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Old 06-14-2004, 10:15 AM   #1
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seatx HB User
Anemia anyone

Hey I know it is somewhat common for us to be anemic and that Plaquenil can be a cause, but can anyone else tell me what this means in the grand scope of things?

My dermapathologist just called and said my latest blood work looks great except that it appears as though I'm a "little anemic". Value in march was 13.3, now is 11.4, normal is 11.7.

My first thought was, "great, something else to make me tired"

Have scheduled a follow up with my rheumatologist.

Any info would be greatly appreciated. Thanks

 
Old 07-18-2004, 07:31 AM   #2
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Question Re: Anemia anyone

wow, my doctor used the exact same words, "a little anemic" i dont like that. i too would like to know why, (im not on plaquenal) and what can i do about it? a friend told me to eat a bowl of total with a glass of orange juice every day because it has your 100% dose of iron and calcium in orange juice makes your body absorb it. why are people with lupus prone to being a "little" anemic, and is it the same as when normal people are anemic, can we help it, or is it just something that comes in the bag??

 
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Old 07-18-2004, 08:27 AM   #3
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Re: Anemia anyone

Anemia is definitely part of the lupus package, alot of the lupus books mention it. My numbers are very low and I am not on Plaquenil. I was taking a high dose iron supplement (300mg daily), but the count still remained low. I did have an endometrial ablation, which has definitely helped my iron count come up into the low-normal range - something it NEVER was. Maybe someone else has another suggestion.

Shari

 
Old 07-18-2004, 08:36 AM   #4
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Re: Anemia anyone

Seatx & Living5oul.

I have never read that Plaquenil carries a high risk of being a contributing factor to anemia.

I have read (and just checked my lupus hardcover again) that the following are much higher contributing factors to anemia:
(1) SLE itself
(2) heavy monthly bleeding & resulting iron-deficiency anemia
(3) stomach lining bleeding (gastritis) from NSAID's (ibuprofen, aspirin, etc.)
(4) slowdown or shutdown of bone marrow, which produces red blood cells (slowdown = "hypoplasia" & shutdown = "aplasia")
(5) chronic renal (kidney) disease
(6) autoimmune hemolytic anemia (AIHA), where autoantibodies to the surface of red blood cells are being produced

My hardcover does mention a very uncommon problem with Plaquenil causing hair to change to gray, damage to muscle cells, and "lower blood counts"---but these side effects occur [so says my hardcover] LESS THAN ONE PERCENT OF THE TIME; and, further, THE RISK OF BLOOD COUNT PROBLEMS, IN ABSENCE OF ALLERGIC RASH, IS "1 IN 30,000".

Anyway---that's what I found on Plaquenil & anemia... To me, the above info makes the correlation sound very, very (etc.) low. QUESTION: Did the info you read citing a correlation between anemia & Plaquenil include any relative risks/odds?

Hope you are both generally OK. I send my best wishes. Vee (P.S. I was slightly anemic but BEFORE starting Plaquenil; I improved after being ON the drug. Hmmmmm.... What does it all mean? Is anything straightforward in this disease, or consistent across patients? )

Last edited by VeeJ; 07-18-2004 at 08:37 AM.

 
Old 07-18-2004, 02:09 PM   #5
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Re: Anemia anyone

I also think that Lupus related anemia is not the typical anemia we think of (low hemoglobin or hemotocrit), as least for the diagnostic aspect....

This is the diagnostic type anemia>>>>Blood abnormalities (hemolytic anemia, low white cell counts, low platelet counts)
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Old 07-19-2004, 05:17 AM   #6
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Re: Anemia anyone

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!)

Last edited by VeeJ; 07-19-2004 at 05:38 AM.

 
Old 07-19-2004, 09:36 AM   #7
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Re: Anemia anyone

it looks to me as though the standard tests (hemoglobin, hematocrit, & red blood cell count) DO identify anemia in lupus patients--

I agree, BUT I don't think these count towards a DX.
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