Which condition is a known cause of increased ESR?

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Multiple Choice

Which condition is a known cause of increased ESR?

Elevated ESR occurs when plasma proteins, especially fibrinogen and immunoglobulins, cause red blood cells to stack together in rouleaux. This rouleaux formation reduces the normal repulsive charge between cells (zeta potential), allowing them to form aggregates that settle more quickly in the tube, increasing the ESR. Conditions that raise acute-phase proteins or globulins—such as inflammatory states or monoclonal gammopathies—often show this effect. Decreased fibrinogen would tend to lower ESR, not raise it, because there’s less protein to bridge red cells. Low immunoglobulins would similarly reduce the protein-mediated interactions. Hypoglycemia has no direct impact on the factors that determine ESR.

Elevated ESR occurs when plasma proteins, especially fibrinogen and immunoglobulins, cause red blood cells to stack together in rouleaux. This rouleaux formation reduces the normal repulsive charge between cells (zeta potential), allowing them to form aggregates that settle more quickly in the tube, increasing the ESR. Conditions that raise acute-phase proteins or globulins—such as inflammatory states or monoclonal gammopathies—often show this effect.

Decreased fibrinogen would tend to lower ESR, not raise it, because there’s less protein to bridge red cells. Low immunoglobulins would similarly reduce the protein-mediated interactions. Hypoglycemia has no direct impact on the factors that determine ESR.

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