Imperial Collage Healthcare

Erythrocyte sedimentation rate (ESR)


Test Background
The ESR is a measurement of the rate of fall of red blood cells. The rate at which red cells fall, or sediment, is influenced by the extent to which they form rouleaux – red blood cells clumped together in distinctive ‘stacks’ like coins. Rouleaux formation of red cells means that the red cells fall at a greater rate than individual red cells. The formation of rouleaux is accelerated by the presence of acute phase proteins, which can occur in a wide variety of infective and inflammatory conditions.


Clinical Indications

  • Diagnosis of multiple myeloma, temporal arteritis, polymyalgia rheumatica, various autoimmune diseases, systemic lupus erythematosus (SLE), rheumatoid arthritis, TB, endocarditis and chronic kidney diseases
  • Differential diagnosis of Kawasaki’s disease
  • Monitoring therapeutic response in temporal arteritis, polymyalgia rheumatica, rheumatoid arthritis and some lymphomas


Reference Range

Male <10 mm/h
Female <20 mm/h


Sample Required
4 mL EDTA (lavender top) at Charing Cross Hospital and Chelsea and Westminster Hospital
VesMatic ESR tube (black top) Hammersmith Hospital and St Mary’s Hospital


Sample Volume
1 mL


Turnaround Time
4 hours


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