ERYTHROCYTE SEDIMENTATION RATE AND C-REACTIVE PROTEIN: ARE THEY STILL WORTHWHILE?
Objective: It is important to use simple, cheap, rapid and reliable laboratory tests in primary care. Erythrocyte sedimentation rate (ESR), one of the most frequently used tests, has lost its popularity after the introduction of modern laboratory test in clinical practice. The aim of this study is to determine the sensitivity and specificity of ESR and C–reactive protein (CRP).
Method: Five hundred patients selected from Adana Numune Hospital Internal Medicine Outpatient Clinic were grouped as healthy, malignancy, rheumatological diseases, infections and other diseases using medical history, physical and laboratory examination.
Results: Of 500 patients, 36.6% (n=183) had infectious diseases, 34.2% (n=171) other diseases, 4.2% (n=21) malignancy, 6.2% (n=31) rheumatological diseases and 18.8% (n=94) were healthy. ESR increased by age in both genders. The highest ESR values were in malignant and rheumatological diseases. High ESR values were found in 100% of malignancy cases, 97% of rheumatological, 65% of infectious, 36% of other diseases and 22% of healthy individuals. Overall sensitivity of ESR was 72.3% and specificity was 77.7%; they were 53.2% and 83% for CRP, respectively. When compared with CRP, the sensitivity of ESR was 81.6% and specificity was 59.6%.
Conclusion: ESR for sensitivity and CRP for specificity seemed to be superior. Using two tests together might provide both high sensitivity and high specificity in diagnosis.