ERYTHROCYTE SEDIMENTATION RATE :GUIDELINES

Svakodnevne su kliničke dileme vezane uz interpretaciju povišenih vrijednosti sedimentacije eritrocita (SE). Prikazom recentne literature izabrali smo neke od smjernica za svakodnevnu kliničku praksu. Klinička slika i fizikalni nalaz (nedavni respiratorni infekt, koæne promjene artralgija, glavobolja, mišićni bolovi, mršavljenje, anemija, srčani ¹umovi , multipli mijelom) te dodatna laboratorijska evaluacija (kompletna krvna slika, urea, kreatinin, alkalna fosfataza, elektroforeza proteina, analiza urina, stolica na okultno krvarenje, RTG srca i pluÊa, PPD) osnovna su evaluacija u pacijenta s ubrzanom SE. Iako nespecifična, SE je važan parametar u ranoj dijagnostici i praćenju bolesti, te ga ne bi trebalo podcijeniti, ali niti precijeniti u kliničkoj obradi.Interpretation of elevated erythrocyte sedimentation rate (ESR) is still everyday clinical dilemma. We rewieved recent literature and suggested guidelines for rational use of ESR. Clinical data and physical examination (recent respiratory infection, skin changes, arthralgia, headache, muscular pain, weight loos, anemia, heart murmurs, multiple myeloma) as well as laboratory evaluation (blood analysis, BUN, creatinine, alcaline phosphatase, protein electrophoresis, urianalysis, occult blood in the feces,chest X-ray, PPD) are basic evaluation in patients with elevated ESR. ESR is nonspecific but important parameter in early diagnosis and follow up so it should not be underestimated or overestimated in clinical practice

A Case of Visceral Leishmaniasis in the Northern Adriatic Region

A 33-year-old male patient with fever, splenomegaly, pancytopenia and lymphocytosis was admitted to the Department of Hematology in Rijeka. Laboratory findings, bone marrow aspiration and biopsy excluded hemoblastosis and aplastic anemia. To exclude primary splenic lymphoma we performed splenic aspiration where Leishmania amastigotes were found. No cases of visceral leishmaniasis have been previously described in the Northern Adriatic region. Considering epidemiology, a contraction of the disease in the Velebit mountain range could be possible despite the current non-endemic status of the region