Significance of Extreme Elevation of Erythrocyte Sedimentation Rate

Zacharski, Leo R.

doi:10.1001/jama.1967.03130170064008

Cited by 52 publications

(7 citation statements)

References 9 publications

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“…Although a very high ESR is usually indicative of the presence of an underlying illness [4][5][6][7], the ESR is also subject to influences that are unrelated to disease. For instance, women tend to have higher ESR values than men; and increased body mass index (BMI) has also been associated with higher ESR values [8,9].…”

Section: Introductionmentioning

confidence: 99%

Erythrocyte sedimentation rate as an independent prognostic marker for mortality: a prospective population‐based cohort study

et al. 2018

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Background A very high erythrocyte sedimentation rate (ESR) is usually an indication of underlying pathology. Additionally, a moderately elevated ESR may also be attributable to biological ageing. Whether the ESR is a prognostic factor for mortality, regardless of age, has been scarcely investigated. Therefore, the objective was to analyse the association between elevated ESR levels and the risk of mortality in a prospective cohort of the general population. Methods We studied data from the Rotterdam Study (1990–2014). ESR levels were measured at baseline and individuals were followed until death or end of study. Associations between moderately (20–50 mm h−1) and markedly (>50 mm h−1) elevated ESR levels and all‐cause mortality were assessed using multivariate Cox proportional hazard models. Results In total, 5226 participants were included, and the mean age was 70.3 years. During a median follow‐up time of 14.9 years, 3749 participants died (71.7%). After adjustment, both a moderately elevated ESR and a markedly elevated ESR were associated with a significantly higher risk of overall mortality [hazard ratio (HR) 1.23, 95% confidence interval (CI) 1.12–1.35 and HR 1.89, 95% CI 1.38–2.60, respectively]. Although the ESR becomes higher with age, in a group aged above 75 years, without any comorbidities, an ESR > 20 mm h−1 remained associated with a significantly increased risk of mortality (HR 1.29, 95%CI 1.01–1.64). Conclusion An elevated ESR is an independent prognostic factor for mortality. Despite the fact that ESR increases with age, it remains associated with an increased risk of mortality and warrants close follow‐up.

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Section: Introductionmentioning

confidence: 99%

Erythrocyte sedimentation rate as an independent prognostic marker for mortality: a prospective population‐based cohort study

et al. 2018

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“…This mechanism may explain significant reduction of blood flow [62] and increased blood viscosity in patients with thrombotic arterial disease [63]. The relationship between inflammation and elevated ESR was emphasized years ago by Zacharski and Kyle [64]. Finally, it should be noted that RBC aggregation and sedimentation were originally thought to be caused by blood soluble fibrin monomers by virtue of their interaction with hydrophobic epitopes on RBC membranes [65].…”

Section: The Role Of Red Blood Cellsmentioning

confidence: 99%

Iron-Induced Fibrin in Cardiovascular Disease

Lipiński¹,

Pretorius

2013

CNR

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Accumulating evidence within the last two decades indicates the association between cardiovascular disease (CVD) and chronic inflammatory state. Under normal conditions fibrin clots are gradually degraded by the fibrinolytic enzyme system, so no permanent insoluble deposits remain in the circulation. However, fibrinolytic therapy in coronary and cerebral thrombosis is ineffective unless it is installed within 3-5 hours of the onset. We have shown that trivalent iron (FeIII) initiates a hydroxyl radical-catalyzed conversion of fibrinogen into a fibrin-like polymer (parafibrin) that is remarkably resistant to the proteolytic dissolution and thus promotes its intravascular deposition. Here we suggest that the persistent presence of proteolysis-resistant fibrin clots causes chronic inflammation. We study the effects of certain amphiphilic substances on the iron- and thrombin-induced fibrinogen polymerization visualized using scanning electron microscopy. We argue that the culprit is an excessive accumulation of free iron in blood, known to be associated with CVD. The only way to prevent iron overload is by supplementation with iron chelating agents. However, administration of free radical scavengers as effective protection against persistent presence of fibrin-like deposits should also be investigated to contribute to the prevention of cardiovascular and other degenerative diseases.

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“…Clinically there is a sudden onset of asymmetrical arthritis, mostly involving the lower extremities. The rheumatoid factor is usually negative, and the sedimentation rate is markedly elevated [52].…”

Section: Carcinoma Polyarthritismentioning

confidence: 99%

Rheumatologic manifestations of malignancy

Harris¹,

Thomas²,

Rest³

et al. 1990

Med. Pediatr. Oncol.

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The relationship between rheumatologic syndromes and cancer covers a very broad array of both common and distinctly rare manifestations. This discussion has outlined some of the known relationships that do exist. A high index of suspicion by both the primary care physician and subspecialist will enhance the probability of detecting cancer in the patient who may present with rheumatologic complaints.

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Significance of Extreme Elevation of Erythrocyte Sedimentation Rate

Cited by 52 publications

References 9 publications

Erythrocyte sedimentation rate as an independent prognostic marker for mortality: a prospective population‐based cohort study

Erythrocyte sedimentation rate as an independent prognostic marker for mortality: a prospective population‐based cohort study

Iron-Induced Fibrin in Cardiovascular Disease

Rheumatologic manifestations of malignancy

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