Journal of Postgraduate Medicine
 Open access journal indexed with Index Medicus & ISI's SCI  
Users online: 7283  
Home | Subscribe | Feedback | Login 
About Latest Articles Back-Issues Article Submission Resources Sections Etcetera Contact
 
  NAVIGATE Here 
  Search
 
 :: Next article
 :: Previous article 
 :: Table of Contents
  
 RESOURCE Links
 ::  Similar in PUBMED
 ::  Search Pubmed for
 ::  Search in Google Scholar for
 ::Related articles
 ::  [PDF Not available] *
 ::  Citation Manager
 ::  Access Statistics
 ::  Reader Comments
 ::  Email Alert *
 ::  Add to My List *
* Registration required (free) 


  IN THIS Article
 ::  Introduction
 ::  Material and methods
 ::  Results and disc...
 ::  Acknowledgement
 ::  References

 Article Access Statistics
    Viewed6494    
    Printed120    
    Emailed4    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal


   
Year : 1983  |  Volume : 29  |  Issue : 3  |  Page : 165-8

A simple method of distinguishing between inflammatory and neoplastic elevation of erythrocyte sedimentation rate.







How to cite this article:
Kulkarni K S, Kendurkar S M, Bhandarkar S D. A simple method of distinguishing between inflammatory and neoplastic elevation of erythrocyte sedimentation rate. J Postgrad Med 1983;29:165


How to cite this URL:
Kulkarni K S, Kendurkar S M, Bhandarkar S D. A simple method of distinguishing between inflammatory and neoplastic elevation of erythrocyte sedimentation rate. J Postgrad Med [serial online] 1983 [cited 2019 Nov 21];29:165. Available from: http://www.jpgmonline.com/text.asp?1983/29/3/165/5524




  ::   Introduction Top

Erythrocyte sedimentation rate (E.S.R.) is elevated in a variety of diseases. It is a non-specific indicator of an inflammatory or a malignant process in the body. Gross et al[1] reported a modification of Ruhenstroth-Bauer's[2] method of distinguishing between elevated E.S.R. due to inflammatory disorder and that due to malignant disease. They showed that in inflammatory disorder the E.S.R. shows a marked reduction when it is repeated after resuspending the cells in incubated plasma. In malignancies, the reduction is much less marked. We reported below a study to evaluate that method.

  ::   Material and methods Top

The test was carried out in 24 patients with various inflammatory conditions (Group A) and in 21 patients with proven malignancies (Group B) admitted to the wards of K.E.M. Hospital, Bombay. Sixteen ml of venous blood was withdrawn into a syringe containing 4 ml of 3.8% aqueous, sodium citrate solution. It was centrifuged at 3000 r.p.m. at room temperature for 10 minutes. The supernatant citrated plasma was pipetted out into a glass container. The cell sediment was washed three times with isotonic saline and then kept aside at room temperature. The citrated plasma was divided into two halves; one was allowed to stand at room temperature, and the other incubated at 37C for 4 hours. Then, the two sedimentation test mixtures were made up (a) with unincubated plasma (E.S.R. I) and (b) with incubated plasma (E.S.R. II), as follows: citrated plasma (unincubated or incubated) 1.4 ml + isotonic saline 0.6 ml + washed cells 1 ml. The two ESR tests were set up in Westergreen tubes and read at the end of one hour.
The difference between the two E.S.R. readings (E.S.R. I - E.S.R. II) was calculated for each patient; it was also expressed as %age of E.S.R. I. Mean and standard deviation were calculated for the data on E.S.R. I, difference between E.S.R. I and E.S.R. II and % difference between E.S.Rs I and II. Unpaired, two tailed, Students "t" test was used to compare the data in inflammatory disorders and malignancies. Further, 95% confidence limits for the above data were calculated.

  ::   Results and discussion Top

[Table - 1] and [Table - 2] show the results in patients with inflammatory disorders and malignant diseases respectively. [Table - 3] shows the means, standard deviation, 95% confidence limits, and "t" and p values for the data. The means of E.S.R. I in inflammatory and malignant conditions are significantly different at 5% level, whereas those of differences between E.S.R. I and E.S.R. II, and % difference between E.S.R. I and E.S.R. II are significant at 0.1% level. As seen from [Fig. 1] there is an overlap between the 95% confidence intervals in the case of E.S.R. I, and the % difference between E.S.R. I and E.S.R. II. However, the confidence intervals in ,,the case of the absolute difference between E.S.R. I and E.S.R. II do not show an overlap. It is, therefore, suggested that the absolute difference between E.S.R. I and E.S.R. II might be a good measure to differentiate elevation of E.S.R. in inflammatory disorders from that due to malignant diseases. By the present reckoning, a difference of 12 mm or larger between E.S.R. I and E.S.R. II would suggest an inflammatory disorder, whereas a difference of 10 mm or smaller would indicate a malignancy. This work is being continued in order to narrow down the confidence intervals and thus give better separation between the 2 groups of patients.


  ::   Acknowledgement Top

We thank the Dean, Seth G.S. Medical College and K.E.M. Hospital for his permission to publish this material.

  ::   References Top

1.Gross, R, Gerrard, W. and Rassner, G.: A simple method for distinguishing inflammatory and neoplastic increase in erythrocyte sedimentation rate. German Med. Monthly, 12: 6-10,1967.  Back to cited text no. 1    
2.Ruhenstroth-Bauer, G.: Der Mechanisimus der Blut korperchensenkung. Acta. Hematol, 18: 98-108, 1957.  Back to cited text no. 2    

Top
Print this article  Email this article
Previous article Next article
Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow