Lupus (Systemic Lupus Erythematosus or SLE)

Lupus (Systemic Lupus Erythematosus or SLE) Lab Test and health information

The lupus blood test can provide an accurate reading of the presence of antinuclear antibodies. 97% of people with lupus will test positive for the ANA that connects to the cell's nucleus or command center and damages or destroys the cells.  

Learn about your health today and order your labs directly from Ulta Lab Tests to screen, diagnose, and monitor for Lupus (Systemic Lupus Erythematosus) (SLE). 

Below the list of tests is a guide that explains and answers your questions on what you need to know about SLE tests, along with information on Systemic Lupus Erythematosus, signs, symptoms, and diagnosis.

 


Name Matches

Includes

  • ANA Screen, IFA, with Reflex to Titer and Pattern
  • DNA (ds) Antibody
  • Sjogren's Antibodies (SS-A, SS-B)
  • Sm Antibody
  • RNP Antibody 
  • Chromatin (Nucleosomal) Antibody
  • Complement Component C3c and C4c
  • Complement, Total (CH50)

If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge - $13.00



Description: An antinuclear antibody screening is a blood test that is going to look for a positive or negative result. If the result comes back as positive further test will be done to look for ANA Titer and Pattern. Antinuclear antibodies are associated with Lupus.

Also Known As: ANA Test, ANA Screen IFA with Reflex to Titer and pattern IFA Test, ANA with Reflex Test, Antinuclear Antibody Screen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

IMPORTANT Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00

When is an ANA Screen test ordered?

When someone exhibits signs and symptoms of a systemic autoimmune illness, the ANA test is requested. Symptoms of autoimmune illnesses can be vague and non-specific, and they can fluctuate over time, steadily deteriorate, or oscillate between periods of flare-ups and remissions.

What does an ANA Screen blood test check for?

Antinuclear antibodies are a type of antibody produced by the immune system when it is unable to differentiate between its own cells and foreign cells. Autoantibodies are antibodies that attack the body's own healthy cells, causing symptoms like tissue and organ inflammation, joint and muscle discomfort, and weariness. The moniker "antinuclear" comes from the fact that ANA specifically targets chemicals located in a cell's nucleus. The presence of these autoantibodies in the blood is detected by the ANA test.

The presence of ANA may be a sign of an autoimmune process, and it has been linked to a variety of autoimmune illnesses, the most common of which being systemic lupus erythematosus.

One of the most common tests used to detect an autoimmune disorder or rule out other conditions with comparable signs and symptoms is the ANA test. As a result, it's frequently followed by other autoantibody tests that can help establish a diagnosis. An ENA panel, anti-dsDNA, anti-centromere, and/or anti-histone test are examples of these.

Lab tests often ordered with an ANA Screen test:

  • ENA Panel
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Complement
  • AMA
  • Centromere antibody
  • Histone Antibody

Conditions where an ANA Screen test is recommended:

  • Autoimmune Disorders
  • Lupus
  • Rheumatoid Arthritis
  • Sjogren Syndrome
  • Scleroderma

How does my health care provider use an ANA Screen test?

One of the most often performed tests to diagnose systemic lupus erythematosus is the antinuclear antibody test. It serves as the first step in the evaluation process for autoimmune diseases that might impact various body tissues and organs.

When a person's immune system fails to discriminate between their own cells and foreign cells, autoantibodies called ANA are created. They attack chemicals found in a cell's nucleus, causing organ and tissue damage.

ANA testing may be utilized in conjunction with or after other autoantibody tests, depending on a person's indications and symptoms and the suspected condition. Antibodies that target specific compounds within cell nuclei, such as anti-dsDNA, anti-centromere, anti-nucleolar, anti-histone, and anti-RNA antibodies, are detected by some of these tests, which are considered subsets of the general ANA test. In addition, an ENA panel can be utilized as a follow-up to an ANA.

These further tests are performed in addition to a person's clinical history to assist diagnose or rule out other autoimmune conditions such Sjögren syndrome, polymyositis, and scleroderma.

To detect ANA, various laboratories may employ different test procedures. Immunoassay and indirect fluorescent antibody are two typical approaches. The IFA is regarded as the gold standard. Some labs will test for ANA using immunoassay and then employ IFA to confirm positive or equivocal results.

An indirect fluorescent antibody is created by mixing a person's blood sample with cells attached to a slide. Autoantibodies in the blood bind to the cells and cause them to react. A fluorescent antibody reagent is used to treat the slide, which is then inspected under a microscope. The existence of fluorescence is observed, as well as the pattern of fluorescence.

Immunoassays—these procedures are frequently carried out using automated equipment, however they are less sensitive than IFA in identifying ANA.

Other laboratory tests linked to inflammation, such as the erythrocyte sedimentation rate and/or C-reactive protein, can be used to assess a person's risk of SLE or another autoimmune disease.

What do my ANA test results mean?

A positive ANA test indicates the presence of autoantibodies. This shows the presence of an autoimmune disease in someone who has signs and symptoms, but more testing is needed to make a definitive diagnosis.

Because ANA test results can be positive in persons who have no known autoimmune disease, they must be carefully assessed in conjunction with a person's indications and symptoms.

Because an ANA test can become positive before signs and symptoms of an autoimmune disease appear, determining the meaning of a positive ANA in a person who has no symptoms can take some time.

SLE is unlikely to be diagnosed with a negative ANA result. It is normally not required to repeat a negative ANA test right away; however, because autoimmune illnesses are episodic, it may be desirable to repeat the ANA test at a later date if symptoms persist.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Includes

  • ANA Screen,IFA, with Reflex to Titer and Pattern
  • DNA (ds) Antibodies
  • Scleroderma Antibodies (SCL-70)
  • Sm and Sm/RNP Antibodies
  • Sjogren's Antibodies (SSA, SSB)

If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge - $13.00

 


ANAlyzeR™ ANA, IFA with Reflex Titer/Pattern, Systemic Autoimmune Panel 1

Includes

  • ANA Screen,IFA, with Reflex to Titer and Pattern
  • DNA (ds) Antibody, Crithidia IFA with Reflex to Titer
  • Chromatin (Nucleosomal) Antibody
  • Sm Antibody
  • Sm/RNP Antibody
  • RNP Antibody
  • Sjogren's Antibodies (SS-A, SS-B)
  • Scleroderma Antibody (Scl-70)
  • Jo-1 Antibody
  • Centromere B Antibody
  • Complement Component C3c and C4c
  • Cardiolipin Antibodies (IgA, IgG, IgM)
  • Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM)
  • Rheumatoid Factor (IgA, IgG, IgM)
  • Cyclic Citrullinated Peptide (CCP) Antibody (IgG)
  • 14.3.3 eta Protein
  • Thyroid Peroxidase Antibodies (TPO)

 

  • If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).
  • If the DNA (ds) Antibody Screen is positive, then DNA (ds) Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

 

Alternative Name(s)

Expanded ANA Antibodies,Systemic Autoimmune Disorder,ANA and Expanded AI Testing,ANA and Systemic Autoimmunity,Comprehensive AI Testing,Early Systemic Autoimmune Disease,Autoimmune Disorders


Testing for anti-neutrophil cytoplasmic antibodies (P-ANCA and/or C-ANCA and/or atypical P-ANCA) has been found to be useful in establishing the diagnosis of suspected vascular diseases, inflammatory bowel disease, as well as other autoimmune diseases.

Testing for anti-neutrophil cytoplasmic antibodies (P-ANCA and/or C-ANCA) has been found to be useful in establishing the diagnosis of suspected vascular diseases (e.g., crescentic glomerulonephritis, microscopic polyarteritis and Churg-Strauss syndrome), bowel disease (Crohn's Disease, ulcerative colitis, primary sclerosing cholangitis, and autoimmune hepatitis) as well as with other autoimmune diseases (drug-induced lupus, SLE, Felty's syndrome). ANCA has classically been divided into C-ANCA and P-ANCA depending on the immunofluorescent pattern observed. More recently the specific antigens responsible for these patterns have been described and isolated. The antigen that gives the C-ANCA pattern is proteinase-3 (PR-3). Multiple antigens are responsible for P-ANCA pattern, the principle antigen being myeloperoxidase (MPO). Patients with vascular diseases will generally have either a C-ANCA pattern or P-ANCA pattern, and give positive results in specific tests for PR-3 or MPO. Patients with bowel disease have been shown to have antibodies that give a P-ANCA or C-ANCA pattern. These antibodies however, may not be directed towards MPO. Patients with drug induced lupus, etc., often present with a P-ANCA pattern that is associated with antibodies against MPO.

The Antiphospholipid Antibody Panel is a comprehensive test that measures nine biomarkers associated with antiphospholipid syndrome (APS). APS is an autoimmune disorder that can lead to recurrent miscarriages, thrombosis, and pregnancy complications. The panel includes tests for beta-2-glycoprotein I antibodies, phosphatidylserine antibodies, and cardiolipin antibodies. This comprehensive testing will provide your healthcare provider with important information about your risk for APS and allow them to tailor your treatment accordingly.

This comprehensive testing will provide your healthcare provider with important information about your risk for APS and allow them to tailor your treatment accordingly. If you have been diagnosed with APS, it is important to see your healthcare provider regularly and follow their treatment recommendations. Sometimes, treatment with blood thinners or other medications may be necessary to prevent serious complications. Most people with APS can lead healthy, normal lives with proper management.

What is included in the antiphospholipid panel?

The panel includes tests for

  • Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM)
  • Phosphatidylserine Antibodies (IgG, IgA, IgM)
  • Cardiolipin Antibodies (IgA, IgG, IgM)

What is the antiphospholipid antibody panel test for?

The Antiphospholipid Antibody Panel is a comprehensive test that measures nine biomarkers associated with antiphospholipid syndrome (APS). APS is an autoimmune disorder that can lead to recurrent miscarriages, thrombosis, and pregnancy complications. The panel includes tests for beta-2-glycoprotein I antibodies, phosphatidylserine antibodies, and cardiolipin antibodies. This comprehensive testing will provide your healthcare provider with important information about your risk for APS and allow them to tailor your treatment accordingly.

What do the results of an antiphospholipid antibody panel test mean?

A positive result on any of the panel tests suggests that you have antibodies associated with APS in your blood. This does not necessarily indicate that you have APS, but it raises your chances of having the disorder. Your healthcare professional will analyze your results and, if necessary, conduct more tests.

What follow-up is necessary after an antiphospholipid antibody panel test?

If you have a positive result on any of the tests in the panel, your healthcare provider will likely order additional testing to confirm the diagnosis of APS. Once APS has been diagnosed, it is important to see your healthcare provider regularly and follow their treatment recommendations. Treatment with blood thinners or other drugs may be required in some cases to avoid serious consequences. With careful management, most persons with APS can live healthy, regular lives.

Is APS the same as lupus?

No, APS is an autoimmune condition that can cause thrombosis, repeated miscarriages, and pregnancy difficulties. Chronic inflammatory disease called lupus can harm several organs. Although they are both autoimmune illnesses, the two conditions are not the same.

Is APS an autoimmune disease?

Yes, APS is an autoimmune condition. When the body's immune system targets healthy cells and tissues, autoimmune disorders result. In APS, the immune system assaults the ubiquitous phospholipids present in all cells. This can result in repeated miscarriages, thrombosis, and problems during pregnancy.

What are the symptoms of APS?

The most common symptom of APS is recurrent miscarriages. Other symptoms may include thrombosis, pregnancy complications, and stroke. Many people with APS do not have any symptoms.

What are the causes of APS?

The exact causes of APS remain unknown. However, it is believed to be a result of both genetic and environmental influences.

What are the risks of APS?

APS can lead to recurrent miscarriages, thrombosis, and pregnancy complications. If left untreated, APS can also lead to stroke or heart attack.

How is APS diagnosed?

APS is typically diagnosed with a blood test. The Antiphospholipid Antibody Panel is a comprehensive test that measures nine different biomarkers that are associated with APS. Your healthcare practitioner will assist you in interpreting your results and, if required, order more tests.

How is APS treated?

There is no cure for APS. However, it is treatable with medicine and lifestyle modifications. Medications may include blood thinners or other medications to prevent serious complications. Lifestyle changes may include avoiding smoking, maintaining a healthy weight, and managing stress. With proper management, most people with APS can lead healthy, normal lives.

What is the prognosis for APS?

The prognosis for APS is generally good. Most people with APS can lead healthy, normal lives with proper diagnosis and treatment. However, APS can lead to serious complications if it is not properly managed. Recurrent miscarriages, thrombosis, and pregnancy complications are the most common complications associated with APS. If left untreated, APS can also lead to stroke or heart attack.

What are the three antiphospholipid antibodies?

The three antiphospholipid antibodies are beta-2-glycoprotein I, phosphatidylserine, and cardiolipin. These antibodies are associated with APS and can lead to recurrent miscarriages, thrombosis, and pregnancy complications.


Clinical Significance

Rheumatoid Arthritis Diagnostic IdentRA® Panel 2 - Early diagnosis of rheumatoid arthritis (RA), ie, diagnosis before significant joint erosion occurs, is difficult. Psoriatic arthritis can also be difficult to diagnose clinically early in the disease process, and there are no specific biomarkers. The 14-3-3η (eta) protein is an emerging biomarker for RA and erosive psoriatic arthritis diagnosis. It may play a biologic role in the joint erosive process. Blood levels appear to be elevated in patients with RA, but not in other diseases including psoriasis, osteoporosis, gout, ulcerative colitis, type 1 diabetes, systemic lupus erythematosus, Crohn disease, primary Sjögren syndrome, scleroderma, and multiple sclerosis. The 14-3-3η protein, used in conjunction with rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody, may improve diagnostic sensitivity in the early diagnosis of RA. It may also help differentiate those with psoriatic arthritis joint damage from those without joint damage.


Antibodies to Sm are highly specific for systemic lupus erythematosus (SLE) and when present are considered a marker antibody. However, these antibodies are found in only 20% of patients with SLE. RNP antibodies (also known as anti-u1 or ribonucleoprotein antibodies) are found in 45% of SLE patients but are also observed in numerous other disease states such as Sjögren's syndrome, scleroderma and polymyositis. Elevated levels of antibodies to RNP are seen in mixed connective tissue disease. In SLE, RNP antibodies have been associated with a relatively benign disease course with lower incidence of renal and central nervous system involvement. Patients may be considered positive for RNP antibodies when the RNP antibody result is significantly higher than the Sm antibody result.

Smith Antibody (Sm) is highly specific for systemic lupus erythematosus (SLE). Smith Antibody is also detected in approximately 15% of patients with SLE. Smith Antibody is detected in more than half of young African-American women with SLE.

RNP Antibody

Clinical Significance

RNP Antibodies have been associated with Mixed Connective Tissue disease.


RPR (Diagnosis) with Reflex to Titer and Confirmatory Testing

IMPORTANT:  NOTE THIS IS A REFLUX TEST - The price charged for this test is only for the RPR. ADDITIONAL CHARGES WILL OCCUR FOR THE REFLUX TO TITER AND CONFIRMATION TESTING .

Clinical Significance

This is a non-treponemal screening test for syphilis. False positive results may occur due to systemic lupus erythematosus, leprosy, brucellosis, atypical pneumonia, typhus, yaws, pinta, or pregnancy. Monitoring of RPR is helpful in assessing effectiveness of therapy.

Limitations

False-positive results have been associated in patients with infections, pregnancy, autoimmune disease, old age, Gaucher disease, and malignancy.

Alternative Name(s) 

Premarital RPR,Syphilis Serology Screen, Blood,ART,Rapid Plasma Reagin,Automated Reagin Test


Description: The RPR test is used to determine if a person has been infected with syphilis. An RPR can be used to monitor treatment for syphilis and the effectiveness of syphilis treatment. Syphilis testing is a two-part test. The first round of testing for syphilis is an RPR test. If these results come back positive, a second round of testing will be required. A positive RPR result will be followed by a second method that will be used to confirm the results. If the second syphilis test comes back positive, the affected person will be diagnosed with syphilis. If the second test comes back negative, it could mean that the first test is a false positive and more testing may be necessary.

Also Known As: Rapid Plasma Reagin with Reflex to Titer, Syphilis RPR, Syphilis Titer test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

IMPORTANT

A positive RPR screen must be followed by a specific treponemal antibody test (e.g., FTA-ABS):

A positive result on the second method confirms the screening result and the affected person is diagnosed with syphilis.

A negative result on the treponemal test may mean that the initial RPR test was falsely positive. Further testing and investigation may be done to determine the cause of the false positive.

Limitations

False-positive results have been associated in patients with infections, pregnancy, autoimmune disease, old age, Gaucher disease, and malignancy.

When is a Syphilis RPR test ordered?

When a person shows signs and symptoms of syphilis, a syphilis test may be done.

Regardless of symptoms, a person should be tested for syphilis if they:

  • Are being treated for gonorrhea or another sexually transmitted disease?
  • If a woman is pregnant, she should be seen during the first prenatal visit, then again in the third trimester and at the time of delivery if she is at high risk.
  • Are a man who has sex with other males; testing should be done at least once a year or every 3-6 months if the risk is significant.
  • Engages in high-risk sexual behavior, such as having intercourse with several partners without protection.
  • If you have HIV, you should get tested when you're initially diagnosed and then at least once a year after that; if you're at high risk, you should get tested more frequently.
  • Has one or more partners who have tested positive for syphilis
  • Officials from the Department of Public Health have told him or her that he or she has been exposed to an infected partner.

When a person has been treated for syphilis, the CDC recommends doing follow-up testing, such as assessing antibody levels, to ensure that the therapy was successful and the infection was cured.

What does a Syphilis RPR blood test check for?

Syphilis is a bacterial infection caused by Treponema pallidum that is primarily spread during sexual activity, such as by direct contact with a syphilis sore. The majority of common syphilis tests can detect antibodies in the blood that were produced in response to a T. pallidum infection. Some less common methods can be used to locate the bacterium or its genetic components.

Syphilis is easily treated with medications, but if left untreated, it can cause serious health concerns. A mother who is afflicted can convey the disease to her unborn child, which can have serious and even fatal effects for the newborn.

With syphilis, there are numerous stages that can occur:

  • The primary stage of syphilis begins about 2-3 weeks following infection. One or more chancres emerge, usually on the body portion exposed to the chancre of the sexual partner, such as the penis or vaginal area. The chancre, on the other hand, is usually painless and may go unnoticed, especially if it is in the rectum or on the cervix, and it goes away within 4-6 weeks, mending whether or not the infected person is treated.
  • If primary syphilis is left untreated, secondary syphilis can develop anywhere from 6 weeks to 6 months after the chancre initially emerges. It is characterized by a rough, red, and speckled skin rash that appears regularly on the palms of the hands and the bottoms of the feet and does not itch. Fever, weariness, enlarged lymph nodes, sore throat, and body aches are some of the other symptoms that can occur.
  • Secondary syphilis can progress to a latent stage, during which an infected individual has no symptoms but still retains the infection, and this stage can remain for years if left untreated. If left untreated, roughly 15% of persons will develop late, or tertiary, syphilis issues. Bacteria can harm the heart, eyes, brain, neurological system, bones, joints, and practically any other component of the body in these situations. Neurosyphilis is a disease that affects the central nervous system. Tertiary syphilis can linger for years, leading to mental illness, blindness, other neurological issues, heart disease, and death in the ultimate stage.
  • If left untreated, syphilis progresses.

The basic and secondary stages of syphilis are the most contagious. About a third of the approximately 63,000 new cases of syphilis reported to the CDC in 2014 were main or secondary stage syphilis. Eighty-three percent of these cases included guys having intercourse with other men.

Antibiotics, usually penicillin, can be used to cure syphilis. Infections that have been acquired recently can be rapidly healed; however, someone who has been infected for more than a year may require prolonged therapy.

Lab tests often ordered with a Syphilis RPR test:

  • HIV Antibody
  • HIV Antigen
  • Gonorrhea
  • Chlamydia
  • Herpes 1 and 2
  • Trichomonas
  • STD Panel

Conditions where a Syphilis RPR test is recommended:

  • Sexually Transmitted Diseases
  • Syphilis
  • Gonorrhea
  • Chlamydia
  • Herpes 1
  • Herpes 2
  • HIV and AIDS
  • Pregnancy

How does my health care provider use a Syphilis RPR test?

Syphilis tests are used to detect and/or diagnose infection with the bacterium Treponema pallidum, which causes syphilis.

There are a variety of tests to choose from. The most common type of test is an antibody test.

Antibody tests identify antibodies in the blood and, occasionally, in the cerebrospinal fluid. Nontreponemal antibody test and treponemal antibody test are the two types of syphilis tests available. Syphilis screening can be done with any type, but it must be followed by a second test that employs a different approach to confirm a positive result and identify active syphilis:

Antibodies that aren't specifically directed towards the Treponema pallidum bacterium are detected by nontreponemal antibody testing. The body produces these antibodies when a person has syphilis, but they can also be produced in a variety of other situations. Because the tests are non-specific, false-positive findings can be produced by things like IV drug usage, pregnancy, Lyme disease, certain types of pneumonia, malaria, tuberculosis, or certain autoimmune disorders like lupus. A positive screening result must be double-checked with a more detailed test. Nontreponemal testing include the following:

RPR—in addition to screening, this test can be used to track syphilis therapy. Antibody levels are tested for this reason. When an initial test for treponemal antibodies is positive, it can also be used to confirm the existence of an active infection.

VDRL—in addition to blood, this test is largely used to identify neurosyphilis in the CSF.

Antibodies to T. pallidum are detected by treponemal antibody tests, which are blood tests. Because they are extremely specific for syphilis, they are unlikely to produce a positive result in other diseases. Once a person is infected and these antibodies form, they remain in the bloodstream for the rest of their lives. Nontreponemal antibodies, on the other hand, usually vanish within 3 years in a properly treated person. As a result, a positive treponemal screening result must be followed by a nontreponemal test in order to distinguish between an active infection and one that has been successfully treated in the past. FTA-ABS is a treponemal antibody test that is beneficial after the first 3-4 weeks after exposure. It can be used to assess antibodies to T. pallidum in the CSF to assist diagnose neurosyphilis in addition to blood testing.

  • TP-PA—instead of FTA-ABS, this test is sometimes used because it is more specific and has less false positives.
  • Another confirmatory approach is MHA-TP, which is presently used considerably less frequently.
  • Immunoassays—Several automated tests have been developed in recent years, making them useful for screening applications.

What do my Syphilis test results mean?

A negative blood test indicates that there is most likely no infection. A negative screening test, on the other hand, simply states that there was no evidence of disease at the time of the test. Antibodies may not be detected for several weeks following bacterial contact. If a person is aware that he or she has been exposed, or if the risk of infection remains high, additional testing may be required. It is also critical for persons who are at a higher risk of contracting syphilis to get regular screening tests to check for infection.

