Associations with degrees of ESR change

Chronic elevation of ESR	Chronic depression of ESR	Subacute elevation of ESR	Subacute depression of ESR
RBC abnormalities (anemia and macrocytosis)	RBC abnormalities (sickle cell, microcytosis, polycythemia)	Inflammatory conditions and infections (PMR, rheumatoid arthritis osteomyelitis, etc)
Age	Other laboratory abnormalities (extreme leukocytosis or bile acid salts) and technical factors of assay performance	Malignancy	Other laboratory abnormalities (extreme leukocytosis or bile acid salts) and technical factors of assay performance
Female sex	Heart failure	Tissue injury or ischemia (gangrene)	Heart failure
Pregnancy	Cachexia	Trauma
Obesity, metabolic syndrome	Hypofibrinogenemia (eg, chronic liver failure)		Hypofibrinogenemia (eg, macrophage activation syndrome)
Renal disease (even on RRT)	High and moderate regular physical activity
Smoking	Light alcohol consumption

ESR: erythrocyte sedimentation rate; RBC: red blood cell; PMR: polymyalgia rheumatica; RRT: renal replacement therapy.

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