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What might be the reason for high ESR?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

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

Please guide.

Hello,

Welcome to icliniq.com.

Based on the information provided, the elevated ESR (erythrocyte sedimentation rate) indicates that there may be an ongoing internal issue, but it does not pinpoint the specific problem or its location. It could be related to an infection, inflammation, or low hemoglobin levels. To gain a better understanding of the current health condition, it would be helpful to know if there is a history of joint pains or cardiac problems.

To provide a more accurate assessment, I would need to review all the reports, including the ESR value that is over 100, and perform a serum protein electrophoresis to rule out multiple myeloma. Additionally, if possible, please upload the chest X-ray. It's important to note that the search for the cause depends on the individual's medical history and symptoms rather than solely on the investigation results.

I hope I have cleared your doubts.

Please follow up with the reports.

Thank you.

Patient's Query

Hi doctor.

Thank you for your reply.

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 half a 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 problems, diabetes, etc. But he is hypotensive. I have attached the reports for your perusal.

Please guide.

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 workup done. Kindly do a 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.

I hope this helps you.

Thank you.

Patient's Query

Hi doctor.

Thank you for your reply.

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

Please guide.

Hello,

Welcome back to icliniq.com.

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

I hope this helps you.

Thank you.

Medically reviewed byDr. K. Shobana

Published At September 13, 2016
Reviewed AtApril 28, 2026

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