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Reduced ESR

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Conditions which cause a decreased ESR include:

  • polycythaemia - vera or secondary
  • conditions which feature abnormal red blood cells:
    • sickle cell anaemia
    • hereditary spherocytosis
    • acanthocytosis
  • microcytosis e.g. haemoglobin disease, iron deficiency (1) produces an artefactual decrease in ESR
  • hypofibrinogenaemia:
    • disseminated intravascular coagulation
    • massive hepatic necrosis
  • over anticoagulation - clotted blood
  • high white blood cell count
  • cachexia
  • heart failure


  1. Pulse (2004), 64 (14), 100.

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