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Q
Hello,my mother (45 years old) has been diagnosed with Diverticulitis and eats a high-fiber diet. But however, she's been pretty ill for the past year, she has frequent bouts of flu-like symptoms and has been hospitalized 3 times. Each hospital visit has said that she was dehydrated, but she drinks large amounts of water most of the time. No one seems to be able to find out why she becomes so ill. One CAT scan revealed lesions on the left adrenal gland and tests reveal an elevated SED rate.

They are now doing blood tests and 24 hr. urine tests. The SED rate was 36. Could you tell us if this indicates anything serious and if they are on the right track? We are getting very frustrated as this has gone on for a long time. She also was diagnosed with Osteo-Arthritis in her spine. Any help you could give us would be greatly appreciated..

A
Hi ... sorry to hear about your mother.

Can't comment on your mother's problems or possible diagnosis, but I can tell you the significance of an elevated SED rate (Erythrocyte Sedimentation Rate, also ESR) - A rate of 36 (Westergren) is a bit high - the usual for adult females is 20mm/hour, a little higher with aging and pregnancy.

In itself, the SED rate is not a test that is specific for one illness - it's like taking a temperature to detect and monitor abnormal inflammation. It is difficult to interpret - the general feeling is that in screening symptomatic individuals, a complete history and physical examination is a much better tool for identifying abnormalities.

There are some patients where the SED is important, namely those suspected of having temporal arteritis or polymyalgia rheumatica. In these, rates of 100 or more are not uncommon. It can also be useful in monitoring certain conditions, e.g. rheumatoid arthritis, temporal arteritis, polymyalgia rheumatica and Hodgkin's Disease, where the activity of the disease is mirrrored by changes in the rate.

Best wishes to you and your mother.

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