Abstract

ABSTRACTTo reevaluate the diagnostic significance of a markedly elevated erythrocyte sedimentation rate (ESR), the clinical diagnosis associated with an ESR of 100 mm/hr or greater was retrospectively analyzed in 200 patients at the Massachusetts General Hospital. In contrast to previously reported experiences in the American literature suggesting a high frequency (58%) of malignant disease in such patients, the present study found infections to be the most frequently associated diseases (35%), while malignant disease accounted for only 15% of the patients. Review of the foreign literature similarly suggested infection rather than malignancy as a major association with markedly elevated ESRs. It is concluded that an ESR ≥ 100 mm/hr has little diagnostic specificity and should not of itself dictate evaluation for occult malignancy in most patients.