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Re: New Dr.
Jun 4, 2005
Hi, deedea.

I just did some scouting around on peripheral blood smear tests. It doesn't look to me that it's specific to lupus. It seems to be looking at red, white & platelet counts; how "mature" the cells are; etc.

In lupus (per my hardcover), the following conditions are fairly common:

(1) Anemia, which can be caused by iron deficiency or chronic disease. But anemia in lupus can also be of the "immune-mediated" type, caused directly by immunological lupus-induced conditions. This is a tougher form often requiring steroids or immune suppressants.

(2) Low white blood cell counts, affecting the ability of the body to fight bacteria & increasing infection risk.

(3) Antibodies to platelets, esp. in people with lupus anticoagulant, lowering ability to properly clot. Steroids & immune suppressants could be required.

(4) Swollen lymph glands & enlarged spleen if its filtering ability becomes overwhelmed.

I just jotted down the most common ones here, so there are probably more... When do you see your dr. next?

ANA (antinuclear antibody) is a *threshold* blood test, and it can be positive in several autoimmunes (lupus, RA, scleroderma); or due to a passing virus; due to a family tendency (like close relatives with autoimmunes); simple aging; or certain prescription drugs. In other words, it's not very specific. It also isn't foolproof in that ANA can wax & wane with disease activity, so the timing of the test can matter.

When ANA is positive & lupus looks possible, typically a whole variety of more specific tests are run looking for *specific* autoantibodies such as anti-ds-DNA, anti-Sm, anti-Ro, anti-La, serum complemets (C3, C4, CH50), anti-RNP, various tests for antiphospholipid syndrome, rheumatoid factor, antiribosomal P, etc.

One other test seems to go straight to the issue of red blood cells. It's called Coombs' antibody; this is a test for autoimmune hemolytic anemia, which can be a serious SLE-induced problem.

There are people here who could probably provide more detail on the above, from their personal experiences. Anyway, I hope you get some results & answers quickly. All my best, Vee





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