What is the soe of the child. The rate of erythrocyte sedimentation rate (ESR) in the blood in children

The sedimentation rate of red blood cells (erythrocytes), or ESR, is a value that shows the ratio of plasma proteins in the blood or its viscosity - the higher it is, the lower this indicator.

This parameter is often called the erythrocyte sedimentation reaction, ROE.

What is the ESR in the blood of a child - the norm in infancy up to a year and older, what can an increase or decrease in the level indicate?

What is erythrocyte sedimentation rate

How can parents far from medicine in the results of a blood test determine ESR value(decoding - “erythrocyte sedimentation rate”) in a child, how much should this indicator be normal?

In blood that is unable to clot, red blood cells slowly settle under the force of gravity.

To determine the value of ROE, the laboratory assistant measures the speed at which they descend, in millimeters per hour.

If the material taken for analysis is placed in a test tube and left, after this time almost clear liquid above and dark mass below.

The latter is red blood cells, which stuck together and sank to the bottom.

The laboratory assistant measures the height of the transparent column from above, it can be 1, 5, 10, 20 or more mm - this is the ROE.

If the parameter value differs from the normal numbers, this may indicate some kind of health problem.

Normal level at the age of one year and older

How much should be the ESR in a child? ESR norms for children change with age:

• the first day after birth - from 2 to 4 mm / hour;
• in children up to a year - from 3 to 10.

After a year the rates go up:

• for children from one to three years old - from 5 to 12 mm / hour;
• from 6 to 14 years - from 4 to 12 mm/hour;
• for boys over 14 years old, the normal values ​​​​are from 1 to 10 mm / hour, for girls - 2-15 mm / hour, that is, the norms become the same as in adults.

What is the norm of ESR in children by age, shown in the table:

Reduced value

What if the child's ESR is below normal? Possible reasons for the decline This indicator includes:

Anisocytosis is a pathology in which there is a change in the size of red blood cells. Its development leads to rapid fatigue, increased heart rate and shortness of breath.

With spherocytosis these cells are reshaped. Normally, they should be flattened, in the form of a disk. In children with spherocytosis, these blood components have the shape of a sphere; as a result, their sedimentation rate is reduced.

With this pathology, jaundice, fatigue, loss of strength, shortness of breath, nervousness and irritability appear.

Polycythemia is a tumor process of the blood system. As a result of its development, a large number of red blood cells, which leads to a decrease in the rate of their sedimentation. The content of platelets and neutrophils increases.

With hyperbilirubinemia increases the content of bilirubin - one of the main components of bile. This is accompanied by yellowing of the skin and whites of the eyes.

Acidosis is called increase in blood acidity.

Note to parents: Read about it in our article.

Do I need and what should be the diet for cystitis in a child? The article will tell about it.

About the treatment of wet cough in children folk remedies can be found in the publication.

Reasons for the increase

The main reasons for the increase ROE include:

• teething;
• poisoning;
• allergy;
• trauma;
• hypovitaminosis;
• infections;
• helminthiases;
• tumor diseases;
• hyperproteinemia;
• elevated ESR syndrome;
• the presence of immature erythrocytes;
• alkalosis.

With hyperproteinemia increased protein content. In the acute phase of this disease, which usually follows first, protein composition plasma changes.

As a result, the amount of C-reactive protein and its other components increases, this causes an increase in its viscosity, and the settling rate decreases.

Such a diagnosis as the syndrome of increased ESR is made if the baby was tested several times a year, the indicator was more than normal, but no signs of another pathology that could cause this increase were identified, and the baby feels good.

immature erythrocytes can also cause an increase in the ROE value. They appear 24-36 hours after the onset of the disease, the development of which is accompanied by the appearance of a focus of inflammation.

And finally alkalosis is a condition, in which the normal acid-base balance is disturbed, shifting towards a decrease in acidity.

Among possible causes increase in settling rate:

• taking certain medications (for example, paracetamol);
• wrong diet;
• stress.

Every person is different, and this applies to babies too.

In a small organism, processes of restructuring and development take place, therefore even in a healthy child, this indicator is very different from the norm.

If it doesn't reach 10 it's ok, also the numbers 15, 20 and even 25 should not cause alarm.

When to consult a doctor

Do not draw any conclusions based only on the speed indicator. deposition of red blood cells.

Any doctor to whom you come for an appointment will ask you about the well-being of the baby, paying attention to possible symptoms diseases, will take into account all other test results before drawing any conclusions.

The specialist will answer all the questions that you want to ask him, for example, low ESR in a child or normal, etc.

Therefore, if you suspect your baby has any health problems, you need to see a doctor to understand if there is a reason for concern and find out what steps to take.

In children, unlike adults, ESR can vary greatly; the difference between the upper and lower limits of the norm is very large.

Therefore, any value of this indicator that you can see among the test results is not a cause for concern.

If there are any signs of health problems, the doctor will definitely look at the tests and take into account their results in order to decide on the examinations that need to be done and the necessary treatment.

If the baby has symptoms after a cold, you need to take blood from the baby, and the ROE will show whether there are reasons to suspect a serious problem or the disease will pass without complications.

Timely contact with the pediatrician will prevent the development of the disease, starting her treatment at an early stage, and avoid situations that are life-threatening for the baby.

If you suspect a serious problem, test results, including ESR values, are important information that will help your doctor prescribe adequate treatment, if needed.

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You can find out a detailed picture of the child's health status by a blood test. Its important element is the ESR indicator (erythrocyte sedimentation rate). This is a non-specific parameter that is highly sensitive to identify pathologies of an infectious and oncological nature. From the materials of this article, you will learn why some children have ESR above the norm, what this means, what measures parents should take.

general information

ESR is one of the main parameters of a blood test. Red blood cells are understood as red bodies, which, under the influence of anticoagulants, settle to the bottom of a medical test tube for a certain amount of time.

A similar process occurs in the human body. For a certain time, red blood cells undergo a process of agglomeration and are gradually deposited on the walls of blood vessels. The ESR indicator is not evaluated in isolation, that is, separately from others. It is highly sensitive. A change in this indicator signals the development of a certain pathology in the body before the appearance of a pronounced clinical picture.

Methods for determining the ESR value

Today in medical practice, two options for determining the amount of erythrocyte cell sedimentation are used: the Panchenkov and Westergren method.

The first involves the placement of biological fluid on glass, which is installed vertically. The second is considered more informative, as it optimally recreates the conditions of a similar process in the human body. Normally, the results of both tests should be identical.

The Westergren method is the most sensitive, because only venous blood is used for its implementation. When the results of the analysis are shown in a child, re-taking is not required.

Normative indicators in children

After the doctor has taken blood from the child, he must place it in a special test tube. In it, under the influence of gravitational forces, red blood cells begin to gradually settle. The task of the laboratory assistant includes with which this process takes place.

Normative indicators of ESR vary in children and adults, and also differ depending on the sex of the child. However, there are certain boundaries that allow you to designate the presence of a pathological process in the body.

• Babies: 2 to 4 mm/h.
• Toddlers under 6: 5 to 11 mm/h.
• Adolescents under 14: 5 to 13 mm/h.
• Young people over 14 years old: 1 to 10 mm/h.
• Girls after 14 years: 2 to 15 mm/h.

In a child, it does not always indicate the presence of inflammation in the body. To make an accurate diagnosis, a more detailed examination and determination of other parameters in the blood is necessary.

Elevated ESR in a child

Often, parents learn about the violation during a routine examination by a pediatrician. If the specialist does not see the reasons that could lead to the problem, a second test is prescribed by a different method.

A high ESR almost always suggests inflammation in the body. However, such an opinion must necessarily be supported by the results of an additional survey. Often a high level of lymphocytes indicates a viral infection, and an increase in neutrophils indicates a bacterial infection. Without taking into account the accompanying test data, it is not possible to identify the disease in a child.

