Lupus Lab Tests

Table of Contents

Blood Tests (w/ normal values) (normal values may vary from lab to lab)

• CBC - Complete Blood Count

  • Red Blood Cells - men 4.6-6.2, women 4.2-5.4
    • Low levels are common in lupus patients due to anemia
  • White Blood Cells - 4.5-11.0
    • Low levels are common in lupus patients
  • Hemoglobin - men 8.7-11.2, women 7.4-9.9
    • Low levels are common in lupus patients due to anemia
  • Hematocrit - men 40%-54%, women 37%-47%
    • Low levels are common in lupus patients due to anemia
  • Mean Corpuscular Volume - 80-100
  • Mean Corpuscular Hemoglobin - 28-32
  • Mean Corpuscular Hemoglobin Concentration - 32-36
  • Red cell Distribution Width - 1.7%-14.2%
  • Platelet - 150-400
    • Low levels are common in lupus patients
  • Neutrophils - 47%-77%
  • Band Neutrophils - 0-3%
  • Lymphocytes - 16%-43%
  • Monocytes - 0.5%-10%
  • Eosinophils - 0.3%-7%
  • Basophils - 0.3%-2%
• Comprehensive Metabolic Panel
  • Sodium (Na) - 135-145
  • Potassium (K) - 3.5-5
  • Calcium (Ca) - 9-10.5
  • Chloride (Cl) - 95-103
  • Carbon Dioxide - 23-29
  • Glucose - 70-125
  • Blood Urea Nitrogen (BUN) - 8-20
  • Creatinine - 0.7-1.2
  • Total Protein - 5.5-9
  • Albumin - 3.5-5.5
  • Total Bilirubin - 0.3-1.0
  • Alkaline Phosphatase Transferase (ALP) - 38-126
  • Aspartate Amino Transferase (AST) - 8-35
  • Alamine Amino Transferase (ALT) - 4-36
• Urinalysis
  • Color and Appearance
  • Specific Gravity - 1.006-1.030
  • pH - 4.6-8
  • Glucose - 0
  • Keytones - 0
  • Protein - 0
    • Proteinuria can indicate nephritis
  • White Blood Cells - 0
  • Red Blood Cells - 0
    • Hematuria can indicate nephritis
  • RBC or WBC casts - 0
    • Blood cell casts can indicate nephritis
• ESR or Sedimentation Rate - women 0-30, men 0-20
  • This test measures how quickly red blood cells settle in a test tube.
  • High rates indicate inflammation, but this is a very non-specific test, the inflammation can be anywhere in the body.
  • This test is used to help monitor disease activity. more...
• The Antinuclear Antibody (ANA) Test - titer below 1:20 or 1:40
  • 97% of Lupus patients have a positive ANA
  • A positive ANA is not however proof of lupus, many other diseases and infections can cause a positive ANA, users of certain medications as well as some otherwise healthy people may also have a positive ANA.
  • The titer indicates how many times the lab technician had to dilute plasma from the blood before the antinuclear antibodies are undetectable.
  • The pattern of the ANA test is used to help determine which autoimmune disease it may be. more...
• LE Cell
  • About 50% to 75% of patients with lupus have a positive test. Some patients with rheumatoid arthritis, scleroderma, and drug sensitivities (see drug-induced lupus erythematosus) also have a positive LE cell test.  This test is rarely performed because better tests now exist to diagnose Lupus.
• Antiphospholipid Antibodies (APLs)
  • These antibodies react to phospholipids as well as phospholipid-binding plasma proteins
  • APLs are usually detected in three types of laboratory assays
    • Anticardiolipin Antibody (ACA)
    • Lupus Anticoagulant
    • Syphilis Serology - certain blood tests for syphilis may be falsely positive in Lupus patients
  • A positive APL test along with the presence of arterial or venous thrombosis or thrombo-embolism or recurrent fetal deaths or thrombocytopenia is called Antiphospholipid Syndrome (APS)
• Other Autoantibodies -
  • Anti-dsDNA - an antibody specifically against double stranded DNA, these are found primarily in SLE patients
  • Anti-Sm - ribonucleoproteins found in the cell nucleus, are found almost exclusively in SLE
  • Anti-Ro (SS-A) and Anti-La (SS-B) - these are found in people with either lupus or Sjogren's Syndrome. Anti-Ro is strongly associated with photosensitivity.
• Complement Levels
  • Complement is a blood protein that destroys bacteria as well as helps mediate inflammation.
  • The most common complements are C3, C4, and CH50
  • Low levels of C3 and C4 with a positive ANA lends weight to a lupus diagnosis as well as may signify active Lupus. more...
• CRP or C-reactive Protein Test - less than 10mg/liter
  • A rise is this protein, that is produced by the liver, can indicate disease activity. more...
• CPK - men 55-170, women 30-135
  • A rise in this muscle enzyme can indicate active Lupus
• Biopsy
  • A sample of tissue from different parts of the body such as the kidneys may be taken and examined under a microscope for inflammation or scarring. This can aid in both diagnosis as well as determining the proper course of treatment.
    

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