Erythrocyte sedimentation Rate (ESR) and C-Reactive protein (CRP)

In this article , we are going to discuss ESR and CRP and thier role in diagnosis of rheumatology disorders .

[1] Erythrocyte sedimentation Rate [ESR]
• Acute phase reactants are proteins e.g fibrinogen are produced in the liver as a response to inflammation i.e acute phase response (APR).
• Increase in the acute phase proteins e.g fibrinogen and gammaglobulins leads to increase of ESR, this is due to change of the
repellent electrostatic negative surface charge of RBCs ---> rouleaux formation
• So, ESR is increased in cases of inflammatory diseases e.g connective tissue diseases, infections or malignancy.

[2] C-Reactive protein [CRP]

• It is an acute phase reactant produced by the liver as a response to inflammation.
• It starts elevation within 4 hours of tissue injury with peak after 24-72 hours. It is rapidly decline once the cause is abolished.
• It is measured by ELISA technique as follows:

   0-1 mg/dl (normal)
   1-10 mg/dl (moderate level).
   > 10 mg/dl (high level).
• It is therefore the single most useful direct measure of the Acute phase response .

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