Which statement is true regarding ESR/CRP in inflammatory/infectious states?

• A. ESR increases with age only
• B. ESR and CRP rise with infection or inflammation
• C. ESR decreases with age
• D. ESR is unaffected by inflammation

Answer: (B)

Inflammatory and infectious states trigger an acute-phase response, so markers of inflammation such as ESR and CRP tend to rise. CRP is produced by the liver in response to cytokines like IL-6 and climbs quickly, often within hours, signaling acute inflammation. ESR rises as plasma proteins such as fibrinogen increase and promote rouleaux formation of red cells, but it changes more slowly and can be influenced by factors like age, sex, anemia, and pregnancy. Because of these dynamics, the statement that both ESR and CRP rise with infection or inflammation is the best choice. The other options are inaccurate because ESR is not limited to age-related increases, ESR is not decreased by age, and ESR is not unaffected by inflammation.