Therapeutic decisions in systemic lupus erythematosus SLE are based on the disease activity and nature of organ involvement. There are various clinical and laboratory methods to assess the lupus flares. Fifty one SLE patients with active disease lupus flare were studied. After remission these tests were done three monthly. Thirteen It was observed that 12 out of 13 The anti-dsDNA levels were elevated in all patients with predominant renal flare. On subgroup analysis it was noticed that this correlation is stronger for renal lupus.
Systemic lupus erythematosus SLE is a multisystem autoimmune disease with a wide spectrum of clinical manifestations characterized by remissions and exacerbations. Tissue damage in SLE is caused by autoantibodies and complement fixing immune complex deposition. Therapeutic decisions are based on the estimation of the degree of damage that may result from untreated disease activity. There are various methods to quantify disease activity, identify flares and to predict flares.
It is a weighted scale for 24 parameters and the score can range from zero to Various manifestations are scored based on their presence or absence in the previous ten days of evaluation.
Higher scores indicate more severe disease activity. SLEDAI has certain limitations in that it does not score some life threatening manifestations such as pulmonary haemorrhage and haemolytic anaemia. It is heavily weighted for central nervous system and does not take into account the severity of manifestations.
Global scores like SLEDAI can be problematic at times in that the score may be the same whether the patients are improving, stable or worsening. For instance a rash can improve and still be present, or deteriorate and yet the score may be same [ 4 ]. Serological tests are commonly used to assess the disease activity and predict lupus flare. During active disease, usually there is a fall in complement levels and a rise in anti-double stranded deoxyribonucleic acid anti dsDNA levels.
Literature suggests strong correlation between disease activity and a rise in dsDNA and fall in complement C3 and C4 levels [ 5 ]. However it may not be true in all patients. There are no prospective studies available in Indian patients on this subject.
These serological changes are analysed in various clinical presentations of SLE. Patients with predominantly renal involvement are compared with those having non-renal flares. Patients below 16 years and pregnant women were excluded from the study. Approval of the hospital ethics committee was taken. Informed consent was taken from every patient. All patients underwent baseline investigations for haematological and biochemical parameters, chest radiograph and electrocardiogram ECG.
Other special investigations were done as per clinical indication. SLEDAI score was calculated on initial visit and then during subsequent monthly visits till clinical remission. After remission these tests were repeated at three monthly intervals.Physicians and other health care professionals test patients periodically and will use the information derived from the tests in various ways.
ANA is a screening test, since almost all patients with lupus have a strongly positive test. Once positive, an ANA mostly stays positive, so need not be repeated. Many laboratories also measure pattern or the way the test looks when viewed through a microscope. Different types of ANA patterns may indicate different characteristics of lupus. These include:. It is usually associated with a homogeneous or peripheral ANA pattern.
Patients with this antibody who do not have SLE usually have a similar illness, such as rheumatoid arthritis. Sometimes the test is positive in otherwise well family members of lupus patients. Monitoring anti-dsDNA is important since levels usually vary with disease activity, high titers indicating active disease, low titers quiescent disease. Laboratories vary in how they report the test.
To know which is high you have to know the range used by the laboratory. A diagnosis of lupus is based on symptoms, physical examination abnormalities, and laboratory tests; not all patients with SLE have anti-dsDNA. It is non-specific and gives no useful information to a physician. Patients who do not have anti-dsDNA usually have a related antibody, anti-Sm. Anti-Sm anti-Smith, named for the first patient known to have this antibody is associated with a speckled ANA pattern and is the antibody seen in most patients who do not have anti-dsDNA.
Some patients have both anti-dsDNA and anti-Sm. Anti-Sm antibody binds to a protein that is attached to DNA. Unlike anti-dsDNA, the Sm antibody does not change in titer during the flare or treatment so need not be monitored.
Anti-RNP anti-U1 ribonucleoprotein is a non-specific antibody, associated with a speckled pattern that occurs in many patients with SLE and other rheumatic diseases. When present in high titer—again, check how the laboratory reports its values to interpret the test--without other autoantibodies anti-RNP suggests a specific lupus-like disease, called mixed connective tissue disease MCTDcharacterized by lupus, scleroderma, and dermatomyositis-like symptoms, that include:.
Two different groups of researchers found these antibodies almost simultaneously.