A particular treponemal antibody test must be performed after a positive RPR or VDRL screen:

The infected person is diagnosed with syphilis once a positive result on the second method confirms the screening result.

A negative treponemal test result could indicate that the initial RPR or VDRL test was incorrectly positive. To discover the reason of the false positive, more testing and investigation may be conducted.

A treponemal antibody test, on the other hand, will be used as an initial test by a healthcare practitioner or laboratory. A positive result indicates the presence of syphilis antibodies in the blood, but because treponemal antibodies stay positive even after an infection is treated, it does not indicate whether the person is now afflicted or has previously been infected. Nontreponemal antibodies found with an RPR, on the other hand, usually vanish after 3 years in a properly treated person. If the initial treponemal test is positive, an RPR can be used to determine whether the infection is active or past. A positive RPR in this scenario would establish that the person has been exposed to syphilis and, if not previously treated, has an ongoing infection or, if treatment occurred more than 3 years ago, possible re-infection.

The results of one or more RPR titers may be used to monitor treatment and/or determine if treatment was successful. Antibodies to syphilis should be decreased after therapy. If the RPR was 1:256 before therapy, a number of 1:16 after treatment would indicate a reduced amount of antibody. The affected person may have a persistent infection or was reinfected if the titer stays the same or rises. The results can also be transformed to a whole number or reported as dilutions.

Nontreponemal antibodies fade away over time after effective treatment, whereas treponemal antibodies remain in the blood for the rest of one's life.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Decreased C3 may be associated with acute glomerulonephritis, membranoproliferative glomerulonephritis, immune complex disease, active systemic lupus erythematosis, and generalized autoimmune processes.

Decreased C3 and C4 levels may be associated with acute glomerulonephritis, membranoproliferative glomerulonephritis, immune complex disease, active systemic lupus erythematosis, cryoglobulinemia, congenital C4 deficiency and generalized autoimmune disease

Decreased C4 level is associated with acute systemic lupus erythematosis, glomerulonephritis, immune complex disease, cryoglobulinemia, congenital C4 deficiency and generalized autoimmune disease

CH50 is a screening test for total complement activity. Levels of complement may be depressed in genetic deficiency, liver disease, chronic glomerulonephritis, rheumatoid arthritis, hemolytic anemias, graft rejection, systemic lupus erythematosis, acute glomerulonephritis, subacute bacterial endocarditis and cryoglobulinemia. Elevated complement may be found in acute inflammatory conditions, leukemia, Hodgkin's Disease, sarcoma, and Behcet's Disease.

Description: A CBC or Complete Blood Count with Differential and Platelets test is a blood test that measures many important features of your blood’s red and white blood cells and platelets. A Complete Blood Count can be used to evaluate your overall health and detect a wide variety of conditions such as infection, anemia, and leukemia. It also looks at other important aspects of your blood health such as hemoglobin, which carries oxygen. 

Also Known As: CBC test, Complete Blood Count Test, Total Blood Count Test, CBC with Differential and Platelets test, Hemogram test  

Collection Method: Blood Draw 

Specimen Type: Whole Blood 

Test Preparation: No preparation required 

When is a Complete Blood Count test ordered?  

The complete blood count (CBC) is an extremely common test. When people go to the doctor for a standard checkup or blood work, they often get a CBC. Suppose a person is healthy and their results are within normal ranges. In that case, they may not need another CBC unless their health condition changes, or their healthcare professional believes it is necessary. 

When a person exhibits a variety of signs and symptoms that could be connected to blood cell abnormalities, a CBC may be done. A health practitioner may request a CBC to help diagnose and determine the severity of lethargy or weakness, as well as infection, inflammation, bruises, or bleeding. 

When a person is diagnosed with a disease that affects blood cells, a CBC is frequently done regularly to keep track of their progress. Similarly, if someone is being treated for a blood condition, a CBC may be performed on a regular basis to see if the treatment is working. 

Chemotherapy, for example, can influence the generation of cells in the bone marrow. Some drugs can lower WBC counts in the long run. To monitor various medication regimens, a CBC may be required on a regular basis. 

What does a Complete Blood Count test check for? 

The complete blood count (CBC) is a blood test that determines the number of cells in circulation. White blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs) are three types of cells suspended in a fluid called plasma. They are largely created and matured in the bone marrow and are released into the bloodstream when needed under normal circumstances. 

A CBC is mainly performed with an automated machine that measures a variety of factors, including the number of cells present in a person's blood sample. The findings of a CBC can reveal not only the quantity of different cell types but also the physical properties of some of the cells. 

Significant differences in one or more blood cell populations may suggest the presence of one or more diseases. Other tests are frequently performed to assist in determining the reason for aberrant results. This frequently necessitates visual confirmation via a microscope examination of a blood smear. A skilled laboratory technician can assess the appearance and physical features of blood cells, such as size, shape, and color, and note any anomalies. Any extra information is taken note of and communicated to the healthcare provider. This information provides the health care provider with further information about the cause of abnormal CBC results. 

The CBC focuses on three different types of cells: 

WBCs (White Blood Cells) 

The body uses five different types of WBCs, also known as leukocytes, to keep itself healthy and battle infections and other types of harm. The five different leukocytes are eosinophiles, lymphocytes, neutrophiles, basophils, and monocytes. They are found in relatively steady numbers in the blood. Depending on what is going on in the body, these values may momentarily rise or fall. An infection, for example, can cause the body to manufacture more neutrophils in order to combat bacterial infection. The amount of eosinophils in the body may increase as a result of allergies. A viral infection may cause an increase in lymphocyte production. Abnormal (immature or mature) white cells multiply fast in certain illness situations, such as leukemia, raising the WBC count. 

RBCs (Red Blood Cells) 

The bone marrow produces red blood cells, also known as erythrocytes, which are transferred into the bloodstream after maturing. Hemoglobin, a protein that distributes oxygen throughout the body, is found in these cells. Because RBCs have a 120-day lifespan, the bone marrow must constantly manufacture new RBCs to replace those that have aged and disintegrated or have been lost due to hemorrhage. A variety of diseases, including those that cause severe bleeding, can alter the creation of new RBCs and their longevity. 

The CBC measures the number of RBCs and hemoglobin in the blood, as well as the proportion of RBCs in the blood (hematocrit), and if the RBC population appears to be normal. RBCs are generally homogeneous in size and shape, with only minor differences; however, considerable variances can arise in illnesses including vitamin B12 and folate inadequacy, iron deficiency, and a range of other ailments. Anemia occurs when the concentration of red blood cells and/or the amount of hemoglobin in the blood falls below normal, resulting in symptoms such as weariness and weakness. In a far smaller percentage of cases, there may be an excess of RBCs in the blood (erythrocytosis or polycythemia). This might obstruct the flow of blood through the tiny veins and arteries in extreme circumstances. 

Platelets 

Platelets, also known as thrombocytes, are small cell fragments that aid in the regular clotting of blood. A person with insufficient platelets is more likely to experience excessive bleeding and bruises. Excess platelets can induce excessive clotting or excessive bleeding if the platelets are not operating properly. The platelet count and size are determined by the CBC. 

Lab tests often ordered with a Complete Blood Count test: 

  • Reticulocytes
  • Iron and Total Iron Binding Capacity
  • Basic Metabolic Panel
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Vitamin B12 and Folate
  • Prothrombin with INR and Partial Thromboplastin Times
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Epstein-Barr Virus
  • Von Willebrand Factor Antigen

Conditions where a Complete Blood Count test is recommended: 

  • Anemia
  • Aplastic Anemia
  • Iron Deficiency Anemia
  • Vitamin B12 and Folate Deficiency
  • Sickle Cell Anemia
  • Heart Disease
  • Thalassemia
  • Leukemia
  • Autoimmune Disorders
  • Cancer
  • Bleeding Disorders
  • Inflammation
  • Epstein-Barr Virus
  • Mononucleosis

Commonly Asked Questions: 

How does my health care provider use a Complete Blood Count test? 

