CUBE 30 TOUCH | USER MANUAL
for pharmacological treatment in many diseases such as rheumatoid arthritis, vasculitis,
collagenosis and septic arthritis. The erythrocyte sedimentation rate is usually higher in
women compared to men, increases in pregnancy, and tends to rise with age in both
genders (Ref. 25).
1.4 Normal ESR values (Westergren citrated)
With the Westergren reference method, the test is performed on blood diluted in citrate,
with 4 parts blood to one part anti-coagulant. The diluted blood is then aspirated inside a
special, graduated, 2.5-mm diameter pipette and kept upright. The erythrocyte
sedimentation level is recorded after exactly one hour, measuring the distance between the
lower side of the plasma meniscus and the meniscus of the sedimented red blood cells.
Guidelines for ESR Reference Values for the Westergren ESR Method* are as follows:
Normal 0-20mm/hr
* Follow CLSI Procedures for the Erythrocyte Sedimentation Rate Test; Approved
Standard. CLSI document H02.
International guidelines identify 3 ranges of ESR: low (ESR <20 mm/hr), medium (20 <ESR
<60 mm / hr) and high (ESR> 60 mm/hr) (Ref. 16) regardless of gender and age.
The scientific literature attributes the normal value of ESR for the age of less than 50
years between 1 and 15 mm/hr for men and between 1 and 25 mm /hr for women. For
older ages these values increase and they stand in between 1 and 20 mm/hr for men and
between 1 and 30 mm/hr for women (Ref. 18). In pathological conditions these values
can increase up to values of 100 mm/hr and more.
Reference values should be established locally in accordance with the individual
laboratory’s accrediting agencies. Refer to CLSI document H02 for age and gender-
specific reference values.
A doctor must interpret the clinical significance of an ESR value obtained from
abnormal samples, including but not limited to icteric or lipemic samples,
samples with anemic conditions, low hemoglobin concentrations, hemolysis, or any
other pathological condition which can interfere or impede a clear reading of the
sedimentation. ESR testing performed on anomalous samples using manual or
automated methods are subject to a high degree of variability. In the CUBE 30 TOUCH,
these samples may be undetected, or they may yield varying results; for this reason, a
visual inspection of the sample at the conclusion of the test is recommended, to verify
the presence of a clear interface between the plasma and sedimented cells.
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