Understanding Laboratory Tests and Results for Lupus (SLE)
These autoantibodies are associated with a speckled ANA. Distinguishing among them is useful in some special circumstances. The heart condition occurs mostly in children of women who are strongly positive for all three 60, 52, and 48kd antibodies. For this reason fetuses of pregnant women with this antibody profile are closely monitored, usually with fetal electro- or echocardiograms, neither of which requires needles or other invasive procedure.
Laboratory tests that identify aPL are:.Forums New posts Search forums. What's new New posts New profile posts Latest activity. Members Current visitors New profile posts Search profile posts. Log in Register. Search titles only. Search Advanced search…. New posts.
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Test results confusion: C3 C4, low
For the last six months I have been really tired. I have also developed discoid lupus in the last two weeks. I've been on placqeunil mg a day for many years. Kathy, Thank you for your reply.
I went to the Rheumatologist yesterday, he believes its my fribromyalgia acting up. I did have some kidney involvement back in because of estrogen replacement caused me to flare and it caused protein in my urine, but it cleared up when I stopped the hormones.
The doctors did run urine screen on me and every thing was normal. He also doubled my placquneil and gave me Trazodone 50mg to help me sleep. Please excuse my spelling. Thanks again for your time. SandiZ New Member.Thanks to dr. All you need do just Email:- pointekhack gmail. Another Amazing thing to you benefit from Hiring our Hackers is that you get a Legit and the best Hacking service, As we provide you with Professional Hackers who have their Hacking Areas of specialization.
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One day I was in the river thinking about where I can go to get a solution. He told me everything I had to do and also gave me instructions to take, which I followed correctly. Good luck! Uche also cures ALS Lou Gehrig's disease 5. Hepatitis B6. COPD chronic obstructive pulmonary disease. I found that I was answering the same questions repeatedly in different discussion boards and the like, and figured it would be easier to make it so I can just link to one site. All the symptoms of mono, including never ending fatigue.
Was started on 10mg prednisone. As time went by more symptoms such as chest pain, shortness of breath, numbness and tingling in the right arm and leg, strange headaches. Prednisone was still the drug of choice. She is leaning toward the idea of chronic fatigue. I had had some time enduring some extreme stress six years ago from family and evidently infected with Epstein Barr.
I have read in an article from the Mayo Clinic that a serious viral infection combined with extreme stress and some degree of depression can be the precursor to chronic fatigue. Feel physically terrible and very confused. It is absolutely possible to have chronic fatigue and SLE at the same time. Honestly, I don't think it's possible to have active lupus without having chronic fatigue, as a matter of fact.
Every time I see a new study "demonstrating" this completely obvious fact I want to smack the researcher upside the head with my Captain Obvious baseball bat. And blood tests are not great diagnostic tools, in my opinion. I normally have very few markers of active lupus even when I am obviously very sick. As for prednisone, for me it has two drawbacks: 1 If I take it for more than 3 days I get suicidal, and 2 It only works when I get mg or higher doses.
I'm not a clinician, so I can't give you a diagnosis, but I can say that I have had similar blood results even after my lupus diagnosis. It infects the same cells that produce the antibodies that damage the body when someone has lupus. There has been a lot of speculation that it may be a risk factor for developing lupus, but I don't think it has ever been proven.
My own experience was that I developed autoimmunity after getting EBV. As a side note, there was a paper that just came out that showed that some cases of chronic fatigue syndrome are caused by undiagnosed autoimmune diseases.
C3 C4 Blood Test Results Explained
This was discovered when people with CF went on chemo for cancer which kills the immune systemand found that their CF went away while they didn't have an active immune system.It appears you have not yet Signed Up with our community. To Sign Up for free, please click here All rights reserved. Do not copy or redistribute in any form! Jul 25, I asked the rheumatologist what else could cause low complement levelsI've looked into complement defficiency causing a Lupus-like syndrome, but my Ch50 was normal She said that at this point I have an "undiagnosed autoimmune disease" Jun 7, Hi there I'm still plugging along waiting for a dx She tested me for vasculitis, because of the low c3 c4but she did the ANCA test althougth those vasculitides don't come with low complements, so The last time I was in the hospital alkalosis, abnormal EKG and electrolytes For this reason I wish that the rheumy wouldn't "wait" she wants to see me every 6 months to check for protein in the urine and the complement levels Although I meet at least the 4 clinical criteria, she isn't interested in that, only the ANA.