The complete blood count (CBC) is a common, comprehensive screening test used to measure a person's overall health status.  

What do my Complete Blood Count results mean? 

A low Red Blood Cell Count, also known as anemia, could be due many different causes such as chronic bleeding, a bone marrow disorder, and nutritional deficiency just to name a few. A high Red Blood Cell Count, also known as polycythemia, could be due to several conditions including lung disease, dehydration, and smoking. Both Hemoglobin and Hematocrit tend to reflect Red Blood Cell Count results, so if your Red Blood Cell Count is low, your Hematocrit and Hemoglobin will likely also be low. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Differential results mean? 

A low White Blood Cell count or low WBC count, also known as leukopenia, could be due to a number of different disorders including autoimmune issues, severe infection, and lymphoma. A high White Blood Cell count, or high WBC count, also known as leukocytosis, can also be due to many different disorders including infection, leukemia, and inflammation. Abnormal levels in your White Blood Cell Count will be reflected in one or more of your different white blood cells. Knowing which white blood cell types are affected will help your healthcare provider narrow down the issue. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Platelet results mean? 

A low Platelet Count, also known as thrombocytopenia, could be due to a number of different disorders including autoimmune issues, viral infection, and leukemia. A high Platelet Count, also known as Thrombocytosis, can also be due to many different disorders including cancer, iron deficiency, and rheumatoid arthritis. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

NOTE: Only measurable biomarkers will be reported. Certain biomarkers do not appear in healthy individuals. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Description: A Comprehensive Metabolic Panel or CMP is a blood test that is a combination of a Basic Metabolic Panel, a Liver Panel, and electrolyte panel, and is used to screen for, diagnose, and monitor a variety of conditions and diseases such as liver disease, diabetes, and kidney disease. 

Also Known As: CMP, Chem, Chem-14, Chem-12, Chem-21, Chemistry Panel, Chem Panel, Chem Screen, Chemistry Screen, SMA 12, SMA 20, SMA 21, SMAC, Chem test

Collection Method: 

Blood Draw 

Specimen Type: 

Serum 

Test Preparation: 

9-12 hours fasting is preferred. 

When is a Comprehensive Metabolic Panel test ordered:  

A CMP is frequently requested as part of a lab test for a medical evaluation or yearly physical. A CMP test consists of many different tests that give healthcare providers a range of information about your health, including liver and kidney function, electrolyte balance, and blood sugar levels. To confirm or rule out a suspected diagnosis, abnormal test results are frequently followed up with other tests that provide a more in depth or targeted analysis of key areas that need investigating. 

What does a Comprehensive Metabolic Panel blood test check for? 

The complete metabolic panel (CMP) is a set of 20 tests that provides critical information to a healthcare professional about a person's current metabolic status, check for liver or kidney disease, electrolyte and acid/base balance, and blood glucose and blood protein levels. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the CMP: 

  • Albumin: this is a measure of Albumin levels in your blood. Albumin is a protein made by the liver that is responsible for many vital roles including transporting nutrients throughout the body and preventing fluid from leaking out of blood vessels. 

  • Albumin/Globulin Ratio: this is a ratio between your total Albumin and Globulin  

  • Alkaline Phosphatase: this is a measure of Alkaline phosphatase or ALP in your blood. Alkaline phosphatase is a protein found in all body tissues, however the ALP found in blood comes from the liver and bones. Elevated levels are often associated with liver damage, gallbladder disease, or bone disorder. 

  • Alt: this is a measure of Alanine transaminase or ALT in your blood. Alanine Aminotransferase is an enzyme found in the highest amounts in the liver with small amounts in the heart and muscles. Elevated levels are often associated with liver damage. 

  • AST: this is a measure of Aspartate Aminotransferase or AST. Aspartate Aminotransferase is an enzyme found mostly in the heart and liver, with smaller amounts in the kidney and muscles. Elevated levels are often associated with liver damage. 

  • Bilirubin, Total: this is a measure of bilirubin in your blood. Bilirubin is an orange-yellowish waste product produced from the breakdown of heme which is a component of hemoglobin found in red blood cells. The liver is responsible for removal of bilirubin from the body. 

  • Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

  • Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. 

  • Calcium: is used for blood clot formation and the formation and maintenance of bones and teeth. 

  • Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

  • Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

  • Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

  • Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

  • Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

  • Globulin: this is a measure of all blood proteins in your blood that are not albumin. 

  • Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

  • Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

  • Protein, Total: this is a measure of total protein levels in your blood. 
    Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

  • Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood UreaNitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

  • Complete Blood Count with Differential and Platelets
  • Iron and Total Iron Binding Capacity
  • Lipid Panel
  • Vitamin B12 and Folate
  • Prothrombin with INR and Partial Thromboplastin Times
  • Sed Rate (ESR)
  • C-Reactive Protein

Conditions where a Comprehensive Metabolic Panel test is recommended: 

  • Diabetes
  • Kidney Disease
  • Liver Disease
  • Hypertension

Commonly Asked Questions: 

How does my health care provider use a Comprehensive Metabolic Panel test? 

The comprehensive metabolic panel (CMP) is a broad screening tool for assessing organ function and detecting diseases like diabetes, liver disease, and kidney disease. The CMP test may also be requested to monitor known disorders such as hypertension and to check for any renal or liver-related side effects in persons taking specific drugs. If a health practitioner wants to follow two or more separate CMP components, the full CMP might be ordered because it contains more information. 

What do my Comprehensive Metabolic Panel test results mean? 

The results of the tests included in the CMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. A high result on one of the liver enzyme tests, for example, is not the same as a high result on several liver enzyme tests. 

Several sets of CMPs, frequently performed on various days, may be examined to gain insights into the underlying disease and response to treatment, especially in hospitalized patients. 

Out-of-range findings for any of the CMP tests can be caused by a variety of illnesses, including kidney failure, breathing issues, and diabetes-related complications, to name a few. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

A wide range of prescription and over-the-counter medications can have an impact on the results of the CMP's components. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide a thorough history because many other circumstances can influence how your results are interpreted. 

What's the difference between the CMP and the BMP tests, and why would my doctor choose one over the other? 

The CMP consists of 14 tests, while the basic metabolic panel (BMP) is a subset of those with eight tests. The liver (ALP, ALT, AST, and bilirubin) and protein (albumin and total protein) tests are not included. If a healthcare provider wants a more thorough picture of a person's organ function or to check for specific illnesses like diabetes or liver or kidney disease, he or she may prescribe a CMP rather than a BMP. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Please note the following regarding BUN/Creatinine ratio: 

The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. 

If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result.  

As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79. 


Description: A Urinalysis complete test is a urine test that is used to screen for, diagnose, and monitor a variety of conditions and diseases urinary tract infections and kidney disorders.

Also Known As: Urine Test, Urine Analysis Test, UA Test, urine microscopic examination Test, Urinalysis Test, Complete Urinalysis Test

Collection Method: Urine Collection

Specimen Type: Urine

Test Preparation: No preparation required

When is a Urinalysis Complete test ordered?

A urinalysis test may be ordered when a person undergoes a routine wellness examination, is admitted into a hospital, will have surgery, or is having a prenatal checkup.

When a person visits a doctor with symptoms of a urinary tract infection or another urinary system ailment, such as kidney disease, a urinalysis will almost certainly be prescribed. The following are some possible signs and symptoms:

  • Pain in the abdomen
  • Backache
  • Urination that is painful or occurs frequently
  • Urine with blood in it

Testing may also be conducted at regular intervals to track the progress of a condition.

What does a Urinalysis Complete test check for?

