Heparin and the ESR

Shmuel Penchas, MD; Z. Stern, MD; David Bar-Or, MD
Arch Intern Med. 1978;138(12):1864-1865. doi:10.1001/archinte.1978.03630370070032.
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To the Editor.—  Heparin sodium is widely used as an anticoagulant in patients with thromboembolic phenomena, while the ESR is still widely used as a measure of inflammatory activity. There are cases in which the ESR is determined concurrently with the administration of heparin. Any interaction between the drug and the test is of interest, as it can influence clinical decisions.We noted that when blood is taken with heparin instead of citrate and the ESR is determined, exceedingly high values averaging 100 mm after one hour (1 SD ± 43) and 116 mm after two hours (1 SD ± 30) are found (13 mixed cases). The corresponding values for the same samples taken with citrate were 23 mm after one hour (1 SD ± 27) and 50 mm after two hours (1 SD ± 47). The difference is statistically significant at the P =.001 level (two-sided paired comparison t


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