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Related Subjects: |Ferritin |CEA |ESR |CRP |ALP |LDH |HbA1c |Alpha Fetoprotein |Anti-Hu ab |Biochemical Lab values
The principle of ESR is based on the fact that during inflammation, red blood cells (RBCs) tend to clump together due to the presence of acute-phase reactants such as fibrinogen. These clumps are denser than individual RBCs, causing them to settle more rapidly.
Cause | Clinical Features | Investigations | Management |
---|---|---|---|
Infections (e.g., Tuberculosis, Endocarditis) | Fever, night sweats, weight loss, chronic cough (tuberculosis), new or changing heart murmur (endocarditis). | Blood cultures, chest X-ray, sputum analysis (for TB), echocardiogram, CBC, ESR, CRP. | Appropriate antibiotics or antitubercular therapy, supportive care, surgical intervention if indicated (e.g., valve surgery in endocarditis). |
Autoimmune Diseases (e.g., Systemic Lupus Erythematosus, Rheumatoid Arthritis) | Joint pain, stiffness, fatigue, skin rashes (malar rash in SLE), photosensitivity, weight loss. | Autoantibody tests (ANA, RF, anti-CCP), ESR, CRP, renal function tests (if SLE), joint imaging (X-ray, MRI). | Immunosuppressive therapy (corticosteroids, DMARDs), biological agents, monitoring for disease progression and complications. |
Malignancies (e.g., Multiple Myeloma, Lymphoma) | Fatigue, bone pain, anaemia, hypercalcemia (in multiple myeloma), lymphadenopathy, unexplained weight loss. | Serum protein electrophoresis (SPEP), bone marrow biopsy, CBC, serum calcium, imaging (CT, MRI), ESR. | Chemotherapy, radiotherapy, surgical resection (if localized tumour), autologous stem cell transplantation (in multiple myeloma), supportive care. |
Vasculitis (e.g., Giant Cell Arteritis, ANCA-associated Vasculitis) | Fever, headache, jaw claudication, visual disturbances (in GCA), systemic symptoms like fatigue, weight loss, myalgia. | ESR, CRP, temporal artery biopsy (for GCA), ANCA test (for ANCA-associated vasculitis), imaging (angiography, ultrasound). | Corticosteroids (high-dose for GCA), immunosuppressive therapy (for ANCA-associated vasculitis), regular monitoring for complications. |
Chronic Inflammatory Diseases (e.g., Inflammatory Bowel Disease) | Abdominal pain, diarrhea (often bloody), weight loss, fatigue, anaemia, extra-intestinal manifestations (e.g., arthritis, uveitis). | Colonoscopy with biopsy, stool studies, CBC, ESR, CRP, imaging (abdominal CT, MRI). | Aminosalicylates, corticosteroids, immunosuppressants, biological agents, surgical intervention if refractory disease or complications. |
Chronic Kidney Disease | Fatigue, weakness, anaemia, hypertension, fluid retention, uremic symptoms (nausea, pruritus). | Serum creatinine, BUN, eGFR, CBC, urine analysis, ESR, imaging (renal ultrasound). | Management of underlying cause, blood pressure control, erythropoiesis-stimulating agents (for anaemia), dialysis, renal transplant in end-stage disease. |
Collagen Vascular Diseases (e.g., Systemic Sclerosis) | Skin thickening, Raynaud's phenomenon, joint stiffness, dysphagia, pulmonary involvement (fibrosis). | Autoantibody testing (ANA, anti-Scl-70), ESR, CRP, pulmonary function tests, imaging (chest X-ray, CT), echocardiogram. | Immunosuppressive therapy, management of organ-specific complications (e.g., pulmonary hypertension), physical therapy. |
Adult Still's Disease | High spiking fevers, salmon-colored maculopapular rash, arthralgia, sore throat, lymphadenopathy, hepatosplenomegaly. | ESR, CRP, ferritin (often markedly elevated), CBC, liver function tests, autoantibody screen to exclude other conditions. | NSAIDs for symptom control, corticosteroids for severe cases, DMARDs (e.g., methotrexate), biological agents (e.g., IL-1 or IL-6 inhibitors), monitoring for complications like macrophage activation syndrome (MAS). |