ESR is a very critical investigation in the diagnosis of Tb. Which of the following is true about ESR in TB?

Ans. c. ESR is raised because of increased RBC aggregate (Ref: Robbins 9/e p99, 8/e p75)when an inflmmatory process is present, the high proportion of fibrinogen in the blood cuses RBCs to stick to each other. Erythrocyte Sedimentation rateFibrinogen binds to red cells and causes them to from stacks (rouleaux) that sediment more rapidly at unit gravity than do individual cells. This is the basis for measuring the ESR.ESR is simple test for systemic inflammatory response caused by any stimulus.The ESR is a simple non-specific screening test that indirectly measures the presence of inflammation in the body.It reflects the tendency of red blood cells to settle more rapidly in the face of some disease states, usually because of increases in plasma fibrinogen, immunoglobulins, and other acute-phase reaction proteins.Changes in red cell shape or numbers may also affect the ESR.Note that the ESR denotes merely the presence of tissue damage or disease, but not its severityIt may be used to follow the progress of the diseased state, or monitor the effectiveness of treatment.ESRIncreasedDecreased* PregnancyQ* InflammationQ* AnemiaQ* Rheumatoid arthritisQ* CancerQ* Kidney disorders* PolycythemiaQ* Sickle cell anemiaQ* Hereditary spherocytosisQ* Congestive heart failureQ