Sedimentation Rate, Modified Westergren

Sedimentation Rate, Modified Westergren

CPT Test code: 85652

Specimen: Whole blood
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.
Storage Instructions: Refrigerate
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.