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To the Editor:—
The article, "Significance of Extreme Elevation of Erythrocyte Sedimentation Rate," by Zacharski and Kyle (202:264, 1967) states that "an elevated level may justify lengthy and costly laboratory and radiologic investigtions." When a patient is found to have an elevated erythrocyte sedimentation rate (ESR), even in the absence of signs or symptoms of disease, he should undergo a complete check-up until the cause of the elevation is found (Conn Med J19:871, 1955). Most of the time, evidence of an asymptomatic but severe disease will be found. If not, no conclusion can be made that "it would appear that a sedimentation rate of more than 100 mm in one hour is not always evidence of serious disease." The only thing one can say is that no evidence could be elucidated at this time, and that the patient must be observed for as long as the rate
Thau M. Erythrocyte Sedimentation Rate. JAMA. 1967;202(11):1057. doi:10.1001/jama.1967.03130240099029