A full set of tests for lupus or something

Lupus is an autoimmune disease and a particularly serious disease. If lupus is not treated in time or is not treated correctly, it can easily worsen the condition. In severe cases, it can cause damage to various organs and endanger life. However, don't be too discouraged if you have lupus. Maintain an optimistic attitude and actively cooperate with the doctor for treatment. The condition can be easily controlled and will not affect people's life safety.

What is a full lupus test?

1. The most common findings in blood routine and erythrocyte sedimentation rate are anemia of varying degrees, mostly normocytic normochromic anemia, a few are hemolytic anemia, with anti-erythrocyte antibodies, and about 15% of patients have a positive Coomb test. The white blood cell count is mostly (2.0～4.0)×109/L, among which the neutrophil or lymphocyte count is decreased. There is a significant correlation between lymphocyte decrease and the activity of SLE. When there is secondary infection, the white blood cell count may increase. If there is no infection, there will be no increase in white blood cell count even if there is a high fever. One-third of patients had mild thrombocytopenia. The ESR rate increases during the active period.

2. Urinalysis may show varying degrees of proteinuria, hematuria, and tubular urine or pyuria.

3. Biochemical examination may show elevated transaminase and abnormal turbidity test. When there is renal insufficiency, BUN and creatinine may increase. However, protein electrophoresis often shows elevated γ-globulin, a change that usually parallels the disease activity and decreases as the condition improves. Therefore, it can also be used as an indicator for dynamic observation of the disease.

4. Immunological examination

(1) Lupus cells: also known as LE cells, are formed when anti-nucleoprotein antibodies in the patient's serum act on the damaged cell nucleus, causing the nucleoprotein to change and form a round, structureless uniform body. The uniform body is phagocytosed by neutrophils to form LE cells. Using Wright's staining, a round, structureless, smoky, purple-red uniform body can be seen in a larger granulocyte, which pushes the nucleus of the neutrophil aside. If this homogenous body is not phagocytosed but surrounded by many neutrophils, a so-called "rosette" can be formed. The test method is to take the patient's blood and let it coagulate, keep it at 37℃ for 2 hours, break up the blood clot, centrifuge the sediment, take the light yellow upper layer of white blood cells smear for Wright staining, and examine it under an optical microscope. The positive rate of this method is 50% to 80%, and its positive rate is related to the examination time, number of times, whether treatment has been given, etc. Usually the positive rate is higher during the active and late stages of the disease and the test should be performed multiple times, and even dozens of tests may be needed to detect LE cells. LE cells are not specific for the diagnosis of SLE and can also be seen in dermatomyositis, scleroderma, rheumatoid arthritis, acute leukemia, etc. Because the method is complicated, affected by the individual influence of the examinee and the influence of drugs, and has a low positive rate, it is increasingly not used by people. Currently, simple and reliable antinuclear antibodies are used instead, and both have the same clinical significance.

(2) Antinuclear antibody spectrum:

① Antinuclear antibody (ANA): It is a general term for antibodies against various cell nuclear components. The ANA positivity rate of SLE is as high as 95%, and its titer is relatively high. ANA greater than 1:80 has great diagnostic significance for SLE. ANA is also not specific for SLE and can also be seen in other connective tissue diseases, such as scleroderma and Sjögren's syndrome, but its positive rate and titer are lower. Peripheral and homogeneous types are more common in SLE and have certain diagnostic significance.

② Anti-dsDNA antibodies are highly specific to SLE, with a positive rate of 50% to 80%. The antibody titer decreases as the disease improves.

③ Anti-Sm antibodies have high specificity and the positive rate in SLE patients is 20% to 30%. This antibody has no correlation with SLE activity.

④ Other autoantibodies, including anti-RNP antibodies, anti-SSA antibodies, anti-SSB antibodies, anti-histone antibodies, etc., may all be positive. There are many autoantibodies that may appear in SLE.

(3) Antiphospholipid antibodies include antiphospholipid antibodies, lupus anticoagulants, and biological false positive reactants (i.e., false positive syphilis tests), all of which are directed against essentially the same phospholipid antigens. Antibodies can inhibit blood coagulation in blood vessels, but patients with such antibodies not only have no tendency to bleed, but are more prone to arterial and venous thrombosis. In addition, habitual miscarriages and thrombocytopenia also often occur. The above symptoms and antiphospholipid antibodies together constitute antiphospholipid syndrome.

(4) Other autoantibodies for SLE: Antibodies against red blood cell membrane antigens show a positive anti-human globulin test, as well as anti-granulocyte antibodies, anti-platelet antibodies and anti-lymphocyte antibodies. Antibodies against Golgi apparatus, ribosomes, antibodies against cell framework components, microfibrils, etc. Rheumatoid factor is positive in about 1/3 of cases.

(5) Immunoglobulin: Most patients have elevated IgG and IgM levels, which is caused by the presence of multiple autoantibodies in the body.

(6) Complement: Half of the patients have hypocomplementemia. The decrease in serum total complement (CH50) and C3 levels can indirectly reflect the increase in the content of circulating immune complexes and is related to the activity of the disease. An increase in complement breakdown products C3a and C5a also indicates disease activity. There are many methods for detecting circulating immune complexes, but none of them is satisfactory.