Sedimentation Rate, Modified Westergren
CPT Test code: 85652
|Volume:||Tube fill capacity|
|Minimum Volume:||2 mL|
|Container:||Lavender-top (EDTA) tube|
|Collection:||Invert tube immediately 8 to 10 times once tube is filled at time of collection.|
|Causes for Rejection:||Hemolysis; clotted specimen; underfilled tube; specimen older than 24 hours; improper labeling; transfer tubes with whole blood; specimen received in any anticoagulant other than EDTA; specimen diluted or contaminated with IV fluid; patient specimen with presence of cold agglutinins or cryoglobulins; specimen received with plasma removed|
|Reference Interval:||• Male: 0-50 years: 0-15 mm/hour, 50 years and older: 0-30 mm/hour
• Female: 0-50 years: 0-32 mm/hour, 50 years and older: 0-40 mm/hour
|Use:||Evaluate the nonspecific activity of infections, inflammatory states, autoimmune disorders, and plasma cell dyscrasias|
|Limitations:||Optimum results are from blood less than two hours old. The ESR is of limited diagnostic value in severe anemia or in hematologic states that affect increased size and shape variation (poikilocytosis) of the RBC (ie, presence of sickle cells or spherocytes). Extreme plasma viscosity will result in a decreased ESR.|
|Additional Information:||Elevations in fibrinogen, α- and β-globulins (acute phase reactants), and immunoglobulins increase the sedimentation rate of red cells through plasma. The test is important in the diagnosis of temporal arteritis, as well as its management.1|
|Footnotes:||1. Wong RL, Korn JH. Temporal arteritis without an elevated erythrocyte sedimentation rate. Case report and review of the literature. Am J Med. 1986; 80(5):959-964.PubMed 3518441|
|References:||Gambino SR, Dire JJ, Monteleone M, et al. The Westergren sedimentation rate using K3 EDTA. Tech Bull Regist Med Technol. 1965; 35:1-8.
Harmening D. Clinical Hematology and Fundamentals of Hemostasis. 2nd ed. Philadelphia, Pa: Lippincott;1992:532-534.