Micro-Erythrocyte Sedimentation Rate in Adults: A Nuanced Perspective on Utility in Emergency and Resource-constrained Clinical Settings

Erythrocyte sedimentation rate (ESR), despite its non-specific nature as a measure of systemic inflammation, continues to be widely utilized in clinical practice with diverse applications.ESR is an effective disease monitoring tool in rheumatoid arthritis, giant cell arteritis and polymyalgia rheumatica.[1]Few researchers have shown ESR to be a promising predictive biomarker in coronary heart disease, cerebrovascular accident and prostate cancer.[2] Elevated ESR levels can offer valuable diagnostic insights across a spectrum of inflammatory and infectious disorders such as chronic obstructive pulmonary disease, acute rheumatic fever, tuberculosis, infective endocarditis, osteomyelitis, etc. and is often preferred over the more specific C-reactive protein levels merely because of its simplicity, low cost and non-necessity of additional kit/equipment.[1]However, prerequisite of a relatively large quantity of venous blood and long test time of one hour are the major drawbacks of conventional Westergren or Wintrobe method of ESR determination.The modern day automated ESR instruments, which require less volume of blood and provide quick results, are usually not affordable and cost-effective for smallscale laboratories with lesser sample loads.