The amount of red cell sedimentation can go beyond the normal range in young children if they lack vitamins or during the test there was an active process of teething. In older patients, the body reacts by increasing this blood parameter to stress or strong feelings.

What factors affect ESR in children?

The main factor increasing this indicator, is the presence of an inflammatory response in the body. However, doctors also identify other reasons that contribute to a decrease / increase in the process of sedimentation of red cells.

1. Changes in blood pH and viscosity.
2. Reducing the number of red blood cells.
3. The presence of helminths.
4. Deficiency of vitamins in the body.
5. Stress.
6. Unbalanced nutrition.

It is important to note that the indicators of erythrocyte sedimentation are among those parameters that very slowly return to normal. After an acute respiratory viral infection, a child may experience a high ESR for some time. After about 1.5 months, these parameters are normalized.

The main reasons for the increase in ESR

As noted earlier in the article, most often the causes of changes in this blood indicator are hidden in the presence of inflammation in the body. In addition, such phenomena can be provoked allergic reactions, poisoning, untreated foci of infection.

Among the main diseases that signal increase in ESR in children include the following:

1. (lupus erythematosus, scleroderma).
2. Blood diseases (anemia, leukemia).
3. Endocrine pathologies ( diabetes, hyperthyroidism).
4. Oncology.

In infants, the ESR analysis is usually increased during teething or due to high fat content. breast milk. Sometimes this condition is quite natural, that is, it is an individual norm of the body. In such cases, pediatricians recommend regular examinations.

It also happens that all indicators are normal except for the amount of erythrocyte sedimentation. A false positive acceleration may be due to the child being obese, taking certain multivitamin complexes, or being vaccinated against hepatitis.

Monocytes and in a child

Monocytes are immature blood cells. Their level can also be determined using a general analysis. When detailed information about the functioning of the child's body is required, check leukocyte formula. Elevated and reduced level these blood cells are indicative of abnormalities. An increase in parameters is called monocytosis. Normally, the number of immature cells should not exceed 11% of the number of leukocytes.

A decrease in the level of monocytes indicates violations in the work immune system. This is usually found in anemia, leukemia and radiation sickness.

Observed in tuberculosis, malaria and lesions lymphatic system. Thus, an increase in the number of immature cells, as well as an increased ESR in a child, should alert parents and the pediatrician.

What treatment is required?

When the red cell sedimentation rate index slightly exceeds the norm, the child's condition is stable, there is no reason to worry. For your own comfort, after a short period of time, you can re-take tests and make sure that the baby is not in danger.

If the ESR parameters exceed 15 mm / h, this almost always means the presence of an infectious focus in the body. When this figure reaches about 30-40 mm / h, this is a clear sign of a serious illness, the fight against which can take several months.

Elevated ESR in a child always means a violation in the body. The pediatrician first of all needs to determine the root cause that provoked such changes. This may require a more serious examination. After the doctor must prescribe the treatment of a specific disease. It usually involves taking antibiotics and antivirals.

Decreased ESR in a child

A decrease in erythrocyte sedimentation usually indicates poor circulation, poor clotting, or blood thinning. The number of red cells increases, but they interact with each other inefficiently.

This phenomenon is observed in children who have recently suffered poisoning or dehydration, have problems with stool. In some cases low rates indicate viral hepatitis.

Only a pediatrician can determine true reason pathology and recommend appropriate therapy.

Conclusion

Very often, parents seek advice from a pediatrician when child ESR above the norm. What does this mean, what are the causes of such disturbances in the functioning of the body, can only be said by a specialist on the basis of a complete diagnostic examination little patient. The erythrocyte sedimentation rate is a serious indicator, so it is not recommended to neglect its values. In case of deviation from the norm, it may be necessary long-term treatment. The sooner the course of therapy begins, the higher the chances of a quick recovery.

If you complain about changes in the body or suspect serious illness often doctors prescribe a complete blood count to the patient along with other studies, whether it is an adult or a child. According to it, various indicators are revealed, including ESR (erythrocyte sedimentation rate), or ROE (erythrocyte sedimentation reaction). This indicator means how quickly red blood cells stick together with each other.

But for each individual indicator in the blood test, one or another diagnosis cannot be made. Therefore, if an increased ESR is detected in a child, you should not worry. This may well be due to rather harmless reasons. If, according to other indicators, data that do not correspond to the norm are also revealed, doctors will make a diagnosis based on them or prescribe other studies.

How is an ESR analysis performed?

General analysis blood must be taken on an empty stomach. On the eve of blood donation, the last time you need to eat is about 8 to 10 hours before blood donation. Doctors also advise not to eat fatty and fried foods two days before the examination to obtain reliable results. 60 - 75 minutes before the analysis, smoking, emotional arousal should be excluded, and you should also rest for 11 - 14 minutes before the analysis. If the patient is taking any medications, the doctor should be informed about this.

This analysis does not need to be carried out after radiography, rectal examination, physiotherapy procedures.

To determine the ESR, blood taken from a finger is placed in containers specially designed for this, in which, under the influence of gravitational forces, erythrocytes begin to settle. The speed at which this process occurs is measured by the laboratory assistant. The ESR norm for different age groups has its own indicators:

• in newborns - from 0 to 2 mm / h;
• in babies under the age of 6 months - 12 - 17 mm / h;
• in girls - 3 - 15 mm / h;
• in boys - 2 - 10 mm / h.

What does an elevated ESR level indicate?

If an erythrocyte settles at a rate that is higher than normal, then this indicates that certain changes are taking place in the body. Erythrocytes can settle faster if

• blood pH level increases;
• blood viscosity decreases, it liquefies;
• the level of albumin decreases (the main blood protein that is produced in the human liver);
• there is an acute or subacute period of any inflammatory process;
• the child has received some kind of injury, he has poisoning, a stressful condition, all kinds of allergic reactions, the presence of helminths or infections that have not been completely cured;
• metabolic disorders (hyper- and hypothyroidism, diabetes mellitus);
• diseases occurring in the connective tissue of the body;
• autoimmune diseases.

If there are no objective reasons for an increase in the erythrocyte sedimentation rate, the district pediatrician may prescribe a second blood test and an additional examination of the body: determining the condition of the tonsils and lymph nodes, palpation of the spleen, examining the kidneys, heart, conducting an electrocardiogram, X-ray of the lungs, blood tests for protein, immunoglobulins , platelets, reticulocytes, biochemical analysis blood, general urinalysis, a thorough external examination and a survey of parents regarding the health of the child. What diseases can be detected after such an examination?

1. With an increase in the level of leukocytes and an accelerated ESR, we can talk about an acute inflammatory process.
2. If the leukocytes are normal, and the ESR is increased, then this is a sign of damage to the child's body by some viral infections or an indicator that recovery is coming (leukocytes bounce back faster than ESR).
3. Anemia (the number of red blood cells in the blood decreases) also provokes an increase in ESR.
4. Parents should be aware that the erythrocyte sedimentation rate in girls may be slightly higher than in boys. The level of ESR can fluctuate depending on the time of day: from 13.00 to 18.00 it increases. Also, children have age periods when the erythrocyte sedimentation rate increases for no reason. These include 27-32 days from the birth of the baby and two years of age.

If it is not possible to associate a prolonged rise in the ESR level with any disease, and also after a thorough examination of the child's health, this fact can be correlated with individual features child's body. It is also necessary to keep in mind the fact that there are cases of false-positive acceleration of ESR, when some factors can cause a long rise in this indicator:

• decrease in hemoglobin and red blood cells;
• taking some vitamins;
• vaccination against hepatitis;
• overweight child.

By appearance the child, as a rule, can be determined whether he is actually sick or healthy. If the child eats and sleeps well, he is mobile, alert, active and in a good mood, then most likely the baby is healthy, and the high ESR is provoked by several other reasons:

• the presence of fatty or spicy foods in the diet (if we are talking about babies, then the reason may be a violation of the diet by the mother);
• insufficient amount of vitamins;
• teething process;
• taking some medicines, which include paracetamol;
• the influence of stressful situations (this also includes the fear of the process of donating blood);
• it is also necessary to take into account the influence of the human factor: it is quite possible that the laboratory assistants made mistakes during the sampling and calculation of the ESR.

High ESR Syndrome

Sometimes, quite rarely, there are patients who have a very high ESR (50-60 mm / h or higher) for a long time.

The so-called elevated ESR syndrome (or accelerated ESR syndrome) requires careful monitoring by doctors. This is only a sign that an in-depth diagnostic study of the patient is needed. If no inflammation, tumors, rheumatic diseases in the body after various studies have been identified, and the patient's health is still vigorous and good, high ESR does not need to be treated separately.

Today, modern doctors often prescribe another study - analysis for C-reactive protein, which shows whether the reason for excitement is real. This study does not depend on many factors, such as the determination of ESR (for example, maintaining high ESR for a month or two even after recovery), and also immediately shows whether there is any inflammation in the body or not.

Erythrocyte sedimentation rate, which shows how well things are in the body little man, is one of the characteristics of the CBC (general blood test). Its increase or decrease is a symptom of many diseases. The norm of ESR in a child is sensitive to the slightest inflammatory changes by an increase, and this is a valuable diagnostic feature for pediatricians.

Meaning of indicator definition

Analysis of the ESR in a child gives an idea of ​​the state of erythrocytes in the body in terms of their sedimentation rate. At the time of blood sampling, these formed blood elements aggregate, sticking together with each other, and due to this, they precipitate. An hour later, the blood is divided into two levels: plasma above, red blood cells below. The height of the erythrocyte-free part is the value that you will receive as an indicator of the ESR response on the standard analysis form. Previously, ESR was deciphered as ROE - the reaction of erythrocyte sedimentation, and there is some truth in this, but in modern medicine this abbreviation is not used.

The state of plasma and erythrocytes affects the ESR: concentration, viscosity, pH, hemoglobin, microelement content. By changing these characteristics, doctors judge the development of pathology at the most early stages which is especially valuable in newborns and infants. But the ESR in a child at 3 years old and at 5 years old is different, they a priori should mean different age characteristics of the child's body, therefore, usually the children themselves different ages prescribe a blood test for ESR preventive examinations not to miss the debut of the disease. In addition, ESR is informative in case of suspected appendicitis, it is used in differential diagnosis tumors, diseases of the heart, kidneys, autoimmune pathological processes.

And in the case when it is difficult to make a diagnosis, a small patient complains of headaches or digestive problems, loses appetite, but there are no symptoms, ESR comes to the rescue, fixing inflammation. But this analysis is purely auxiliary in nature, it does not guarantee an accurate diagnosis, so it must be used as part of a survey. ESR has another important role. It monitors the dynamics of the condition of a small patient and as soon as the cause that caused the inflammation is eliminated - ESR norm lyses.

Factors that change the indicator

The erythrocyte sedimentation rate is an incredibly sensitive assay that can change both physiologically and pathological changes in the body: increase or decrease. For example, after suffering the flu or SARS, the ESR may remain elevated for about six months, which is associated with the presence of inflammatory immune complexes in the bloodstream: antigen-antibody. Until they all leave the bloodstream, the blood cell sedimentation rate may respond to them. In addition, response rates are affected by:

Indications for the purpose of the analysis

ESR is not decisive in the diagnosis, but plays an important supporting role and is recommended for use in:

• High temperature of unknown origin (adenoids, allergies, tonsillitis, bronchitis, otitis media).
• Suspicion of an infection.
• Identification of neoplasms, both benign and malignant, in order to select adequate therapy.
• Before surgery to characterize the blood system.
• Medical examination.

Methods for determining ESR in the blood

Modern ways definitions of ESR in multidisciplinary large clinics differ from the conservative ones still used in district hospitals that does not have of great importance, since the principle of separation of blood plasma and erythrocytes remains the same everywhere. There are several methods for determining ESR:

• Panchenkov's method. It is based on the determination of the sedimentation of the mass of red blood cells, the rate of which is dictated by the presence of proteins in them - globulins, oxygen content and a number of other factors. Blood is taken from the finger, piercing it and removing the first drop along with the cells of the epidermis with a sterile swab. The second drop is transferred to a glass slide with a capillary, an anticoagulant is added and placed in a special graduated pipette. After 1 hour, evaluate the column of clear liquid on a scale in mm/hour.
• Westergren's method. This is a more accurate technique, and it is used in specialized laboratories to detect latent forms of pathological processes or hematopoietic disorders. Blood is taken from a vein (80-100 ml), diluted with an anticoagulant (4%) in a ratio of 4:1 in a special container. An hour later, they look not at the height of the transparent column, but at the thickness of the erythrocyte sediment. Pediatricians consider this method the most reliable today.
• ESR analyzers. This is an affordable and the most modern, highly accurate method of blood testing. They provide fast, reliable results. ESR is recorded by special sensors. The blood is placed in a small test tube, where conditions are created close to natural. This eliminates errors associated with temperature fluctuations or other background changes in the laboratory. In addition, the analyzers immediately print the result with the indication in brackets of the norm for each individual patient, many innovative devices also give the reasons for deviation from it. This greatly facilitates the work of laboratory assistants and a diagnostician.

The norm of ESR indicators by age

The erythrocyte sedimentation rate is a very individual reaction, which is influenced by gender, physiology and external factors. But the main thing is age. It is most convenient to analyze this in a table where the ESR norm in children is presented by age.

Deciphering the analysis is the prerogative of the doctor. The laboratory value should not overestimate normal performance, but this happens due to poor-quality reagents or an oversight of the researcher, therefore, with questionable results, they always practice re-delivery of the biological fluid.

The norm of ESR in the blood in children does not guarantee the complete health of the child, but its increase indicates the possible development of acute inflammation in the infant's body and requires re-testing and additional examination according to the full algorithm.

If all other indicators are normal, you should not worry, since fluctuations in ESR are possible due to individual moments of hormonal changes in the body or its reaction to some external factors.

Children have special periods ESR growth: from 28 to 31 days after birth and at 2 years, when ESR physiologically increases to 17 mm / h. But usually, the difference between the age norm and the individual ESR in children by 10 mm / h is a reason to search possible pathology. With a reaction rate of more than 30-40 mm / h, even in the absence of visible reasons ill health, the doctor prescribes preventive antibiotic therapy (most often an antibiotic) against the background of a thorough clinical and laboratory examination of the baby.

Causes of increased ESR in children

The level of ESR is not a constant value even under normal conditions. But when they rise, both parents and doctors urgently need to look for the cause. A high level of sedimentation rate of blood cells is a sign of trouble in the body. And there are several reasons for this:

• diseases internal organs: liver, kidneys, especially the pericardium, blood vessels,
• significant blood loss
• leukemia,
• blast diseases of the blood,
• anemia of various origins,
• thyroid disease,
• body sensitization,
• systemic autoimmune processes,
• dysfunction of the pancreas,
• collagenosis,
• injury,
• septicemia,
• neoplasms (malignant and benign),
• infection with mycobacteria and spirochetes,
• aseptic and purulent processes in the body of unclear etiology (pneumonia, arthritis, uncontrollable cough),
• taking medications,
• postoperative period (up to 6 months),
• transferred viral disease(influenza, chicken pox, herpes virus, SARS),
• immunodeficiency.

An altered reaction requires analysis along with platelets, monocytes, stab neutrophils, lymphocytes and leukocytes, eosinophils, which are required to be responsible for normal immunity. In addition, it should be remembered that acute inflammation, accompanied by a rise in temperature, will give a high ESR only a day after the debut. There is also the so-called false positive result. These include:

For unclear reasons, doctors are not always worried about a decrease in ESR. But such a reaction of the blood, although it does not fix attention on the risk of developing inflammation, does not speak of well-being in the body. A low response is recorded in the case of:

• dehydration due to severe somatic diseases: oncology, epilepsy, pathology of the heart and blood vessels, hematopoietic disorders, viral hepatitis.
• Loss of fluid in case of intoxication, accompanied by diarrhea and vomiting (poisoning).
• Hereditary pathology that can lower the ESR.
• Lack of protein food by a child (sometimes this happens in vegetarian families) due to an unbalanced diet, which may indicate an unscrupulous attitude of parents to the health of the baby.
• Taking medications (aspirin, calcium chloride, for example) can greatly reduce the indicator.
• A physiological decrease in ESR occurs in the first two weeks of a baby's life.

Thus, the seriousness of the reasons contributing to the decrease in ESR should be the reason for re-analysis of the biological fluid and careful monitoring of the baby.

How to normalize indicators

ESR cannot serve as a basis for a diagnosis. It must be remembered that this is a symptom of many diseases. Therefore, if the erythrocyte sedimentation rate deviates from the norm, it is necessary to prescribe additional laboratory, and sometimes instrumental methods research. The algorithm for additional examination of a child includes the following steps:

Usually, after the examination, the doctor finds the ESR deviation trigger, the norm of which in children is so unstable, eliminates it, and the reaction returns to normal. It takes a couple of weeks after treatment. During this period, a control blood test is taken.

Complete blood count is one of the most affordable, fast and safe ways evaluate the work of internal organs and general state child. After receiving a form with test results, parents, as a rule, are lost in an abundance of complex and incomprehensible terms.

In order to have an idea about the health of the crumbs even before going to the pediatrician, it is important to know what exactly each indicator means, how it is deciphered, and what values ​​\u200b\u200bare recognized as a variant of the norm for a child of a particular age category.

In addition to the level of platelets, leukocytes and other important components of the blood, another, no less important indicator, ESR, is studied in the laboratory. Most parents know about ESR only that elevated values ​​indicate the onset of the inflammatory process.

It is not always so. Many factors can affect the rate of erythrocyte sedimentation / binding (abbreviated as ESR), for example, the size of leukocytes, the consistency of the blood and its composition.

The rate of erythrocyte sedimentation / binding is an indicator of a non-specific type that characterizes the speed of interaction of erythrocytes and their connection with each other. It is important to understand that the level of ESR in itself does not give a complete picture of the health of the child's body.

It is possible to talk about pathologies and deviations only in two cases:

• the ESR level is significantly different from the norm for at least 10 days;
• along with fluctuations, there is a deviation from the norm in other indicators (for example, the content of leukocytes, platelets, etc.).

blood test to determine elevated ESR

In order to assess the rate of binding of erythrocytes, it is enough to take a blood test (general). It is performed in the morning, no later than 3-4 hours after waking up. Before performing, it is necessary to exclude any food (a small amount of clean water is allowed).

To obtain a reliable result, do not rub the fingertips before submitting the material for analysis. Many parents believe that by such manipulations they will reduce the sensitivity of children's fingers. This is not true. From pain these actions will not save, but they can quite influence the result of the analysis.

• at least once a year if the child is healthy;
• at least once every six months, if the child often suffers from colds and infectious diseases;
• at least 2 times a year - for children under the age of 3;
• before each preventive vaccination (according to the vaccination schedule).

If, according to the results of the analysis of ESR according to Westergren, it turns out to be increased, it is impossible to vaccinate. You should retake the analysis and see what the indicators turned out to be. If the level again exceeds the permissible values, the child needs a mandatory examination, since there is a high probability of developing an inflammatory process.

In some cases, the doctor may send the baby for analysis within a few days. This is necessary in cases where the child looks healthy, but the erythrocyte sedimentation rate remains high according to the results of 2-3 studies. If the ESR is elevated for 10 days in a row, it is possible that there are hidden foci of inflammation in the body.

ESR norm for children of different ages

The ESR indicator can differ significantly in children of different ages, but it should not go beyond the permissible values.

