Elevation of ESR, CRP, or Plasma Viscosity

CLINICAL DIAGNOSTIC MANUAL

Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and plasma viscosity are inflammatory markers used in clinical practice to assess the presence and severity of inflammatory or infectious processes in the body.

An elevation in these markers can indicate a significant inflammatory response due to various conditions, including infections, autoimmune diseases, neoplasms, and other chronic illnesses.

These markers are non-specific, so clinical context and additional tests are crucial to identify the underlying cause.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Severe bacterial infection	Fever, chills, sweating, fatigue, localised pain, systemic symptoms	Clinical history, acute symptoms	Full blood count, blood/urine cultures, elevated CRP and ESR
Giant cell arteritis	Headache, jaw pain, vision loss, fever, malaise	Elderly patients with typical symptoms	Elevated ESR and CRP, temporal artery biopsy, Doppler ultrasound of large vessels
Bacterial endocarditis	Fever, heart murmur, embolisms, Janeway lesions, Osler’s nodes	History of persistent fever, history of valvular disease	Positive blood cultures, echocardiogram, elevated ESR and CRP
Myeloma	Bone pain, anaemia, fatigue, recurrent infections, hypercalcaemia	History of chronic symptoms, elevated protein levels	Serum protein electrophoresis, bone marrow biopsy, elevated ESR
Prostate carcinoma	Urinary symptoms, bone pain, weight loss, fatigue	History of prostate symptoms, elevated PSA	Prostate biopsy, CT/MRI imaging, elevated ESR and CRP