ESR (high)
Last reviewed 07/2021
Causes of a high ESR include:
- malignancy:
- malignant lymphoma
- carcinomas of colon and breast
- haematologic:
- multiple myeloma - a high ESR plus osteoporosis equals multiple myeloma until proved otherwise
- anaemia of acute or chronic disease, alone or combined with iron deficiency anaemia - not Fe deficiency alone
- macrocytosis elevates ESR (1)
- connective tissue disorders - especially:
- systemic lupus erythematosus } normal in 5% of
- rheumatoid arthritis } patients
- polymyalgia rheumatica
- temporal arteritis
- systemic sclerosis
- infections:
- tuberculosis
- acute hepatitis
- bacterial
- others:
- sarcoidosis
- renal diseases - especially with azotemia
- drug fever
- hepatic cirrhosis
- physiological increases in fibrinogen e.g. during pregnancy, also raise ESR levels
Reference:
- Pulse (2004), 64 (14), 100.
investigations of high ESR of unknown aetiology