TOC  | D-Dx    

Sedimentation Rate Differential  -  Outlines in Clinical Medicine on Physicians' Online

A. Increased Sedimentation Rate

1.Infection

• a.Bacterial Endocarditis, Osteomyelitis - ESR often >100
• b.Abscess, Pelvic Inflammatory Disease, etc.
• c.Tuberculosis - ESR often >100
• d.Acute hepatitis, thyroiditis

2.Tissue Necrosis - especially Neoplasms

3.Acute MI (inflammatory response)

4.Low Serum Albumin

5.Arsenic and lead intoxication

6.Nephrosis, renal disease with azotemia

7.Dysglobulinemia with positively charged proteins

• a.Multiple Myeloma - ESR often > 100
• b.MGUS (monoclonal gammopathy of unknown significance)

8.Vasculitides

• a.Giant Cell Arteritis (ESR often >100)
• b.Polymyalgia Rheumatica

9.Other Collagen Vascular Disorders

B. Decreased Sedimentation Rate

1. Sickle Cell Anemia
2. Polycythemia
3. Hyperviscosity syndrome
4. Multiple myeloma (negative charged proteins with high viscosity)
5. Macroglobulinemia, Cryoglobulinemia

122004