How is the erythrocyte sedimentation rate (ESR) measurement used in the diagnosis of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Updated: Sep 20, 2018
  • Author: Burke A Cunha, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Erythrocyte sedimentation rate (ESR) elevations occur in virtually all patients early in the course of EBV infectious mononucleosis. Similar to the early and mild elevations of the serum transaminases that occur in EBV infectious mononucleosis, an elevated ESR can be a useful diagnostic test early in the course of the disease in patients presenting with pharyngitis. While the ESR is elevated in patients with EBV as well as with other causes of viral pharyngitis, it is not elevated in patients with group A streptococcal pharyngitis. In patients with pharyngitis, elevations of the ESR are most useful in differentiating EBV infectious mononucleosis from group A streptococcal pharyngitis early in the course of the disease before the heterophile or the antistreptolysin-O (ASO) titers increase.

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