Inflammatory Diseases

• A raised ESR is frequently seen in chronic inflammatory and autoimmune conditions, such as rheumatoid arthritis, lupus, or polymyalgia rheumatica.
• It can also be elevated in infections ranging from bacterial (like tuberculosis) to other chronic inflammatory diseases.

Infections and Malignancy

• Elevated ESR may serve as a clue when monitoring infections or even certain cancers, as it reflects increased levels of acute-phase proteins in the blood.

Age-Related Variations

• In children, the ESR is usually low.
• In older adults, low-grade elevations—sometimes referred to as “inflammaging”—can occur.
• Even pregnancy may lead to increased ESR in certain instances.

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Absence of Inflammation

• Very low ESR is typically not a concern.
• It generally reflects a lack of significant systemic inflammation.

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ESR Interpretation

• Complementary Assessment:
  ESR is best interpreted alongside clinical findings and specific tests.
• Sensitivity vs. Specificity:
  While it is sensitive to a broad range of inflammatory states, ESR remains nonspecific on its own, necessitating additional diagnostic context.

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