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January 25, 2010 
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[phpostock]High, 20[/phpostock]
How high do sedimentation rates go in someone with lots of inflammation?
Question:
It looks like anything under 20 or so is normal. But how high is a fairly high number in someone with active inflammation? In something like Lupus, what is an average value if there's something going on? How high is *high*, what's the highest you've heard of them going?
Answer:
There is a maximimum value for sed rates(ESR for short) that is dependent on the technique/instrumentation used to measure it. Generally it is around 140mm/hr. I'm afraid that there is no real good answer to what is high in someone with active inflammation. The upper limit of normal is about 20 for men and a little higher for women(around 30) but it also increases with age. It is difficult to answer how high is high with active inflammation. Some have described an "extremely high" range as >100 which is thought to be seen primarily in infection, malignancy, renal disease, and inflammatory disorders(like lupus). However, this does not mean that having that high of an ESR means you have to have one of these conditions nor does having a lower value exclude these conditions. For an illness such as lupus it is most helpful to determine what your baseline values are when you are not having flare ups and when you are. This helps your physician use this test as a gage to try and determine the progress of your illness, diagnosis of flare ups, and effectiveness of treatment particularly during flare ups. In other words: it's importance is to find your "normal" to follow over time as it can be very different from someone else's because of the high variability in severity and in which organs/tissues are affected in those with lupus.
A little about the test itself. It is measured in mm/hr because it is essentially the rate at which the red cells settle out of suspension due to gravity in a well mixed slightly diluted sample of blood. So the test is limited by the height of the column used to measure it. Generally, the test has not been shown to provide very useful information at values higher then the 100-140 range enough to lengthen the columns used to measure it past that point. You might try going to the link below to get some more basic info about this test. You will notice the lack of specific values - because there just isn't a given value that we can say "an elevation of this much means this is what is specifically happening to you" without putting it together with the rest of your symptoms and tests. Hope this helps.
P.S. I perform this test regularly(but don't usually know each individuals exact diagnosis while performing it) and don't often see values greater then 110.
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[phpzon]High, 10[/phpzon]
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