Evaluation of sedimentation rate methodology reveals an unusual pediatric subpopulation with lupus or lupus-like syndrome and hemolytic anemia
© Wong et al; licensee BioMed Central Ltd. 2012
Published: 13 July 2012
Sedimentaion rate is often used to manage pediatric patients with rheumatologic disease. Most management decisions are dependent on studies which have used Wintrobe or Westergren sedimentation rate methodologies. However, these methods suffer from the need for relatively large amounts of blood and long turn-around times. Determination of sedimentation rate using laser kinetic rate determination has allowed calibration to Westergren methods, low volume of blood needed for testing and very rapid results. We sought to compare the Wintrobe method to the ESR Stat method (kinetic method; HemaTechnologies, Lebanon NJ) to determine suitability of the ESR Stat method for patient testing.
We performed a prospective comparison between the traditional Wintrobe and ESR Stat sedimentation rates in consecutive pediatric patients at a tertiary care pediatric hospital. Wintrobe and ESR Stat sedimentation data was fitted using a logarithmic model. Outliers were defined as those samples with ESR Stat sedimentation rates greater than 80 mm/hr and Wintrobe sedimentation rates less than 30 mm/hr (normal or mildly elevated sedimentation rate). Retrospective chart review was performed on all patients undergoing testing.
Discrepancies in Wintrobe and ESR Stat sedimentation rates may identify a subgroup of with lupus (or lupus-like syndrome) and a history of hemolytic anemia. Careful consideration of methodology is needed when sedimentation rate testing is performed on pediatric lupus patients.
Edward C. Wong: None; Deborah Yuan: None; Claas Hinze: None; Lawrence Jung: None.
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