Thanks to the analysis of the child's blood, it is possible to determine if the baby is healthy or if he has any diseases. This is especially important if the disease is latent. To identify such hidden pathologies, all children are routinely sent for tests at a certain age. And the analysis of the blood of children is given increased attention.
ESR is one of the important indicators determined in the laboratory in the study of blood. After seeing such an 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 blood of a child, this causes feelings and anxiety. To know what to do with such changes, you need to understand how ESR is analyzed in children and how its results are deciphered.
What is ESR and how is its value determined
The abbreviation ESR stands for "erythrocyte sedimentation rate", which is found during a clinical blood test. The indicator is measured in millimeters per hour. For its determination, the 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. One hour later, the height of the upper layer is measured - the transparent part of blood (plasma) above the blood cells that have settled down.
Now in many medical institutions the ESR is determined in an automatic device.
Table of norm values
When a blood test is deciphered, all indicators are compared with the standards that depend on the age of the children. This also applies to the rate of sedimentation of red blood cells, because the ESR immediately after birth will be the same, at the age of 2-3 years or 8-9 years, the indicator will be different.
The ESR norm is the following results:
An increase in the indicator at the age from 27 days of life to two years is considered the norm. In children of this age, the ESR can reach 12-17 mm / h. In adolescence, the results differ in girls (up to 14 mm per hour is considered the norm) and in boys (normal ESR is called 2-11 mm per hour).
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 erythrocytes are deposited is much less common. The most common cause of such changes is increased blood viscosity.
A lower ESR occurs when:
- Dehydration, such as from an acute intestinal infection.
- Heart defects.
- Sickle anemia.
- Acidosis (lowering blood pH).
- Severe poisoning.
- Dramatic weight loss.
- Taking steroid medications.
- An increase in the number of blood cells (polycythemia).
- The presence of altered erythrocytes in the blood (spherocytosis or anisocytosis).
- Pathologies of the liver and gallbladder, especially manifested by hyperbilirubinemia.
The reasons for the increase in 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 acting on the child. However, quite often an increase in ESR is a symptom of a disease, and sometimes very serious.
Non-hazardous
For such reasons, it is characteristic a slight increase in ESR, for example, up to 20-25 mm / h. TWhich ESR indicator can be detected:
- When teething.
- With hypovitaminosis.
- If the child is taking retinol (vitamin A).
- With strong feelings or stress, for example, after a long crying baby.
- With a strict diet or fasting.
- While taking certain medications, such as paracetamol.
- With obesity.
- With 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 Cindrom of increased ESR. With him, the indicator is high, but the child does not have any complaints and health problems.
Pathological
In case of diseases, ESR rises much more than the norm, for example, up to 45-50 mm / h and above. 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 cause of a higher ESR is the appearance of immature erythrocytes during inflammatory diseases. All these changes lead to more rapid sedimentation of blood cells, as a result of which the ESR increases.
An increase in ESR is observed when:
- Infectious diseases. An increased rate is often diagnosed with bronchitis, acute respiratory viral infections, scarlet fever, sinusitis, rubella, cystitis, pneumonia, parotitis, as well as with tuberculosis and other infections.
- Poisoning, for example, caused by toxins in food or heavy metal salts.
- Helminthiasis and giardiasis.
- Anemia or hemoglobinopathy.
- Injuries to both soft tissues and bones. ESR also rises during the recovery period after surgery.
- Allergic reactions. ESR increases both with diathesis and with anaphylactic shock.
- Diseases of the joints.
- Tumor processes, for example, with leukemia or lymphoma.
- Endocrine pathologies, for example, with diabetes mellitus or thyrotoxicosis.
- Autoimmune diseases, in particular lupus.
ESR for infections
The most common pathological cause of increased ESR is infectious diseases. At the same time, the nature of the infection can be determined by the leukocyte formula, because leukocytes and ESR are increased in a child with both viral and bacterial infections. However, in case of infection with a virus, there will be lymphocytosis in the leukoformula. If the infection is bacterial, the white blood cell count will indicate an increased number of neutrophils.
It should be remembered that for the diagnosis of infection, not only changes in the blood are taken into account, but also the clinical picture, as well as anamnesis. In addition, it is important to note that after recovery, the ESR indicator remains elevated for several months.
See the following video about the ESR rate and the reasons for the increased rates.
Symptoms
In some cases, the child is not worried about anything at all, and a change in ESR is detected during a routine examination. However, often a high ESR is a sign of a disease, so babies will have other symptoms:
- If red blood cells sediment faster due to diabetes, the child will have 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 pains, headaches. Parents will notice a slight increase in temperature and a deteriorated appetite.
- With such a dangerous cause of increased ESR, 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 rises 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 be ignored 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 pronounced 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 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 send the child for an additional examination, which will include biochemical and immunological blood tests, chest x-rays, urinalysis, ECG and other methods.
If no pathologies are detected, and an increased ESR, for example, 28 mm / h, will remain the only alarming symptom, the pediatrician after a while will send the baby for a retake of a clinical blood test. Also, the child will be advised to determine the 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 any 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 increased ESR is not an independent disease, but is only one of the symptoms. In this case, treatment should be directed to the cause due to which red blood cells are deposited faster.
How to get tested
To avoid a false positive result (increased ESR without inflammation in the body), it is important to get a blood test correctly. Quite a few factors affect the ESR, so when taking the analysis, it is recommended to carry it out on an empty stomach and in a calm state.
- Do not donate blood after x-rays, eating, crying for a long time, or physical therapy.
- It is advisable that the child eat no later than 8 hours prior to blood sampling.
- In addition, two days before the examination, very high-calorie and fatty foods should be excluded from the children's diet.
- On the day before the test, the child should not be given fried or smoked foods.
- Immediately before blood sampling, the baby needs to be reassured, because whims and experiences 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.
We recommend watching the release of the program of Doctor Komarovsky, which covers in detail the topic of clinical blood analysis in children
