<s>[INST] sir, my father is 71 years old  now ,when he was 68 he got knee pain and he went to ortho and he took varios test and confirmed nothing and ask him to take some pain killers if he get the pain. after few year, he got some rashes in leg few years ago , some times muscle and join pain, stiffness. He is suffering from this for last 2 years. Recently he got rashes and his blood clotted and he is taking blood thinning medications. for the last 2 years his ESR rate is  high - 110 mm/hr. His RA - negative, TB - negative, cancer test - negative, ANA - negative, CRP - negative, c-ANCA; p-ANCA - negative. Reumatologist based on the symptoms gave Immuno-suppresive medication- Zyclorin and PREDMET to control inflammation. is it right to take these medications ? what is the cause of high ESR ? please let me know [/INST] Thank you for posting your question. Although it is a bit difficult to comment on the exact diagnosis just from the tests and description, but I can certainly help you.  ESR is the short form for Erythrocyte sedimentation rate. It gets raised in any kind of inflammation. Your father certainly has some sort of an inflammation in the form of what may be  vasculitis,which is inflammation of blood vessels. These medications are an absolute okay. You can further ask your doctor about the diagnosis. There is not much to worry. Thank you </s>