New Dr. - Lupus Message Board

deedea · 06-03-2005, 08:10 PM

Hi. Just wondering if someone could answer a question for me. I have been to my gp a few times in the past few months, every time she brushed my symptoms off and said she would see me in one month. I was not satisfied with this at all considering I have enlarged lymph nodes and very low blood counts every time she ran a CBC. Anyway had to go through alot of jargon with my insurance company to get permission to go to a new dr. I saw her last friday and explained my symptoms and showed her previous blood tests. She ran her own CBC which is worse than the last one a month ago and immediately ordered a pheripheral smear. I was so relieved that she was actually going to do something. I did not mention to her that I think I might have lupus. She just suggested that she believed I have some autoimmune disease. My question is "Will a pheripheral smear detect anything that will determine if I do have lupus?" I have read about positive ANA and such but have not found how this test is performed. If someone could enlighten my I would be grateful. I am really going nuts because today has been one week and the results are not back from the lab. The office is probably sick of me because I have been calling every afternoon to see if it is back yet. I guess after what I went through with my last dr. just trying to find out the results of a simple CBC that I am a little untrusting as far as dr.'s are concerned. Anyway, thanks in advance for any information you can provide. deedea.

patience 50 · 06-04-2005, 06:01 AM

Hi deedea,

Many of us here have some difficulty trusting the medical profession, and for good reason. However, we really have little choice. I don't know what the exact test for ANA is called. I only know that it is a blood test. When I had them done they did many at one time. I got all the results in about 2 weeks. Perhaps in the future you may want to ask you Dr. approx. how long it will take for the results to come back. You may also want to get copies of all tests run and keep your own records. You already have a good start with all the CBC tests results that you have. If for any reason you need to see another Dr. you will have your history. Good luck. I hope you get answers soon.

May God Bless and Keep Us All
Patience 50

Glojer · 06-04-2005, 10:34 AM

The test I had to show positive ANA was a blood test for antinuclear antibodies. It will show the results in titers (some new tests do not show this) but it should give a range and tell you if it is high, or normal. Mine gradually went up until I was on plaquenil and it came back normal when done on the meds. But I think ANA is like that it can be normal one time and high the next.

VeeJ · 06-04-2005, 02:36 PM

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

life_is_good · 06-04-2005, 03:11 PM

Vee,
I was told that I had autoimmune anemia. Is this the same as the Coomb's antibody? Is there a specific test for this? If so, what can you tell me about this type of anemia?

~Sam~