Department of Laboratory Medicine, Hallym University, College of Medicine, Anyang, Korea.
Department of Occupational and Environmental Medicine, Hallym University, College of Medicine, Anyang, Korea.
Int J Lab Hematol. 2018 Oct;40(5):540-548. doi: 10.1111/ijlh.12859. Epub 2018 May 23.
The erythrocyte sedimentation rate (ESR) as measured using the Westergren method is extremely elevated in patients with monoclonal gammopathy (MG) owing to the abundance of positively charged paraproteins. However, it has not been determined if the ESR is likewise high in patients with MG when measured using alternate ESR methods.
The ESR was measured using both the modified Westergren and microhemagglutination method (TEST1) in 36 patients with MG and in 159 individuals with other diseases.
Erythrocyte sedimentation rates measured by the Westergren vs microhemagglutination methods showed substantial, but not remarkably high correlation. ESR measured using the Westergren method was higher in MG than in non-MG patients; however, ESR measured using microhemagglutination was not different in the 2 groups, resulting in a larger ΔESR (microhemagglutination ESR-Westergren ESR) in MG patients. When considered as continuous variables, none of the tested interfering plasma proteins (C-reactive protein, globulin, or fibrinogen) showed substantial correlations with Westergren or microhemagglutination ESRs. MG and low hematocrit were the only factors independently associated with ΔESR on multivariate analysis.
We demonstrated, for the first time, that the ESR as measured by microhemagglutination is not elevated in patients with MG compared with those without. The ESR does not correlate with a particular plasma protein, showing that its measurement is multifactorial. The presence of MG is an independent factor for ΔESR.
由于单克隆丙种球蛋白病（MG）患者中存在大量带正电荷的副蛋白，使用 Westergren 法测量的红细胞沉降率（ESR）极高。然而，尚未确定使用其他 ESR 方法测量时，MG 患者的 ESR 是否同样升高。
我们在 36 例 MG 患者和 159 例其他疾病患者中分别使用改良 Westergren 和微血凝法（TEST1）测量了 ESR。
Westergren 与微血凝法测量的红细胞沉降率之间存在显著但并非非常高的相关性。与非 MG 患者相比，Westergren 法测量的 ESR 在 MG 患者中更高；然而，两组之间微血凝法测量的 ESR 没有差异，导致 MG 患者的 ΔESR（微血凝法 ESR-Westergren ESR）更大。当作为连续变量考虑时，测试的干扰血浆蛋白（C 反应蛋白、球蛋白或纤维蛋白原）均与 Westergren 或微血凝法 ESR 无明显相关性。多元分析显示，MG 和低血细胞比容是与 ΔESR 独立相关的唯一因素。
我们首次证明，与无 MG 患者相比，使用微血凝法测量的 ESR 在 MG 患者中并未升高。ESR 与特定的血浆蛋白不相关，表明其测量是多因素的。MG 的存在是 ΔESR 的独立因素。