The thing is that I have still been going through other tests dermatologist says it can be dermatomyositis, but EMG was neg.
MRI, etc. MRI was negative, so they want to do tests on the fluid, but that means going to a big medical center and being told by more doctors that it's "non-specific" I have done so much research to put together my symptoms ALL of the typical Lupus symptoms Add in the fibromyalgia that I have been diagnosed with, and it just comes up Lupus.
Test results confusion: C3 C4, low
I wonder if at this point it is time to stop trying to find what else it could be, and just wait for the ANA to turn positive. What about "lymph" blood tests-do you mean part of the WBC?
I have 3 kids and besides the fibro stuff, I can barely move sometimes from weakness myelitisnausea, etc. All times are GMT The time now is PM. Mark Boards Read. Lupus Board Index. Jun 7, Hi thereThis protein is part of the complement system. The complement system is a group of nearly 60 proteins that are in blood plasma or on the surface of some cells.
The proteins work with your immune system and play a role to protect the body from infections, and to remove dead cells and foreign material. Rarely, people may inherit deficiency of some complement proteins. These people are prone to certain infections or autoimmune disorders.
There are nine major complement proteins. They are labeled C1 through C9. This article describes the test that measures C3. Blood is drawn from a vein venipunctureusually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test. Blood is drawn from a vein. Most often, a vein from the inside of the elbow or the back of the hand is used. In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed.
The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding. When the needle is inserted to draw blood, some people feel moderate pain. Afterward, there may be some throbbing.
A complement test may be used to monitor people with an autoimmune disorder. It is done to see if treatment for their condition is working. When the complement system is turned on during inflammation, levels of complement proteins may go down. For example, people with active lupus erythematosus may have lower-than-normal levels of the complement proteins C3 and C4. Complement activity varies throughout the body. For example, in people with rheumatoid arthritiscomplement activity in the blood may be normal or higher-than-normal, but much lower-than-normal in the joint fluid.
Note: Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results. The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens. The complement cascade is a series of reactions that take place in the blood.
The cascade activates the complement proteins. The result is an attack unit that creates holes in the membrane of bacteria, killing them. C3 attaches to bacteria and kills them directly. C3 complement beta-1c-globulin - serum. Laboratory Tests and Diagnostic Procedures. Holers VM. Complement and its receptors: new insights into human disease. Annu Rev Immunol.
PMID: www.Complement tests are ordered by medical providers in order to determine the presence of an abnormality or a deficiency within the complement system. It may be used to look at pathways or components that could be leading to disease development or a deteriorating condition.
One of the most common forms of complement system testing is the C4 complement blood test result. To help with the diagnostic process of microbial infections that occur on a regular basis. To help monitor complex-related conditions or diseases such as vasculitis. A medical provider will order the C4 complement blood test when there is edema or inflammation of an unexplained nature. The complement system helps the immune system eliminate pathogens that may have invaded the body. C4 levels are just one of the complement measures that are looked at.
C3, CH50, and CH blood tests may also be ordered for a complete look at the immune system to determine at least a guess as to what may be happening medically.
If someone has been to a medical provider several times within a short amount of time because of recurring bacterial infections, then a follow-up appointment for the C4 complement blood test is often a good idea. Any time there are symptoms that could be tracked to an autoimmune disorder is also a good time to speak with a doctor.
Inflammation that occurs for some reason without explanation may also trigger this blood test order. People who have certain symptoms of lupus should immediately approach their medical provider for this test. This includes mouth ulcers, hair loss, a butterfly rash across the checks, and unusual joint pain or swelling.
No preparation is usually necessary for this blood test to be completed. It can be drawn the same day that it is ordered. The C3 blood test is often ordered with the C4 complement blood test.
All components from C1-C9 may be requested. The C4 complement blood test can be abnormally high or abnormally low. Most people, however, will have a test result that comes back as normal.
If the test results show that there is a C4 deficiency, then it can mean there could be a number of potential health concerns present. The most common would be a bacterial infection. There may also be these additional health concerns based on an individualized medical history. When there is an increased level of C4 in the blood test results, then this is generally an indication that there is inflammation happening somewhere within the body.
This may be acute or chronic in nature.