Comparative evaluation of Wintrobe method and the automated Alifax® system for Erythrocyte Sedimentation Rate determination
DOI:
https://doi.org/10.71068/52yb8j78Keywords:
ESR, Wintrobe, Alifax®, InflammationAbstract
The erythrocyte sedimentation rate (ESR) was a widely used hematological test that served as a nonspecific marker of inflammation. Despite the development of more specific techniques, its simplicity, low cost, and clinical value in the appropriate context maintained its relevance in medical practice. This article addressed the principles, advantages, and technical considerations of two methods used for ESR measurement: the manual Wintrobe method and the automated Alifax® system.
The Wintrobe method, although less sensitive than the Westergren method, allowed ESR determination without sample dilution and with a smaller blood volume, making it useful in low- resource settings or for special populations. In contrast, Alifax® used automated capillary photometry technology, providing results equivalent to the reference method in just 20 seconds, with high reproducibility and operational efficiency.
A key aspect of this study was the discussion of reference values, which should not have been considered interchangeable across methods. While Wintrobe tended to underestimate ESR in cases of active inflammation, Alifax® adopted the reference ranges of the Westergren method, for which it had been calibrated. Therefore, the need to establish and validate method-specific reference values for each population was emphasized.
This study established specific reference intervals for ESR, stratified by sex, age, and analytical method, in accordance with the guidelines of CLSI EP28-A3c. The results showed consistent
differences between the manual Wintrobe method and the automated Alifax® system, highlighting the importance of not interpreting their results interchangeably. Thus, it was essential for each laboratory to validate its own reference intervals to ensure accurate and clinically meaningful diagnostic interpretation.
This work underscored the importance of selecting the most appropriate method for each clinical setting, considering both patient characteristics and laboratory capabilities, to ensure proper interpretation and effective integration of ESR in medical decision-making.
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Copyright (c) 2025 Alfredo Ibarra-Sánchez, Claudia Soto-Félix , Anaid Guzmán-Mendoza , Leticia Cano-Barraza , Delia Barraza-Sámano (Autor/a)
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