The child's erythrocyte sedimentation rate is increased. Increased ESR in the blood of a child

After complete recovery, this indicator may remain unchanged for several months, which should not be alarming only if there are no other changes in the blood.

An increased ESR in a child should not be perceived by parents as a sign of serious illness, as it may indicate minor changes in the body that do not require treatment. Despite this, after receiving “alarming” results, you should take a biochemical blood test, a urine test, and also conduct an external examination of the child. Erythrocyte sedimentation rate is a fairly serious indicator, so it is not recommended to ignore it.

Dear Oksana!

Erythrocyte sedimentation rate (ESR) is an indicator indicating how quickly red blood cells - red blood cells - stick together, i.e. settle. If the ESR indicator is outside the normal range for age, this indicates that there is a reason that influenced this process. Typically, specialists analyze the overall picture, because ESR itself cannot indicate the development of any specific disease and cannot be a symptom of pathology. However, it cannot be excluded from the overall clinical picture.

ESR norms in children

The normal level of ESR in a child’s blood depends on age:

• Newborns - 0 - 2 mm/h, maximum - 2.8 mm/h;
• 1 month - 2 - 5 mm/h;
• 2 - 6 months - 4 - 6 mm/h;
• 6 - 12 months - 3 - 10 mm/h;
• 1 - 5 years - 5 to 11 mm/h;
• 6 to 14 years old - from 4 to 12 mm/h;
• Over 14 years old: girls - from 2 to 15 mm/h, boys - from 1 to 10 mm/h.

Reasons for increasing ESR

If a child exhibits an increase in ESR, then most often experts assume the presence of some kind of infectious-inflammatory process. In this case, other indicators in the results of a general blood test must also be changed. The child’s behavior must also change, because any infection is accompanied by alarming symptoms and poor health.

In addition, erythrocyte sedimentation rate increases in some non-infectious diseases. It can be:

• Autoimmune or systemic diseases (rheumatoid arthritis, bronchial asthma, systemic lupus erythematosus);
• Endocrine diseases (hyper- and hypothyroidism, diabetes mellitus);
• Blood diseases, anemia, hemoblastosis;
• Oncological diseases, tuberculosis of the lungs and other organs, myocardial infarction, etc.;
• Injuries.

It should be noted that the erythrocyte sedimentation rate normalizes rather slowly after the child recovers, only after 4 - 6 weeks. Remember if your child had colds or other infectious or inflammatory diseases at the age of 1.5 - 2 months? If the answer is yes, then to make sure that the inflammation has passed, you can take a blood test for C-reactive protein, because the factor of unresolved infection in the case of pediatric diagnosis is most likely.

There are other, less dangerous reasons for increased ESR. For example, if you are breastfeeding, your blood test could be affected by eating fatty foods or taking certain medicines, in particular, paracetomol. ESR also increases during teething in children. This may also indicate a lack of vitamins or infection with worms. In case of an allergic reaction in children or heavy feeding before taking the test, the erythrocyte sedimentation rate may also increase.

If we talk about statistics, then infectious diseases are responsible for an increase in ESR by 40%, oncological diseases by 23%, systemic diseases by 17%, anemia, inflammation of the gallbladder or pancreas, intestines, ENT organs, etc. by 8%. .d., 3% - kidney disease.

What to do?

First of all, it is necessary to exclude a false result. Take a complete blood test again. If high ESR values ​​are observed over time, then you need to immediately consult a doctor, because the child may require in-depth diagnostics in order to exclude dangerous diseases. However, you should not worry ahead of time. Sometimes, although rarely, some children have a certain individual feature, manifested in an increase in ESR against the background of normal values ​​of other blood components.

Best regards, Ksenia.

anonymously

Hello, Boris Leonidovich, the situation is this: At the time of illness, the child is almost 4 months old. Suddenly stood up heat, up to 39.6. There was a slight cough. Called ambulance, wheezing and no indications of pneumonia were found. They gave me an injection and took me to the infectious diseases hospital. In the evening of the same day, a blood test was taken and a high ESR was revealed - 53. Other indicators did not cause concern among the doctors. The next day the temperature dropped to normal. The doctor prescribed amoxicillin drops and an examination of doctors began. The ENT doctor detected slight redness in the throat and prescribed inhalations. High ESR was addressed to other reasons. Urine tests were done - normal. An ultrasound of the abdominal organs was done - normal. Electrocardiogram is normal. An x-ray was taken due to the possibility of hidden pneumonia. Pneumonia was not detected, but it was diagnosed in advance. diagnosis - obstructive bronchitis due to increased transparency of the lungs. This diagnosis was refuted by another doctor (apparently ENT), because... When listening, no wheezing was detected, and increased transparency of the lungs is typical for children of this age (4 months). At the moment, 3 days after admission to the hospital, the question of what inflammatory process occurs in the body has not been resolved. The child’s health is not bad; behavior is normal, active, not whiny, throat is almost better, temperature is 36.7-37.0, coughing is rare: a couple of times a day. The ESR the day after the illness was 50 (decreased by 3 units), all other indicators were normal. Please tell me what to do next? An ultrasound of the heart and brain is still to be performed. What else is worth paying attention to in this case? What concerns might be associated with such a high ESR?

Hello! Unfortunately, I cannot say whether the diagnosis is correct or incorrect, but I can say unequivocally that there is an inflammatory process that can be successfully treated with an antibacterial drug, and therefore this process is caused by bacterial flora sensitive to this drug and all you have to do is complete the treatment of the child and do everything in In the near future, the inflammatory process did not occur. this process, judging by your description, is somewhere in the upper or middle respiratory tract

anonymously

Thank you very much for your prompt response. In our case, the disease came with lightning speed and goes away, but we are still looking for the answer and continue to be examined. As I understand it, is it still worth returning to considering the diagnosis of bronchitis and its follow-up treatment?

anonymously

Sorry to ask again. We are very concerned. The child is on his 6th day in the infectious diseases hospital. The blood test was repeated today. ESR - 58, even higher than before. The presence of pneumonia or bronchitis is still excluded. By external signs the child feels fine. The throat has already healed. They did an ultrasound of the brain - it was normal. A urine test came back, which was done the next day after admission, and revealed the presence of staphylococcus and E. coli. Regarding the latter, the doctor suggested that hygiene was not very well observed when collecting the analysis. Regarding ESR, the doctor said “much more.” She prescribed a new antibiotic, Ceftriaxone, 2 times a day and the next blood test for ESR after 2 days. If this does not have an effect, then further examination by an Oncologist follows. Do you think that cancer is possible in this situation, despite the fact that other blood test parameters and ultrasound are normal? A blood test was also done from a vein for chlamydial infections, we are waiting for the result. Is it worth repeating the biochemistry for C-reactive protein? Thank you in advance for your answer and attention to my question.

Thanks to a child's blood test, you can determine whether the baby is healthy or has any diseases. This is especially important if the disease is hidden. To identify such hidden pathologies, all children are routinely sent for tests at a certain age. And increased attention is paid to blood tests in children.

One of the important indicators determined in the laboratory during blood testing is ESR. Seeing this abbreviation on a blood test form, many parents do not know what it means. If, in addition, the analysis revealed an increased ESR in the child’s blood, this causes worry and anxiety. To know what to do with such changes, you need to understand how ESR analysis is carried out in children and how its results are deciphered.

What is ESR and how is its value determined?

The abbreviation ESR abbreviates the “erythrocyte sedimentation rate,” which is found during a clinical blood test.

The indicator is measured in millimeters per hour. To determine it, blood combined with an anticoagulant (it is important that it remains liquid) is left in a test tube, allowing its cells to settle under the influence of gravity. After one hour, the height of the upper layer is measured - the transparent part of the blood (plasma) above the blood cells that have settled down.

Nowadays, in many medical institutions, ESR is determined using an automatic device.

Table of norm values

The normal ESR results are:

An increase in the rate between the 27th day of life and two years is considered normal. In children of this age, ESR can reach 12-17 mm/h. In adolescence, the results differ for girls (an indicator of up to 14 mm per hour is considered normal) and for boys (an ESR of 2-11 mm per hour is considered normal).

Why is it below normal?

Deviations of ESR from the norm are often manifested by an increase in this indicator, and a decrease in the rate at which red blood cells are deposited is observed much less frequently. Most common cause Such changes are caused by increased blood viscosity.

A lower ESR occurs when:

• Dehydration, for example due to acute intestinal infection.
• Heart defects.
• Sickle anemia.
• Acidosis (lowering blood pH).
• Severe poisoning.
• Sharp weight loss.
• Taking steroid medications.
• An increase in the number of blood cells (polycythemia).
• The presence in the blood of red blood cells with an altered shape (spherocytosis or anisocytosis).
• Pathologies of the liver and gall bladder, especially manifested by hyperbilirubinemia.

Reasons for increasing ESR

A high ESR in a child does not always indicate health problems. This indicator can change under the influence of various factors, sometimes harmless or temporarily affecting the child. However, quite often an increase in ESR is a sign of illness, and sometimes very serious.

Non-hazardous

For such reasons it is typical a slight increase in ESR, for example, up to 20-25 mm/h. T What ESR indicator can be detected:

• During teething.
• With hypovitaminosis.
• If your child is taking retinol (vitamin A).
• In case of strong feelings or stress, for example, after a baby has been crying for a long time.
• During a strict diet or fasting.
• When taking certain medications, such as paracetamol.
• If there is an excess of fatty foods in the diet of a baby or a nursing mother.
• After vaccination against hepatitis B.

