Dear colleagues,
Elevated ESR in the presence of normal CRP is an issue indeed worth
considering. It should be noted that this scenario is not uncommon. It
reflects that ESR is rather an integrative measure (erythrocyte
sedimentation and aggregation is recorded) and includes more than
increased acute phase reactants. The magic triangle of factors consists
of haematological changes (haematocrit, erythrocyte size and shape,
anaemia), ongoing immune response and inflammatory reaction. Hence, the
differential diagnosis is wide and should be guided by the clinical
presentation.
Dr. Michael Steiner
University of Rostock
Institute of Clinical Chemistry & Pathobiochemistry
Ernst-Heydemann-Str. 6
18057 Rostock
GERMANY
email: [log in to unmask]
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