Q: My 50 years old mother’s complete blood count and Erythrocyte sedimentation rate (ESR) test results are cited below: WBC 6500 RBC 4.6 lakhs HGB 12.9 g/dl HCT 38.2% MCV 82.9 fL MCH 28.0 pg MCHC 33.8 g/dL PLT 247 x 103/micro L RDW 42.2 fL PDW 13.6 fL MPV 10. 1 fL P-LCR 27.4 % Do the test report indicate that my mother is suffering from tuberculosis?

A:Erythrocyte sedimentation rate (ESR) is a nonspecific screening test for various diseases. It is a simple and inexpensive test that measures the distance that red blood cells have fallen after one hour in a vertical column of anticoagulated blood under the influence of gravity. The amount of fibrinogen (a blood protein) in the blood directly correlates with the ESR. Although many studies have been done, an increased ESR remains a nonspecific finding. The use of the ESR as a screening test in asymptomatic persons is limited by its low sensitivity and specificity as it is affected by many variables. Women tend to have higher ESR values, as do the elderly. Obese people too tend to have raised ESR for some unknown reason though this is not thought to have any clinical significance. Any condition that increases fibrinogen levels (e.g., pregnancy, diabetes mellitus, end-stage renal failure, heart disease, collagen vascular diseases, malignancy) may elevate the ESR. In anemia the ESR rises as the speed of the upward flow of plasma is altered so that red blood cell aggregates fall faster. Earlier, this test was commonly used as an index of disease activity in patients who had certain disorders. With the development of more specific methods of evaluation, the ESR has remained an appropriate measure of disease activity or response to therapy for only a few diseases like temporal arteritis, polymyalgia rheumatica, rheumatoid arthritis and, possibly, Hodgkins disease. The ESR remains an important diagnostic criterion for only two diseases: polymyalgia rheumatica and temporal arteritis. No obvious cause is apparent in fewer than 2 percent of patients with a markedly elevated ESR. An elevated ESR in the absence of other findings should not prompt an extensive laboratory or radiographic evaluation but a mild to moderately raised one without any obvious cause should be repeated after a few months rather than an expensive search for occult disease. The diagnosis of TB is based on specific tests like looking for the bacterium in the sputum (or other body fluids) and not ESR. Please consult a physician who can examine your mother and then advise appropriate tests to exclude TB.