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Re: Anemia anyone
Jul 19, 2004
Hi, everyone. I did a browser search, on "anemia lupus" and found an article on it, which says---

(1) Anemia is the most common hematological abnormality in lupus. About 50% of ALL patients with active lupus have it at some point. Dx tests are either hematocrit, hemoglobin, or red blood cell count.

(2) It is not a specific condition, but rather one with many causes. In lupus, its main causes are listed in (3) to (6) below.

(3) Cause = *inflammation*: this hinders production of red blood cells by the bone marrow. Iron accumulates unused in the marrow. Treatment with iron is USELESS for this type: the underlying inflammation MUST be addressed.

(4) Cause = *prolonged uremia* (impaired kidney function): Treated with androgens or erythropoietin (a new hormone that stimulated red blood cell production). Sometimes blood transfusions are required, too.

(5) Cause = *iron deficiency* due to periods, internal bleeding: Unlike anemia caused by inflammation, this type is rapidly corrected with iron tablets.

(6) Cause = *autoimmune hemolytic anemia* (red blood cells being prematurely destroyed; instead of lasting 120 days, they live only 10-15): This condition has many causes, but in lupus patients, it's usually an autoantibody that is destroying red blood cells. Is treated with steroids like Prednisone; worse cases require removal of spleen &/or blood transfusions.

OTHER BLOOD DISORDERS SEEN IN LUPUS PATIENTS OTHER THAN ANEMIA include (a) thrombocytopenia (deficiency of blood platelets essential for clotting); (b) lupus anti-coagulant (which, despite its name, actually promotes instead of impedes clotting!); (c) granulocytopenia (low granulocyte count, most often caused by a medication reaction), which is usually not harmful, except that when severe it can cause susceptibility to bacterial infection; and (d) lymphocytopenia (low lymphocyte count), which is usually not harmful.

So.... it looks to me as though the standard tests (hemoglobin, hematocrit, & red blood cell count) DO identify anemia in lupus patients---BUT that *further work* would be needed to identify which of these common causes in lupus is to blame. That would seem to be the only way to determine which course of treatment is required---and those treatments clearly vary greatly, depending on cause.

Hmmmmm.... All very interesting?! I'd bet my own past problem was due to chronic inflammation, as mine cleared quickly on Plaquenil as it worked on the underlying inflammation... Vee (ready now to go back to sleep!)

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