title: Enhanced erythrocyte aggregation in clinically diagnosed pelvic inflammatory disease.
abstract: OBJECTIVE
  Enhanced erythrocyte aggregation, revealed using a simple bedside test, has been found recently in several inflammatory conditions. The diagnosis of pelvic inflammatory disease (PID) is at times difficult because of the vague symptoms and signs, but is crucial because even mild PID can have future reproductive consequences. Our objective was to determine the degree of erythrocyte aggregation in PID. The demonstration of an increase in aggregation could be of additive value in cases in which the diagnosis is difficult.
  
  
  METHODS
  A prospective case-control study was conducted. Fifteen consecutive women diagnosed clinically as having PID based on Centers for Disease Control and Prevention criteria, and 15 matched controls were enrolled. Blood samples were drawn for hematologic indices, C-reactive protein, fibrinogen levels, and red cell aggregation. We studied the degree of red cell aggregation using a simple slide test and image analysis. The variable measured was the erythrocyte percent (EP), equivalent to the slide area covered by erythrocytes.
  
  
  RESULTS
  Erythrocyte percent was 59.6 +/- 4.2 and 80.0 +/- 3.6 for the study group and controls, respectively (P <0.001). A significant difference was noted also for the other hematologic and biochemical markers of inflammation between patients and the controls.
  
  
  CONCLUSIONS
  We conclude that the degree of erythrocyte aggregation is increased in PID. Its simplicity, rapidity, and low cost should be further evaluated as a diagnostic tool in the context of this frequent disease.
authors.affiliation: Department of Gynecology, Lis Maternity Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. bennyalm@post.tau.ac.il
authors.forename: Benny
authors.initials: B
authors.lastname: Almog
authors.forename: Ronni
authors.initials: R
authors.lastname: Gamzu
authors.forename: Ronit
authors.initials: R
authors.lastname: Almog
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Lessing
authors.forename: Itzhak
authors.initials: I
authors.lastname: Shapira
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.forename: David
authors.initials: D
authors.lastname: Pauzner
authors.forename: Sharon
authors.initials: S
authors.lastname: Maslovitz
authors.forename: Ishai
authors.initials: I
authors.lastname: Levin
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004903:Erythrocyte Aggregation; D005260:Female; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000097:blood* / Q000175:diagnosis / Q000517:prevention & control*; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity