Nordic Biosite together with Streck is delighted to announce Diesse ESR product line to provide you with a quick and hassle-free diagnostics tool!
Diesse is an automated system that can be used for analysis of erythrocyte sedimentation rate (ESR). This instrument is designed to measure the ESR of blood samples, that are anticoagulated with K2EDTA or K3EDTA. And it is hassle-free as EDTA tubes can directly be placed in the instrument and voila, in as little as 20 minutes the analysis will be complete!
Diesse comes in two sizes, one that is called Diesse MINI-CUBE and the second, Diesse CUBE 30 Touch. The MINI-CUBE automated sediment-rate instrument can run up to 4 samples simultaneously and CUBE 30 Touch can run as many as 30 samples at once or on continual loading.
This automated system provides an exceptional correlation to the Modified Westergren method. It works on the basic principle that, anticoagulated blood that is placed in a vertical column and left undisturbed for a specific time. This will result in varying rate of sedimentation of particles of different size and acceleration at different time intervals. This is measured in mm/hour using the Westergren reference method.
The sedimentation of red blood cells (RBCs) is accelerated due to increase in plasma concentration of acute phase proteins (APPs). An increase in APPs can be seen in case of acute tissue damage, chronic infection/inflammation and during pregnancy. ESR indicates rise in accelerating proteins such as gamma globulins & fibrinogens and, it can also indicate decline in retarding proteins such as albumin. Under conditions that fosters rouleaux formation will result in an elevated ESR.
Additionally, according to Manley’s Nomogram the instrument is capable of compensating temperatures above 18°C offering the ability to adjust patient’s Haematocrit values <40%. Following completion of analysis, the results are printed out automatically and sent to data output port (LIS).
Clinical Significance of ESR
As ESR measures the distance travelled by RBCs in autologous plasma in a specific time. Under normal circumstances, due to the presence of negative electric charge from residuals of sialic acid at membrane glycoprotein level, RBCs are inclined to mutually move apart. However, change in plasma protein composition due to production of APPs at hepatic level leads to a change in membrane potential negative load (Z) which in turn causes rouleaux formation. The cells aggregate to form microspheres with a uniform density which begins to sediment when their density exceeds that of plasma. ESR values are seen to increase in all conditions with elevated APPs and therefore, it is considered as a non-specific measurement of an inflammatory state. This method can still be useful to diagnose some diseases such as rheumatoid arthritis and Hodgkin’s disease, polymyalgia rheumatica and temporal arteritis. Not only that but ESR can also perform as an effective tool in pharmacological treatment in some disease types. Generally, ESR is higher in females in comparison to males which drastically increases during pregnancy and with age among both gender.
ESR Reference Values
Measuring the sedimentation of blood due to illness or injuries was observed by a British surgeon John Hunter in the 18th century. ESR has been studied for its clinically application as a hematology test since the 19th century. In 1921, Dr. Westergren defined the standard measurement of ESR that is used to this day! In this method, blood is diluted in sodium citrate to perform the test, in addition to one part of anti-coagulant such as EDTA. Following an hour after the erythrocyte sedimentation, distance between the plasma meniscus and the top layer of sedimented RBCs is measured. Under normal conditions the reference values for Westergren ESR method are 0-20mm/hr. Remarkably, despite the latest inventions of automated machines used in the analysis of ESR, Westergren method has been the gold standard.
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Article by Supreetha Toplar