I am posting for my Dad, he has been diagnosed with PMR for around 6 weeks, he is very poorly, we are beginning to think that it is the wrong diagnosis and are becoming increasingly concerned about him. He has lost loads of weight, can barely walk, he is 62, and up until 10 weeks ago was working as a builder! he has no muscle tone in his arms and legs, they are withering away, I keep reading about SED rate, and wondered what that is, I need all of the information possible. He is on steroids and although he has lost no more weight, he certainly hasn't gained any. He is still undergoing tests. We are desperate for answers, please help if you can. Many thanks.
Hi,
I got this off a web page. I hope this explains some of your questions.
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The Test
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How is it used? When is it ordered? What does the test result mean? Is there anything else I should know? The ESR is an easy, inexpensive, nonspecific test that has been used for many years to help diagnose conditions associated with acute and chronic inflammation, including infections, cancers, and autoimmune diseases. ESR is said to be nonspecific because increases do not tell the doctor exactly where the inflammation is in your body or what is causing it, and also because it can be affected by other conditions besides inflammation. For this reason, ESR is typically used in conjunction with other tests. ESR is helpful in diagnosing two specific inflammatory diseases, temporal arteritis and polymyalgia rheumatica. A high ESR is one of the main test results used to confirm the diagnosis. It is also used to monitor disease activity and response to therapy in both of these diseases. A physician usually orders an ESR test (along with others) to evaluate a patient who has symptoms that suggest polymyalgia rheumatica or temporal arteritis, such as headaches, neck or shoulder pain, pelvic pain, anemia, unexplained weight loss, and joint stiffness. There are many other conditions that can result in a temporary or sustained elevation in the ESR and some that will cause a decrease. Since ESR is a nonspecific marker of inflammation and is affected by other factors, the results must be used along with the doctor’s other clinical findings, the patient’s health history, and results from other appropriate laboratory tests. If the ESR and clinical findings match, the doctor may be able to confirm or rule out a suspected diagnosis. A single elevated ESR, without any symptoms of a specific disease, will usually not give the physician enough information to make a medical decision. Before doing an extensive workup looking for disease, a doctor may want to repeat the ESR test after a period of several weeks or months. If a doctor already knows the patient has a disease like temporal arteritis (where changes in the ESR mirror those in the disease process), s/he may order the ESR at regular intervals to assist in monitoring the course of the disease. In the case of Hodgkin’s disease, for example, a sustained elevation in ESR may be a predictor of an early relapse following chemotherapy. What does the test result mean?
NOTE: A standard reference range is not available for this test. Because reference values are dependent on many factors, including patient age, gender, sample population, and test method, numeric test results have different meanings in different labs. Your lab report should include the specific reference range for your test. Lab Tests Online strongly recommends that you discuss your test results with your doctor. For more information on reference ranges, please read Reference Ranges and What They Mean. Doctor’s do not base their decisions solely on ESR results. You can have a normal result and still have a problem.
A very high ESR usually has an obvious cause, such as an acute infection. The doctor will use other follow-up tests, such as cultures, depending on the patient’s symptoms. Moderately elevated ESR occurs with inflammation, but also with anemia, infection, pregnancy, and old age. A rising ESR can mean an increase in inflammation or a poor response to a therapy; a decreasing ESR can mean a good response. A common cause of high ESR is anemia, especially if it is associated with changes in the shape of the red cells; however, some changes in red cell shape (such as sickle cells in sickle cell anemia) lower ESR. Kidney failure will also increase ESR. Persons with multiple myeloma or Waldenstrom’s macroglobulinemia (tumors that make large amounts of immunoglobulins) typically have very high ESR even if they don't have inflammation. Although a low ESR is not usually important, it can be seen with polycythemia (a condition where a patient makes too many red blood cells), with extreme leukocytosis (patient has too many white blood cells), and with some protein abnormalities. ESR and C-reactive protein (CRP) are both markers of inflammation. Generally, ESR does not change as rapidly as does CRP, either at the start of inflammation or as it goes away. CRP is not affected by as many other factors as is ESR, making it a better marker of inflammation. However, because ESR is an easily performed test, many doctors still use ESR as an initial test when they think a patient has inflammation.
Females tend to have higher ESR, and menstruation and pregnancy can cause temporary elevations. Drugs such as dextran, methyldopa (Aldomet), oral contraceptives, penicillamine procainamide, theophylline, and vitamin A can increase ESR, while aspirin, cortisone, and quinine may decrease it. | ||