Erythrocyte sedimentation rate (ESR) by Westergreen and Ziehl- Neelsen staining techniques were performed on 128 samples collected between January 2010 to November 2011 in the city of Porto Novo ,Cape Verde among whom 73(57%) were males and 55(43%) were females. 8(6.25%) were positive for tuberculosis with elevated ESR in all the eight samples. In all the samples, 77.3% showed elevated ESR without evidence of pulmonary tuberculosis and elevated ESR were influenced by age. In conclusion, ESR could serve as an important prognostic index but not a diagnostic index unless used in conjunction with other specific tests such as cultural techniques, nucleic acid probes and nucleic acid amplification using polymerase chain reaction (PCR). ESR left alone cannot serve as an important diagnostic index for tuberculosis since elevated results were recorded even in the absence of disease.
KEYWORDS: Erythrocyte Sedimentation rate, Diagnostic index, pulmonary, Tuberculosis
Table of Contents
1. INTRODUCTION
2. METHODOLOGY
3. RESULTS
4. DISCUSSION AND CONCLUSION
Objectives and Research Themes
This research aims to evaluate the clinical utility of the erythrocyte sedimentation rate (ESR) as a diagnostic index for pulmonary tuberculosis, specifically analyzing its sensitivity and specificity in a clinical setting.
- Clinical efficacy of ESR in diagnosing pulmonary tuberculosis.
- Assessment of rouleaux formation and influencing physiological factors.
- Comparative analysis of ESR results across different age groups.
- Prognostic monitoring of tuberculosis treatment efficacy.
- Limitations of ESR as a standalone diagnostic tool.
Excerpt from the Book
INTRODUCTION
The erythrocyte sedimentation rate(ESR) is a non- specific test. Although an empirical test, the estimation of the erythrocyte sedimentation rate has been widely used in clinical medicine. The method for measuring the ESR recommended by the international council for standardization in hematology (ICSH 1993) and also by various national authorities (NCCLS 2000) is based on that of Westergreen, who developed the test in 1921 for studying patients with pulmonary tuberculosis.
Essentially, it is the measurement after 1hour of the sedimentation of red cells in diluted blood in an open ended glass tube of 30cm length mounted vertically on a stand Lewis S M (2006). The phenomenon of ESR has been exhaustively investigated and the rate of fall of the red cells is influenced by a number of inter reacting factors Hardwicke J et al (1952). Basically, it depends upon the difference in specific gravity between red cells and plasma but the actual rate of fall is influenced very greatly by the extent to which the red cells form rouleaux, which sediment more rapidly than single cells. Other factors which affect sedimentation include the ratio of red cells to plasma, that is the packed cell volume(PCV), the plasma viscosity, the verticality or otherwise of the sedimentation tube, the bore of the tube and the dilution if any of the blood Thygesen J E (1942).
The all-important rouleaux formation is mainly controlled by the concentrations of fibrinogen and other acute- phase proteins; for example haptoglobin, ceruloplasmin, α1 acid-glycoprotein, α1-antitrypsin and C- reactive protein. Rouleaux formation is also enhanced by the immunoglobulin but is retarded by Albumin.
Summary of Chapters
INTRODUCTION: Provides a background on the ESR test, its historical development, and the physiological mechanisms of red cell sedimentation.
METHODOLOGY: Details the collection of venous blood and sputum samples from 128 subjects and the application of Ziehl-Neelsen staining for tuberculosis identification.
RESULTS: Presents the statistical data and graphical analysis of 128 tested subjects, highlighting the incidence of elevated ESR in both tuberculosis-positive and healthy individuals.
DISCUSSION AND CONCLUSION: Interprets the study findings, concluding that ESR is a useful prognostic tool but lacks sufficient diagnostic specificity for tuberculosis on its own.
Keywords
Erythrocyte Sedimentation rate, Diagnostic index, pulmonary, Tuberculosis, Westergreen method, Ziehl-Neelsen, Rouleaux formation, Hematology, Inflammation, Clinical utility, Prognosis, Sputum smear, Acid fast bacilli, Fibrinogen, Pathophysiology.
Frequently Asked Questions
What is the primary focus of this study?
The study evaluates whether the erythrocyte sedimentation rate (ESR) can serve as a reliable diagnostic index for identifying pulmonary tuberculosis in patients.
What are the central themes discussed?
The themes include the physiological mechanisms of sedimentation, the influence of rouleaux formation, the impact of patient demographics on test results, and the clinical limitations of ESR.
What is the main objective of the research?
The primary goal is to determine the clinical utility of the ESR test in the diagnosis of pulmonary tuberculosis, specifically assessing if it can distinguish between infected and non-infected individuals.
Which methodology was employed?
The author collected blood and sputum samples from 128 subjects and utilized the Westergreen-Katz method for ESR measurement alongside Ziehl-Neelsen staining for bacterial identification.
What does the main body cover?
It covers the history and theory of the ESR, detailed laboratory procedures, statistical tables summarizing test results, and a critical discussion of the results compared to other diagnostic markers.
Which keywords define this work?
Key terms include Erythrocyte Sedimentation rate, Diagnostic index, Pulmonary Tuberculosis, Westergreen method, and Ziehl-Neelsen.
Can ESR diagnose tuberculosis on its own?
No, the author concludes that ESR is a non-specific test and should only be used in conjunction with more specific tests like cultural techniques or PCR, as elevated results occur in the absence of disease.
How does age affect the findings?
The study indicates that ESR levels are influenced by age, with older subjects frequently showing elevated results even without tuberculosis infection.
Is ESR useful after a tuberculosis diagnosis is made?
Yes, the study finds that ESR is efficient for the prognostic monitoring of treatment, as levels typically decrease once the bacteria are successfully eliminated.
What happens when HIV is present?
The findings suggest that in HIV-co-infected patients, ESR may remain persistently elevated even after successful tuberculosis treatment, indicating the need for supplementary HIV screening.
- Arbeit zitieren
- Peter Ubah Okeke (Autor:in), 2011, Erythrocyte Sedimentation Rate: Is It An Important Diagnostic Index For Pulmonary Tuberculosis?, München, GRIN Verlag, https://www.hausarbeiten.de/document/183069