A urinalysis is a series of examinations done on urine that are physical, chemical, and microscopic. The tests identify and/or measure a number of elements in the urine, including cells, cellular fragments, and microbes. These elements include byproducts of healthy and unhealthy metabolism.

Urine is produced by the kidneys, two fist-sized organs located on either side of the spine near the base of the rib cage. The kidneys help the body regulate its water balance, filter wastes from the blood, and store proteins, electrolytes, and other molecules for later use. To get rid of everything unnecessary, urine travels from the kidneys to the ureters, bladder, and urethra before exiting the body. The color, amount, concentration, and content of urine will change slightly every time a person urinates due to the varied elements in urine, despite the fact that pee is normally yellow and clear.

By screening for components in the urine that aren't typically present and/or monitoring aberrant levels of specific substances, many illnesses can be caught early on. Glucose, bilirubin, protein, red and white blood cells, crystals, and germs are among examples. They could be present because of the following reasons:

  • The body responds to an elevated amount of the substance in the blood by attempting to remove the excess through urine.
  • There is a problem with the kidneys.
  • As with bacteria and white blood cells, there is a urinary tract infection present.

Three separate phases make up a full urinalysis:

  • The color and clarity of the urine are assessed using a visual examination.
  • Chemical examination, which determines the concentration of urine and tests for roughly 9 chemicals that provide useful information about health and disease.
  • Microscopic inspection that identifies and counts the different types of cells, casts, crystals, and other components found in urine, such as bacteria and mucus.

When abnormal results are found, or if a healthcare provider requests it, a microscopic analysis is usually performed.

It may be essential to repeat the test if the findings of a urinalysis are abnormal, and further other urine and blood tests may be needed to help establish a diagnosis, if the results are abnormal.

Lab tests often ordered with a Urinalysis Complete test:

  • Complete Blood Count
  • Iron Total and Total Iron binding capacity
  • Hemoglobin A1c
  • Lipid Panel
  • CMP
  • TSH
  • Urine Culture
  • Bilirubin Fractionated
  • Glucose

Conditions where a Urinalysis Complete test is recommended:

  • Diabetes
  • Kidney Disease
  • Liver Disease
  • Hypertension
  • Pregnancy
  • Hematuria
  • Proteinuria
  • Kidney Stones

How does my health care provider use a Urinalysis Complete test?

A urinalysis is a series of tests that can diagnose a variety of disorders. It can be used to screen for and/or diagnose a variety of illnesses, including urinary tract infections, renal abnormalities, liver diseases, diabetes, and other metabolic disorders, to name a few.

Urinalysis may be used in conjunction with other tests, such as urine albumin, to monitor the progress of treatment in patients with diseases or conditions like diabetes or kidney disease.

What do my urinalysis complete test results mean?

There are numerous ways to interpret the results of a urinalysis. Unusual results are a warning sign that something isn't right and needs further testing.  To connect the urinalysis results with an individual's symptoms and clinical findings and to look for the causes of aberrant findings, other targeted tests must be done, such as a complete blood count, metabolic panel, or urine culture.

It is more likely that a problem must be addressed the higher the concentration of the atypical component, such as noticeably increased levels of protein, glucose, or red blood cells. On the other hand, the outcomes do not inform the medical professional as to what led to the finding or whether it is a transient or ongoing sickness.

A normal urinalysis does not rule out the possibility of disease. Early in a disease process, some persons will not release elevated amounts of a drug, and others will release them irregularly throughout the day, which means they could be overlooked by a single urine sample. Small amounts of substances may be undetectable in very dilute urine.

NOTE: Only measurable biomarkers will be reported.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: Sed Rate is a blood test that is used to measure the rate that red blood cells fall to the bottom of a test tube. The measurement is based how many cells fall within one hour. This test can be used to determine infection or inflammation.

Also Known As: Erythrocyte Sedimentation Rate Test, ESR Test, Sed Rate Test, Sedimentation Rate Test, Westergren Sedimentation Rate Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Sed Rate test ordered?

When a condition or disease is believed to be causing inflammation in the body, an ESR may be ordered. Several inflammatory illnesses can be identified using this test. It may be requested, for example, if arthritis is suspected of producing joint inflammation and pain, or if inflammatory bowel disease is suspected of causing digestive symptoms.

When a person develops symptoms of polymyalgia rheumatica, systemic vasculitis, or temporal arteritis, such as headaches, neck or shoulder discomfort, anemia, pelvic pain, poor appetite, joint stiffness, and unexplained weight loss, a doctor may recommend an ESR. To follow the development of specific illnesses, the sed rate test can also be routinely ordered.

A health practitioner may wish to repeat the ESR before undertaking a full workup to look for disease.

What does a Sed Rate blood test check for?

The erythrocyte sedimentation rate is a test that evaluates the degree of inflammation in the body indirectly. The test evaluates the rate at which erythrocytes fall in a blood sample that has been placed in a tall, thin, vertical tube. The millimeters of clear fluid present at the upper portion of the tube after one hour are reported as the results.

When a drop of blood is inserted in a tube, the red blood cells settle out slowly, leaving just a small amount of transparent plasma. In the presence of an increased number of proteins, particularly proteins known as acute phase reactants, red cells settle at a faster pace. Inflammation raises the levels of acute phase reactants such as C-reactive protein and fibrinogen in the blood.

An inherent component of the immune system's response is inflammation. It could be chronic, showing symptoms over time with conditions like autoimmune illnesses or cancer, or acute, showing symptoms right away after a shock, injury, or infection.

The ESR is a non-specific indication that can rise in a number of disorders; it is not a diagnostic test. It provides you with a fundamental understanding of whether you have an inflammatory condition or not.

Given the availability of more recent, specialized tests, there have been reservations about the ESR's utility. The ESR test, on the other hand, is commonly used to diagnose and monitor temporal arteritis, systemic vasculitis, and polymyalgia rheumatica. Extremely high ESR values can aid in differentiating between rheumatic diseases. Furthermore, ESR may still be a viable alternative in some cases, such as when newer tests are unavailable in resource-constrained places or while monitoring the progression of a disease.

Lab tests often ordered with a Sed Rate test:

  • C-Reactive Protein
  • ANA
  • Rheumatoid Factor

Conditions where a Sed Rate test is recommended:

  • Vasculitis
  • Autoimmune Disorders
  • Rheumatoid Arthritis
  • Osteoarthritis
  • Celiac Disease
  • Lupus
  • Chronic Fatigue Syndrome
  • Juvenile Rheumatoid Arthritis
  • Inflammatory Bowel Disease

How does my health care provider use a Sed Rate test?

The erythrocyte sedimentation rate is a non-specific, very straightforward test that has been used for many years to detect inflammation associated with infections, malignancies, and autoimmune illnesses.

Because an elevated ESR often indicates the presence of inflammation, but does not tell the health practitioner where the inflammation is in the body or what is causing it, it is referred to as a non-specific test. Other illnesses besides inflammation may have an impact on an ESR. As a result, other tests, such C-reactive protein, are routinely paired with the ESR.

ESR is used to identify temporal arteritis, systemic vasculitis, and polymyalgia rheumatica, among other inflammatory illnesses. A notably elevated ESR is one of the crucial test results used to support the diagnosis.

This test can be used to track disease activity and treatment response in both of the disorders mentioned above, as well as several others including systemic lupus erythematosus.

What do my Sed Rate test results mean?

Because ESR is a non-specific inflammatory measure that is influenced by a variety of circumstances, it must be used in conjunction with other clinical findings, the individual's medical history, and the results of other laboratory tests. The health practitioner may be able to confirm or rule out a suspected illness if the ESR and clinical data match.

Without any signs of a specific condition, a single elevated ESR is usually insufficient to make a medical conclusion. A normal result does not, however, rule out inflammation or illness.

Inflammation, as well as anemia, infection, pregnancy, and aging, can cause a moderately raised ESR.

