Q. What might be the reason for high ESR?

Answered by Dr. Naresh Kumar Monigari and medically reviewed by iCliniq medical review team.

 

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Hi doctor,

My father is 72 years old. His ESR is 102. All kidney, liver and hemoglobin are in the range along with clear chest x-ray. Recently, he had right ribs and collar bone fracture. Also, he was diagnosed to have hemopneumothorax and chest tube was given for that. What may be the possible cause for high ESR?


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Dr. Naresh Kumar Monigari
MBBS., MD GENERAL MEDICINE., FELLOWSHIP 2D ECHO
General Medicine, Internal Medicine

Hello,

Welcome to icliniq.com.

I had gone through all the details posted.

ESR is an acute phase reactant (erythrocyte sedimentation reaction). It suggests that there is something is going on inside body, but it does not localize the problem. Any infection, inflammation or low hemoglobin can cause raised ESR.

  • Kindly tell me any problem that he suffers from now?
  • Is there any history of joint pains or cardiac problem?
  • Can you upload all the reports for me?

I can have a look as some subtle variations you may not be aware of. As it is more than 100, it is better to do serum protein electrophoresis to rule out multiple myeloma. Kindly upload the reports and chest x-ray if possible and the search for the cause depends on history and symptoms rather than on investigations.

Revert back with the reports to an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

 

Thank you doctor,

He was very weak almost one month ago and did not like to eat anything. Now, he is able to eat regularly, but cannot walk for even a half kilometer and feels very tired. His BP has become high like 180/80 mmHg. He has no joint pain and there is no history of cardiac problem, diabetes, etc. But, he is hypotensive. I have attached the reports for your perusal.

 

Dr. Naresh Kumar Monigari
MBBS., MD GENERAL MEDICINE., FELLOWSHIP 2D ECHO
General Medicine, Internal Medicine

Hello,

Welcome back to icliniq.com.

I had gone through all the details posted (attachment removed to protect patient identity).

He has hypertension and feels very weak after walking. So, he needs to get a cardiac work up done. Kindly do fasting lipid profile, ECG and 2D echocardiogram, which will help to rule out any cardiac issue.

Feeling tired of walking can be related to heart disease. Also, check SPEP (serum protein electrophoresis). ESR can be elevated in cardiac problems. Kindly let me know what blood pressure medications he is on. Decrease salt content in the diet and avoid pickles.

Revert back with the reports to an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

 

Thank you doctor,

Sure, I will do as per your advice. He has been taking Envas-5 daily for BP.

 

Dr. Naresh Kumar Monigari
MBBS., MD GENERAL MEDICINE., FELLOWSHIP 2D ECHO
General Medicine, Internal Medicine

Hello,

Welcome back to icliniq.com.

I had gone through the data posted. As you mentioned the BP as 180, it means that BP is not in good control on that medication. Kindly mention about this to his cardiologist when you go for an evaluation and discuss on modifying therapy.

For further information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

 
 
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