Extremely high erythrocyte sedimentation rate revisited in rheumatic diseases: a single-center experience


Ozsoy Z., BİLGİN E., Aksun M. S., EROĞLU İ., KALYONCU U.

TURKISH JOURNAL OF MEDICAL SCIENCES, vol.52, no.6, pp.1889-1899, 2022 (SCI-Expanded) identifier identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 52 Issue: 6
  • Publication Date: 2022
  • Doi Number: 10.55730/1300-0144.5536
  • Journal Name: TURKISH JOURNAL OF MEDICAL SCIENCES
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.1889-1899
  • Gazi University Affiliated: Yes

Abstract

Background/aim: The objectives were to define the distribution of rheumatic diseases in patients with erythrocyte sedimentation rate (ESR) >= 100 mm/h and to find variables that can differentiate main study groups from others. Materials and methods: Charts of patients admitted with ESR >= 100 mm/h between 2015 and 2020 were reviewed. Patients were divided into four diagnostic groups based on etiology: infection (without a rheumatic diagnosis), oncologic (without a rheumatic diagnosis), rheumatic, and no definitive diagnosis. Patients with the rheumatic diagnosis were divided into three main study groups: those who had been recently diagnosed with a rheumatic disease, those who had a flare-up of the rheumatic disease, and those who had an infection in the course of the rheumatic disease. Appropriate statistical tests and decision-tree analysis by R and ROC curve were applied. p < 0.05 was considered statistically significant. Results: A total of 2442 patients (311 (12.7%) with rheumatic disorders) were identified. Eighty-six (27.7%) patients had newly diagnosed rheumatic disease (41; 47.7% with vasculitis); 111 (35.7%) had rheumatic disease flare-up (92; 82.9% with inflammatory arthritis); and 114 (36.6%) had coexisting infection (61; 53.5% inflammatory arthritis). Irrespective of the study group, the most commonly encountered diseases were rheumatoid arthritis and spondyloarthritis. Serum albumin levels (2.78 mg/dL) and platelet count (290/mm(6)) were valuable to discriminate disease flare-up and coexisting infection; moreover, high ferritin levels were accounted for adult-onset Still disease among patients with newly diagnosed rheumatic diseases. Conclusion: Extremely high ESR is still a valuable clinical parameter, and rheumatic causes are significant besides malignancy and infections. Albumin, thrombocyte count, and ferritin are other tests that clinicians should consider when caring for a patient with ESR = 100 mm/h who has rheumatic disease.