A severe infection with a rise in globulins, polymyalgia rheumatica, or temporal arteritis are common causes of an extremely high ESR. Depending on the person's symptoms, a health practitioner may employ various follow-up tests, such as blood cultures. Even if there is no inflammation, people with multiple myeloma or Waldenstrom's macroglobulinemia have extraordinarily high ESRs.

Rising ESRs may suggest increased inflammation or a poor response to therapy when monitoring a condition over time; normal or falling ESRs may indicate an adequate response to treatment.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: The CRP test is used to identify and/or monitor inflammation in patients.

Also Known As: CRP Test, Inflammation test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a C-Reactive Protein test ordered?

When a person's medical history and signs and symptoms indicate that they may have a significant bacterial infection, a CRP test may be recommended. When a newborn displays signs of infection or when a person has sepsis symptoms including fever, chills, and rapid breathing and heart rate, it may be ordered.

It's also commonly requested on a regular basis to check illnesses like rheumatoid arthritis and lupus, and it's routinely repeated to see if medication is working. This is especially effective for inflammation issues because CRP levels decrease as inflammation decreases.

What does a C-Reactive Protein blood test check for?

C-reactive protein is a protein produced by the liver and released into the bloodstream within a few hours following tissue injury, infection, or other inflammatory event. After trauma or a heart attack, with active or uncontrolled autoimmune illnesses, and with acute bacterial infections like sepsis, markedly higher levels are reported. CRP levels can rise by a thousand-fold in response to inflammatory diseases, and their elevation in the blood can occur before pain, fever, or other clinical signs. The test detects inflammation caused by acute situations or monitors disease activity in chronic diseases by measuring the level of CRP in the blood.

The CRP test is not a diagnostic tool, although it can tell a doctor if inflammation is occurring. This information can be combined with other indicators like signs and symptoms, a physical exam, and other tests to establish whether someone has an acute inflammatory disorder or is having a flare-up of a chronic inflammatory disease. The health care provider may next do additional tests and treatment.

This CRP test should not be confused with the hs-CRP test. These are two separate CRP tests, each of which measures a different range of CRP levels in the blood for different purposes.

Lab tests often ordered with a C-Reactive Protein test:

  • Sed Rate (ESR)
  • Procalcitonin
  • ANA
  • Rheumatoid Factor
  • Complement

Conditions where a C-Reactive Protein test is recommended:

  • Arthritis
  • Autoimmune Disorders
  • Pelvic Inflammatory Disease
  • Inflammatory Bowel Disease
  • Sepsis
  • Vasculitis
  • Systemic Lupus Erythematosus
  • Meningitis and Encephalitis

Commonly Asked Questions:

How does my health care provider use a C-Reactive Protein test?

A health practitioner uses the C-reactive protein test to diagnose inflammation. CRP is an acute phase reactant, a protein produced by the liver and released into the bloodstream within a few hours following tissue injury, infection, or other inflammatory event. The CRP test is not a diagnostic test for any ailment, but it can be used in conjunction with other tests to determine whether a person has an acute or chronic inflammatory disorder.

CRP, for example, can be used to detect or track substantial inflammation in someone who is suspected of having an acute ailment like:

  • Sepsis is a dangerous bacterial infection.
  • An infection caused by a fungus
  • Inflammation of the pelvis

People with chronic inflammatory diseases can use the CRP test to detect flare-ups and/or see if their medication is working. Here are a few examples:

  • Inflammatory bowel disease
  • Arthritis, which can take many forms.
  • Autoimmune disorders, examples include lupus and vasculitis

CRP is occasionally requested in conjunction with an erythrocyte sedimentation rate, another inflammatory test. While the CRP test is not specific enough to diagnose an illness, it does serve as a broad marker for infection and inflammation, alerting doctors to the need for more testing and treatment. A variety of additional tests may be used to determine the source of inflammation, depending on the probable cause.

What do my C-Reactive Protein test results mean?

CRP levels in the blood are usually low.

CRP levels in the blood that are high or rising indicate the existence of inflammation, but they don't tell you where it is or what's causing it. A high CRP level can establish the presence of a severe bacterial infection in people who are suspected of having one. High levels of CRP in persons with chronic inflammatory disorders indicate a flare-up or that treatment isn't working.

When the CRP level rises and then falls, it indicates that the inflammation or infection is diminishing and/or responding to treatment.

Is there anything else I should know about C-Reactive Protein?

CRP levels can rise during pregnancy, as well as with the use of birth control tablets or hormone replacement therapy. Obese people have also been found to have higher CRP levels.

In the presence of inflammation, the erythrocyte sedimentation rate test will also rise; however, CRP rises first and then falls faster than the ESR.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: A hs-CRP or High Sensitivity C-Reactive Protein test is a blood test used to accurately detect lower concentrations of the protein C-Reactive Protein. This test is used to evaluate your risk of cardiovascular and heart disease and to check for inflammation and many other issues.

Also Known As: hsCRP Test, Cardiac CRP Test, high sensitivity C-reactive protein Test, CRP Test for heart disease.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a hs-CRP test ordered?

There is currently no consensus on when to get an hs-CRP test. It may be beneficial for treatment purposes to order hs-CRP for those that have kidney disease, diabetes or inflammatory disorders.

It's possible that hs-CRP will be tested again to confirm that a person has persistently low levels of inflammation.

What does a hs-CRP blood test check for?

C-reactive protein is a protein found in the blood that rises in response to infection and inflammation, as well as after trauma, surgery, or a heart attack. As a result, it's one of numerous proteins referred to as acute phase reactants. The high-sensitivity CRP test detects low levels of inflammation in the blood, which are linked to an increased risk of developing cardiovascular disease.

According to the American Heart Association, CVD kills more people in the United States each year than any other cause. A number of risk factors have been related to the development of CVD, including family history, high cholesterol, high blood pressure, being overweight or diabetic, however a considerable number of people with few or no recognized risk factors will also acquire CVD. This has prompted researchers to investigate for new risk variables that could be causing CVD or could be used to identify lifestyle modifications and/or treatments that could lower a person's risk.

High-sensitivity CRP is one of an increasing number of cardiac risk markers that may be used to assess an individual's risk. According to certain research, monitoring CRP with a highly sensitive assay can assist identify the risk level for CVD in persons who appear to be healthy. CRP levels at the higher end of the reference range can be measured with this more sensitive test. Even when cholesterol levels are within an acceptable range, these normal but slightly elevated levels of CRP in otherwise healthy persons might indicate the future risk of a heart attack, sudden cardiac death, stroke, and peripheral artery disease.

Lab tests often ordered with a hs-CRP test:

  • Complete Blood Count
  • Lipid Panel
  • Comprehensive Metabolic Panel
  • Lp-Pla2
  • Glucose

Conditions where a hs-CRP test is recommended:

  • Heart Attack
  • Heart Disease
  • Cardiovascular Disease
  • Stroke

How does my health care provider use a hs-CRP test?

A test for high-sensitivity C-reactive protein can be used to assess a person's risk of cardiovascular disease. It can be used in conjunction with a lipid profile or other cardiac risk markers, such as the lipoprotein-associated phospholipase A2 test, to provide further information regarding the risk of heart disease.

CRP is a protein that rises in the bloodstream as a result of inflammation. A continuous low level of inflammation, according to studies, plays a crucial role in atherosclerosis, the narrowing of blood vessels caused by the build-up of cholesterol and other lipids, which is typically linked to CVD. The hs-CRP test successfully detects low levels of C-reactive protein, indicating low but chronic inflammation, and so aids in predicting a person's risk of developing CVD.

