ESR is a non-specific inflammation marker influenced by various factors including anemia, pregnancy, and smoking. C-reactive protein (CRP) is a less expensive and more sensitive and specific reflection of the acute phase of inflammation, hence should be used for this purpose. In the first 24 hours of a disease process, the CRP will be elevated, while the ESR may be normal. If the source of inflammation is removed, CRP will normalize within a day or so, while ESR will remain elevated for days. Only CRP should be used as a measure of systemic inflammation. For more information:
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