The Diagnostic Value of Extremely Elevated Erythrocyte Sedimentation Rate in A Tertiary Pediatric Hospital

Abstract

Objective: The aim of this study was to evaluate the frequency, demographic and clinical characteristics of pediatric patients with extremely elevated erythrocyte sedimentation rate (ESR) in a reference children's hospital, and to improve clinicians' ability to use extremely elevated ESR in the differential diagnosis.

Material and Methods:  A retrospective cohort study was conducted to examine the clinical data of pediatric patients with extremely elevated ESR ( ≥100 mm/h). The patients were divided into 6 main groups according to their diagnosis as infectious, non-infectious inflammatory disease (NIID), malignancy, nephrologic, miscellaneus and unknown. Then, the specific sub-diagnoses of the patients were determined and evaluated. Clinical and laboratory data of the patients were recorded.

Results: We analyzed the results of a total of 3166 patients with high ESR (≥20 mm/h) and 189 (5.96%) patients with extremely elevated ESR were included in the final analysis. The most common etiology of extremely elevated ESR was NIID (35.9%), followed by infections (33.3%), malignancies (19.0%) nephrologic (2.6%), miscellaneus (4.7%) and unknown (4.2%). The most common specific diagnosis was acute rheumatic fever, Kawasaki disease, lymphadenitis and leukemia. The high ESR was only negatively correlated with hemoglobin and albumin levels.

Conclusion: Identifying the most common diseases that cause extreme ESR elevation in children can help clinicians in the differential diagnosis of diseases but it cannot be used as a screening tool for diseases.

Keywords

• Acute phase reactants
• erythrocyte sedimentation rate
• children
• differential diagnosis

Üçüncü Basamak Bir Çocuk Hastanesinde Belirgin Yüksek Eritrosit Sedimantasyon Hızının Tanısal Değeri

Abstract

Amaç: Bu çalışmanın amacı, referans bir çocuk hastanesinde belirgin olarak artmış eritrosit sedimantasyon hızı (ESR) olan pediatrik hastaların sıklığını, demografik ve klinik özelliklerini değerlendirmek ve klinisyenlerin aşırı yüksek ESR'yi ayırıcı tanıda kullanma becerilerini geliştirmektir.

Gereç ve Yöntem: Retrospektif, kesitsel olarak planlanmış olan bu çalışmada ESR değeri ≥100 mm/saat olan pediyatrik hastalar değerlendirilmiştir. Hastalar tanılarına göre enfeksiyöz, enfeksiyöz olmayan inflamatuar hastalıklar (NIID), malignite, nefrolojik, diğer ve bilinmeyen olarak 6 ana gruba ayrıldı. Daha sonra hastaların spesifik alt tanıları belirlenerek, klinik ve laboratuvar verileri değerlendirildi.

Bulgular: Yüksek ESR'si (≥20 mm/saat) olan toplam 3166 hasta içerisinde belirgin yüksek ESR'si olan 189 (%5.96) hasta çalışmaya dahil edildi. Belirgin yüksek ESR'nin en yaygın nedeni NIID (%35.9) iken, bunu enfeksiyonlar (%33.3), maligniteler (%19.0), nefrolojik (%2.6), diğer (%4.7) ve bilinmeyen (%4.2) olarak bulundu. En sık görülen spesifik alt tanı akut romatizmal ateş, Kawasaki hastalığı, lenfadenit ve lösemi idi. Yüksek ESR, yalnızca hemoglobin ve albümin seviyeleri ile negatif korelasyon gösterdi.

Sonuç: Çalışmamız 3. Basamak, referans bir çocuk hastanesinde yapılmış literatürdeki en geniş seridir. Çocuklarda belirgin ESR yükselmesine neden olan en yaygın hastalıkların bilinmesi, klinisyenlere ayırıcı tanıda yardımcı olacaktır.

Keywords

• akut faz reaktanlar
• eritrosit sedimentasyon hızı
• çocuklar
• ayırıcı tanı

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