The erythrocyte sedimentation rate: old and new clinical applications.

BACKGROUND The erythrocyte sedimentation rate (ESR) is a simple and inexpensive laboratory test. It is commonly used to assess the acute phase response. METHODS A review of the recent literature was done to evaluate the role of the ESR and its importance in different clinical conditions both inflammatory and noninflammatory. RESULTS Despite the critical role cytokines have in inflammatory conditions, the ESR still maintains its important role in the diagnosis and follow-up of rheumatoid arthritis and temporal arteritis. Recently, ESR has been reported to be of clinical significance in sickle cell disease, osteomyelitis, and, surprisingly, in noninflammatory conditions such as stroke, coronary artery disease, and prostate cancer. Erythrocyte sedimentation rate measured by the Westergren method is marginally affected by age, race, and blood storage. CONCLUSION Despite its importance in many clinical conditions, ESR should be used only as a clinical guide to aid the diagnosis, management, and follow-up of these different clinical situations.