blood test will help determine his condition.

Conclusion

ESR is a nonspecific, up-to-date blood test that reflects the child’s health status. Its increase most often indicates the presence of a focus of inflammation, and the value of the indicator reflects the activity of the pathological process.

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