The feasibility of estimating the erythrocyte sedimentation rate within a few minutes by using a simple slide test

Abstract

The acute phase response is accompanied by the appearance of aggregated red blood cells in the peripheral blood. The Westergren erythrocyte sedimentation rate (ESR) is an indirect measurement of this enhanced aggregability. We adopted a simple slide test and image analysis to reveal the adhesiveness/aggregation of red blood cells. A significant correlation was found between the erythrocyte adhesiveness/aggregation test (EAAT) and the ESR. A predictive model for ESR based on EAAT and the age of the patients was created. This new approach will enable us to obtain within a few minutes a good estimate of whether a given individual has a mild moderate or significant acute phase response. With further development, we will be able to use a bedside small cartridge that will deliver the extrapolated ESR at low costs and within a couple of minutes.

The Picture of Inflammation: A New Concept That Combines the White Blood Cell Count and Erythrocyte Sedimentation Rate into a New Hematologic Diagnostic Modality

“…The Inflammation Meter (INFLAMET™) [1, 2, 3, 4, 5, 6, 7, 8]. For analysis of the slides, we used an image analysis system (INFLAMET) consisting of a Pentium computer running Win 95, equipped with a Matrox Meteror color frame grabber, a color CCD camera and a microscope which was operated at ×200 magnification, resulting in an image resolution of 0.4 µm per pixel.…”

“…Indeed, the degree of both leukocyte and erythrocyte adhesiveness/aggregation was shown to correlate significantly with other classical markers of the acute phase response, i.e. fibrinogen concentration and the erythrocyte sedimentation rate (ESR) or quantitative CRP [1, 2, 3, 4, 5, 6, 7, 8]. We now report our findings that show that a quantitative analysis of the above-mentioned phenomena is feasible, that the results obtained by our image analyzer reflect the intensity of the acute phase response, and that there is a high level of agreement between different observers in their assessment of the pictures and numeric data.…”

“…Using the peripheral blood slide test and image analysis we were able to adopt a new diagnostic concept that is based on the detection of the number of white blood cells (WBC), their state of adhesiveness/aggregation in the peripheral blood, as well as the determination of red blood cell aggregability [1, 2, 3, 4, 5, 6, 7, 8]. This approach has the advantage of obtaining simultaneous information on the degree of the leukocytic response and the intensity of the humoral acute phase response, the latter being characterized by the synthesis of multiple proteins, part of which can induce WBC [9]and red blood cell [10]aggregation.…”

The Usefulness of an Inflammation Meter to Detect the Presence of Infection/Inflammation in Elderly Patients

“…It is based on the known observations that this response is accompanied by the appearance of increased leukocyte numbers in the peripheral circulating pool of blood, increased leukocyte adhesiveness/aggregation, as well as enhanced synthesis of adhesive proteins (fibrinogen, for example) that can induce leukocyte as well as erythrocyte aggregation (10). Because all of these phenomena can be detected at real time and low cost by using a simple slide test (1)(2)(3)(4)(5)(6)8), the next question is whether the diagnostic yield of our novel approach is comparable to what can be obtained by "conventional" markers, including the WBCC, erythrocyte sedimentation fibrinogen, or quantitative CRP concentrations. By using the same cohort of elderly patients, we could indeed show that the discrimination between the presence or absence of an inflammatory response in elderly patients with acute bacterial infections is as good as the one obtained by the above-mentioned conventional methods (6).…”

“…This system enables us to count the number of peripheral blood leukocytes per mm 2 as well as determine their degree of adhesiveness/aggregation (percent of aggregated leukocytes) ( Figure 1). In addition, the degree of erythrocyte adhesiveness/aggregation can be determined by measuring the "spaces" that are present between the aggregated red blood cells (8). A variable in the name of vacuum radius (VR) is created to represent the size of these holes ( Figure 2).…”