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Lupus Lab Tests

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

Result meanings are not meant to be comprehensive. Included in this list is how these tests relate to Lupus. There are other causes for abnormal results.

Complete Blood Count (CBC)~Comprehensive Metabolic Panel (CMP)~Urinalysis~Sedimentation Rate (ESR)~Antinuclear Antibody (ANA)~LE Cell~Antiphospholipid Antibodies (APLs)~Other Autoantibodies~Complement Levels~C-reactive Protein (CRP)~Creatine Phospokinase (CPK)~Biopsy

  • CBC-Complete Blood Count

    • Red Blood Cells (RBCs) - men 4.6-6.2, women 4.2-5.4
      • This test counts how many red blood cells are in a blood sample
      • Red blood cells deliver oxygen to the body
      • Low levels of red blood cells is known as anemia
        • Lupus can attack and kill red blood cells causing low levels
        • Low iron levels can cause low red blood cells
        • Anemia of chronic disease can cause low red blood cells
        • Renal failure from Lupus Nephritis can interfere with the production of RBCs and cause low levels
        • Acute or chronic bleeding can cause anemia
      • High levels is known as polycythemia
        • Dehydration can cause an artificial rise in red blood cells
        • Smokers have higher red blood cell levels
        • Lack of oxygen from Lung disease can cause high RBCs
    • White Blood Cells (WBCs) - 4.5-11.0
      • This test counts how many white blood cells are in a blood sample
      • White blood cells are the body's defenders
      • Low levels of white blood cells is known as leukopenia
        • Lupus can attack and kill white blood cells causing low levels
        • Low levels can be caused by medications used to treat Lupus, primarily cheomotheraphy drugs
        • Overwhelming infections can "use up" WBCs causing leukopenia
        • Infections such as HIV, TB, Hepatitis or influenza can cause low WBCs
      • High Levels is called Leukocytosis
        • Infections of all kinds can cause a high white count
        • Inflammation can cause high white blood cell levels
    • Hemoglobin (Hgb) - men 8.7-11.2, women 7.4-9.9
      • This test counts how much hemoglobin is in a blood sample
      • Hemoglobin is an oxygen carrying protein
      • Low levels of hemoglobin is called anemia
        • Low iron levels can cause low hemoglobin
        • Anemia of chronic disease can cause low hemoglobin
        • Renal failure from Lupus Nephritis can interfere with the production of RBCs and cause low levels
        • Acute or chronic bleeding can cause anemia
      • High Levels
        • Dehydration can cause an artificial rise in hemoglobin
        • Smokers have higher hemoglobin levels
        • Lack of oxygen from Lung disease can cause high Hgb
    • Hematocrit (Hct) - men 40%-54%, women 37%-47%
      • This test determines the percentage of a blood sample that is made up of red blood cells
      • Low levels of hemoglobin is called anemia
        • Low iron levels can cause low hemoglobin
        • Anemia of chronic disease can cause low hemoglobin
        • Renal failure from Lupus Nephritis can interfere with the production of RBCs and cause low levels
        • Acute or chronic bleeding can cause anemia
      • High Levels is known as polycythemia
        • Dehydration can cause an artificial rise in hemoglobin
        • Smokers have higher hemoglobin levelsLack of oxygen from Lung disease can cause high Hgb
    • Mean Corpuscular Volume (MCV) - 80-100
      • This test measures the average size of each red blood cell
      • Larger than normal RBCs (elevated MCV) can indicate anemia caused by vitamin B12 deficiency
      • Smaller than normal RBCs (decreased MCV) can be caused by iron deficiency
    • Mean Corpuscular Hemoglobin (MCH) - 28-32
      • This test measures the average mass of hemoglobin in each red blood cell
      • Low levels can be found in certain types of amemia
    • Mean Corpuscular Hemoglobin Concentration (MCHC) - 32-36
      • This test measures the average concentration of hemoglobin in each red blood cell
      • Low levels can be found in certain types of amemia
    • Red cell Distribution Width (RDW) - 1.7%-14.2%
      • This test measures the variation in size of red blood cells
      • High Levels
        • Iron deficiency causes high RDW and low MCV
        • Folate and Vitamin B12 anemia causes high RDW and high MCV
        • Hemorrhage causes high RDW and normal MCV
    • Platelet - 150-400
      • This test counts the number of platelets in a blood sample
      • Platelets are pieces of blood cells that help blood clot
      • Low levels of platelets is known as thrombocytopenia
        • Medications used to treat Lupus, primarily chemotherapy drugs can cause high platelets
        • Lupus can attack and kill platelets causing low levels
        • Celiac Disease, another autoimmune disease, can cause low platelets
      • High levels of platelets is known as thrombocytosis
        • Some anemias can cause high platelets
    • Neutrophils (NEU) - 47%-77%
      • This test counts the percentage of neutrophils in a blood sample
      • Neutrophils are a type of white blood cell
      • Low levels of neutrophils is known as neutropenia
        • Lupus can attack and kill neutrophils causing low levels
        • Low levels can be caused by primarily chemotherpy drugs
        • Overwhelming infections, like sepsis, can "use up" WBC causing neutropenia
      • High levels of neutrophils is known as neutrophilia
        • Infections can cause low neutrophils
        • Inflammation can cause neutrophilia
    • Band Neutrophils - 0-3%
      • This counts the percentage of band neutrophils in a blood sample
      • Band Neutrophils are immature neutrophils
      • High band neutrophils can indicate inflammation
    • Lymphocytes (Lymphs) - 16%-43%
      • This test counts the percentage of lymphocytes in a blood sample
      • Lymphocytes are a type of white blood cell
      • Low levels of lymphocytes is known as lymphocytopenia
        • Lupus can attack and kill neutrophils causing low levels
        • Infections such as HIV, TB, Hepatitis or influenza can cause low Lymphs
        • Immune deficiency can cause lymphocytopenia
      • High levels of lymphocytes is known as lymphocytosis
        • Viral infections like hepatitis, chicken pox, rubella, Epstein Barr virus (EBV), and cytomegalovirus (CMV) can cause lymphocytosis
        • Bacterial infections such as tuberculosis (TB), and pertussis (whooping cough) can cause lymphocytosis
    • Monocytes (Monos) - 0.5%-10%
      • This test counts the percentage of monocytes in a sample of blood
      • Monocytes are a type of white blood cells
      • Low levels of monocytes is known as monocytopenia
      • High levels of monocytes is known as monocytosis
        • Chronic infections such as fungal infections and tuberculosis (TB) can cause monocytosis
        • Bacterial endocarditis can raise monocyte levels
        • Collagen vascular diseases such as Lupus, Scleroderma, Rheumatoid Arthritis, and Vasculitis can cause high monocyte levels
        • Inflammatory bowel disease can raise monocyte levels
    • Eosinophils (Eos) - 0.3%-7%
      • This test counts the percentage of eosinophils in a sample of blood
      • Eosinophils are a type of white blood cells
      • High levels of eosinophils is known as eosinophila
        • Inflammation of the skin as in dermatitis or eczema can cause low eosinophils
        • Parasitic infections can raise eosinophils
        • Inflammatory bowel disease can cause eosinophilia
    • Basophils (Baso) - 0.3%-2%
      • This test counts the percentage of basophils in a sample of blood
      • Basophils are a type of white blood cells
      • High levels is known as basophilia
        • Basophilia can be caused by inflammation
  • 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 (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)&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- less than 10mg/liter
    • A rise is this protein, that is produced by the liver, can indicate disease activity.more...
  • CPK or Creatine Phosphokinase Test - 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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