In addition, in childhood the so-called C syndrome of increased ESR. With it, the indicator is high, but the child does not have any complaints or health problems.

Pathological

In diseases, ESR increases much more than normal, for example, to 45-50 mm/h and higher. One of the main reasons for faster erythrocyte sedimentation is an increase in the amount of protein in the blood due to an increase in the level of fibrinogen and the production of immunoglobulins. This condition occurs during the acute phase of many diseases.

Also, a common reason for a higher ESR is the appearance during inflammatory diseases immature red blood cells. All these changes lead to faster sedimentation of blood cells, resulting in an increase in ESR.

An increase in ESR is observed when:

• Infectious diseases. An increased rate is often diagnosed with bronchitis, ARVI, scarlet fever, sinusitis, rubella, cystitis, pneumonia, mumps, as well as tuberculosis and other infections.
• Poisoning, for example, caused by toxins in food or salts of heavy metals.
• Helminthiasis and giardiasis.
• Anemia or hemoglobinopathies.
• Injuries of both soft tissues and bones. ESR also increases during the recovery period after surgery.
• Allergic reactions. ESR increases both during diathesis and anaphylactic shock.
• Joint diseases.
• Tumor processes, for example, with leukemia or lymphoma.
• Endocrine pathologies, for example, diabetes mellitus or thyrotoxicosis.
• Autoimmune diseases, in particular lupus.

ESR in infections

The most common pathological cause of an increase in ESR is infectious diseases. In this case, the nature of the infection can be determined by the leukocyte formula, because leukocytes and ESR are elevated in a child with both a viral and bacterial infection. However, in case of infection with a virus, the leukoformula will show lymphocytosis. If the infection is bacterial, a white blood cell count will indicate an increased number of neutrophils.

It should be remembered that to diagnose an infection, not only changes in the blood are taken into account, but also clinical picture, as well as medical history. In addition, it is important to note that after recovery, the ESR remains elevated for several months.

About the ESR norm and reasons increased indicators watch in the next video.

Symptoms

In some cases, nothing bothers the child at all, and changes in ESR are detected during a routine examination. However, often a high ESR is a sign of illness, so babies will also have other symptoms:

• If red blood cells sediment faster due to diabetes, the child will experience increased thirst, increased urination, weight loss, skin infections, thrush and other signs.
• With an increase in ESR due to tuberculosis the child will lose weight, complain of malaise, cough, chest pain, headaches. Parents will notice a slight increase in temperature and poor appetite.
• With such dangerous cause of increased ESR, such as an oncological process, the baby’s immunity will decrease, lymph nodes will increase, weakness will appear, and weight will decrease.
• Infectious processes, in which the ESR increases most often, will be manifested by a sharp rise in temperature, increased heart rate, shortness of breath and other signs of intoxication.

What to do

Since most often a high ESR signals the doctor about the presence of an inflammatory process in the child’s body, a change in this indicator should not go unnoticed by the pediatrician. In this case, the actions of doctors are determined by the presence of any complaints in the child.

As a rule, the activity of the disease and the level of ESR have a direct relationship - the more extensive the inflammation and the more severe the disease, the higher the ESR will be. And therefore, indicators of 13 mm/h or 16 mm/h will not alert the pediatrician as much as ESR of 30, 40 or 70 mm/h.

If the child does not have any manifestations of the disease, and the ESR in the blood test is high, the doctor will refer the child for additional examination, which will include a biochemical and immunological blood test, chest x-ray, urinalysis, ECG and other methods.

If no pathologies are detected, and an increased ESR, for example, 28 mm/h, remains the only warning symptom, after some time the pediatrician will refer the baby to retake a clinical blood test. The child will also be recommended to determine C-reactive protein in the blood, which is used to judge the activity of inflammation in the body.

If an increase in ESR is a symptom of a disease, the pediatrician will prescribe medication.

As soon as the child recovers, the indicator will return to normal values. In case of an infectious disease, the child will be prescribed antibiotics and other medications; in case of allergies, the child will be prescribed antihistamines.

In any case, parents should understand that an increase in ESR is not an independent disease, but is only one of the symptoms. In this case, treatment should be aimed at the reason why red blood cells settle faster.

How to get tested

• To avoid a false positive result (an increase in ESR without the presence of inflammation in the body), it is important to get a correct blood test.
• ESR is influenced by quite a few factors, so when taking the test it is recommended to do it on an empty stomach and in a calm state.
• You should not donate blood after an X-ray, eating, crying for a long time, or physical therapy.
• It is advisable that the child eats no later than 8 hours before blood sampling.
• Immediately before taking blood, the baby needs to be calmed down, because whims and worries provoke an increase in ESR.
• It is not recommended to come to the clinic and immediately donate blood - it is better for the child to rest for a while after the street in the corridor and be calm.