Proteins other than a cute phase reactants cause elevation of the ESR. High plasma concentrations of immunog lobulins,caused by myeloma or paraproteinaemias,are examples of this.
•The ESR is also affected by the size and shape of the red blood cells. Thus anaemia, old age and pregnancy can
lead to an elevationin ESR.
• Poly my algia rheumatica is characterized by an ESR >100 mm/hand pain and stiffness of the shoulder and pelvic girdles. It is rare before the age of 50 and is associated with giant cell arteritis.
This mnemonic provides a simplified list of the more common causes of immunodeficiency, which can be categorize in to primary (common variable) and secondary (the rest).