The rate of interaction of erythrocytes is a variable value and what it will be depends even on the sex of the child. For example, in girls (regardless of age), this indicator may be slightly higher than in boys of the same age category.

The norm of ESR depending on the age of the child

Various factors can affect the ESR, so it is not a stable value and can change with each blood test. If the results of several analyzes consistently show deviations from the permissible limits, we are talking about malfunctions in the work of the child's body.

On what factors does ESR depend?

• Gender of the child.

In girls, the erythrocyte sedimentation rate is always slightly higher than in boys.

• Anemia.

With a reduced number of erythrocytes, their sedimentation rate increases.

• Times of Day.

The maximum erythrocyte sedimentation rate is observed in the period from 10 to 15 hours.

• The presence of inflammatory foci.

Prolonged inflammation leads to a stable increase in ESR.

• The composition of the blood.

Acute-phase proteins of blood plasma contribute to the acceleration of erythrocyte binding due to adsorption on their surface.

• Infections (bacterial, viral and fungal).

With the development of the infectious process, the indicators change a day after the onset of signs of malaise (fever, fever, etc.).

Increased ESR - causes

An increase in the rate of erythrocyte binding is observed with various inflammatory processes resulting from infectious diseases.

The most common reasons for an increase in the erythrocyte sedimentation rate are the following:

• tuberculosis;
• measles, rubella;
• tonsillitis and other bacterial infections of the respiratory tract;
• anemia (anemia);
• allergic reaction upon contact with irritants / allergens;
• damage to bone and articular tissue (trauma, fractures);
• hemoblastosis;
• whooping cough;
• endocrine pathologies.

Parents should remember that the rate of erythrocyte binding returns to normal only 30-45 days after complete recovery. Therefore, do not panic if for some time after the illness the level of ESR will be slightly increased.

False positive ESR analysis

In some cases, an increase in the rate of interaction of erythrocytes is in no way associated with infections and pathologies in the work of internal organs.

In newborns and infants, an increase in ESR is often caused by errors in the mother's diet (in case the woman is breastfeeding). In order for the indicator to return to normal, everything will have to be excluded from the diet. fatty foods. If it is impossible to exclude, then at least limit it as much as possible.

Why can ESR be lowered?

A low level of ESR in children is much less common than a high level. If the high rate of interaction of erythrocytes may be the result of the influence external factors, not related to the health of the child, then low almost always indicates serious violations in the work of the child's body.

Pathology of the circulatory system is one of the common reasons why the ESR in a child may fall below acceptable limits. At the same time, the number of red blood cells in the blood remains the same or even increases, but they interact weakly with each other.

If, according to the results of the analysis, it was found that the baby has a low rate of erythrocyte binding, this may indicate one of the following pathologies:

• poor clotting;
• severe blood thinning;
• circulation disorder.

Intoxication after an infection. Vomiting and diarrhea, which are integral companions of any type of poisoning, lead to dehydration of the body and the accumulation of toxic substances and poisons in the cells of the body. With this condition, a decrease in ESR is almost always observed. The same picture is typical for viral hepatitis.

Cardiac pathologies. Disorders in the work of the heart (dystrophic type) are also accompanied by a persistent decrease in ESR. It is for this reason that all children who have a low rate of erythrocyte binding must be examined by a cardiologist without fail.

If ESR is abnormal

Almost all parents start to worry if the indicators laboratory research blood values ​​are different from normal values. In the case of ESR, you should first familiarize yourself with the numbers.

What does the difference mean?

Important! It is impossible to draw a conclusion about the presence of infection only by the level of ESR, since this indicator is very unstable.

To confirm and clarify the diagnosis, the child will be assigned additional studies, for example:

• C-reactive protein;
• Ultrasound of internal organs;
• urine test;
• rheumatic tests;
• blood test for biochemical parameters.

Fluctuations in ESR do not require any special treatment, since this value is only an indicator characterizing the work of internal organs. Therapy of the child is prescribed only if the cause is identified and an accurate diagnosis is made, since it depends on the elimination of the main factor how quickly the ESR will return to normal.