Some specialists believe that high-sensitivity CRP is a good test for assessing CVD, heart attacks, and stroke risk, and that it can help in the evaluation process before a person gets one of these health problems. Some experts believe that combining a good marker for inflammation, such as hs-CRP, with a lipid profile is the best way to predict risk. This test has been recommended by several organizations for persons who are at a moderate risk of having a heart attack in the following ten years.

What does my hs-CRP test result mean?

Even when cholesterol levels are within an acceptable range, high levels of hs-CRP in otherwise healthy people have been found to predict an elevated risk of future heart attacks, strokes, sudden cardiac death, and/or peripheral arterial disease.

Higher hs-CRP concentrations indicate a higher risk of cardiovascular disease, while lower values indicate a lower risk. Individuals with hs-CRP values at the high end of the normal range are 1.5 to 4 times more likely than those with low levels of hs-CRP to have a heart attack.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Beta-2-microglobulin normally passes through the glomerulus into the proximal tubule where much of it is reabsorbed. Serum levels are therefore an index of glomerular function. When impaired, serum levels rise in inverse ratio to glomerular filtration rate. Increased amounts of beta-2-microglobulin are excreted in several renal disorders, e.g., Balkan nephropathy, heavy metal poisoning and renal tubular disease due to therapeutic agents. Serial levels of beta-2-microglobulin in serum and urine are used to evaluate transplant viability and anticipate rejection. Following a successful graft, serum levels decline toward normal. Increasing serum levels provide an early sign of rejection. Elevated levels are also noted in lymphproliferative disorders, neoplasms (malignant and benign), inflammatory disease, and autoimmune diseases such as systemic lupus erythematosus (SLE) and Sjögren's disease


What is Lupus (SLE)?

Lupus, also known by the formal name Systemic lupus erythematosus (SLE), is a chronic (long-term) autoimmune disorder where the body’s own immune system attacks healthy tissue. This causes inflammation, swelling, and pain in the body, most commonly in joints, skin, and organs. 

According to the National Resource Center on Lupus and the Lupus Foundation of America, more than 16,000 new cases of Lupus are confirmed each year in the United States, with an estimated 1.5 million Americans living with Lupus today. Many folks have heard about Lupus from celebrities that have the disease, such as singers Seal, Selena Gomez, and Paula Abdul. 

One of the methods used to confirm a Lupus diagnosis is to perform lab tests of the patient’s blood. These tests will screen for the presence of antibodies, specifically anti-nuclear antibodies (ANA), and other components of the blood to identify if the immune system is working abnormally. 

The cause and risk factors of Lupus are not well understood yet. There is no prevention or cure. Treatment efforts are focused on reducing the patient’s symptoms, especially pain and swelling. Lupus will require a lifetime of care, but celebrities suffering from the disease provide evidence and inspiration that individuals with Lupus can live successful lives.

What are the Risk Factors for Lupus (SLE)?

The following groups appear to be more likely to get Lupus:

  • 9 out of 10 Lupus patients are women, mostly aged 15-44
  • Certain racial or ethnic groups, including African American, Hispanic, and Pacific Islander
  • People who have a family member with Lupus

Due to the weakened immune system, Lupus patients are more susceptible to infections such as respiratory, yeast, urinary tract, herpes, and shingles. People suffering from repeat infections such as this should investigate if they may have an autoimmune disorder. 

Interestingly, Lupus patients may also have a false positive test for syphilis; meaning the blood test says a person has syphilis, but they actually do not. So individuals receiving a surprise and unexplainable diagnosis of syphilis should consider Lupus as a possibility.

What Causes Lupus (SLE)?

Doctors do not know what causes Lupus. Leading theories usually involve a complex mix of genes, hormones, and environmental factors. 

Theories about the cause of Lupus are primarily based on the risk factors for Lupus (the groups most likely to get the disease). 

  • With 9 out of 10 Lupus patients being female, it is assumed that hormones such as estrogen play a role. 
  • With Lupus appearing within families and races, it is assumed there is a genetic component; scientists have narrowed down a list of 50 genes that Lupus patients share, which may play a role.
  • But some people at high risk, such as an identical twin, never get the disease, so there is an assumed environmental component; something that triggers the disease to start. 

Lupus patients report certain environmental changes trigger their symptoms to flare-up, including increased exposure to sunlight, exercise, and sudden stress. Scientists are researching if these factors play a role in causing Lupus.

What are the Symptoms of Lupus (SLE)?

Lupus is a very challenging disease to recognize and diagnose because no two people have identical symptoms, and its symptoms look like many other diseases. In addition, Lupus symptoms are known to come and go in rounds of flares and temporary remissions. Sometimes the symptoms are overwhelming and sometimes they are barely noticeable. Symptoms can also change over time. It takes six years for the average Lupus patient to finally be diagnosed with the disease.

The most common symptoms of Lupus are:

  • Skin rashes; especially a butterfly-shaped rash on the cheeks and nose
  • Pain or swelling in the joints (arthritis)
  • Swelling in the feet and the eye area
  • Extreme fatigue
  • Sjogren's syndrome: dryness of mouth, eyes, and other body parts that self-lubricate
  • Low fevers
  • Headaches
  • Sensitivity to sunlight or fluorescent light
  • Chest pain when deeply breathing
  • Hair loss
  • Sores in the mouth and nose
  • Fingers and toes turning white/blue and feeling numb

According to the Lupus Foundation of America, 65% of people with Lupus say having chronic pain is the worst part of the disease. 76% of Lupus patients have to cut back on social activities due to extreme fatigue. And 89% of Lupus patients can no longer work full-time jobs due to complications from Lupus.

How is Lupus (SLE) Confirmed?

Lupus is a challenging disease to diagnose, and confirming the disease may involve a complicated review of symptoms and family history. However, there are blood tests that can help indicate that the body is suffering from a disease such as Lupus.

The most common blood tests for Lupus search for Anti-nuclear antibodies (ANA), which are found in almost all Lupus patients

  • ANA Pattern
  • ANA Screen, IFA
  • Anti-Nuclear Ab Titer

And searching for other antibodies that are common with autoimmune disorders

Other tests look at the blood’s ability to clot and look at red blood cells and white blood cells:

As well as the body's ability to attack infections:

There is no single test that can confirm Lupus, which is why testing for Lupus requires so many different blood tests. However, seeing any of the biomarkers out of range can certainly hint at Lupus. These test results can then be combined with physical symptoms and family history to make a Lupus diagnosis.

To simplify SLE testing and ensure that crucial biomarkers are analyzed, Ulta Lab Tests offers the Systemic Lupus Erythematosus (SLE) Comprehensive Diagnostic Panel that tests for the following 12 key biomarkers:
 
        1. ANA Pattern
        2. ANA Screen, IFA
        3. Anti-Nuclear Ab Titer
        4. Chromatin (Nucleosomal)
        5. Complement Component C3c
        6. Complement Component C4c
        7. Complement, Total (Ch50)
        8. Dna (Ds) Antibody
        9. Rnp Antibody
        10. Sjogren's Antibody (Ss-A)
        11. Sjogren's Antibody (Ss-B)
        12. Sm Antibody

What Happens if Lupus (SLE) Goes Untreated?

If left untreated, Lupus patients can expect inflammation to continue to worsen until major organs are impacted. The most serious consequences of Lupus are:

  • Inflammation of the kidneys, eventually leads to kidney failure and/or the need for dialysis and/or kidney transplant.
  • Inflammation of the nervous system causes memory problems, headaches, and strokes
  • Inflammation of blood vessels in the brain causing fevers, seizures, and changes to behavior
  • Inflammation of the heart and arteries leading to heart attack
  • Inflammation of the skin causing rashes, ulcers, and sores 

The damage from Lupus can accrue over time. Those suffering from severe symptoms at the start of the disease, or suffering severe symptoms for more than two years, or have four or more severe episodes of the disease, are more likely to suffer organ damage.

Research is also showing that even brief periods where symptoms are reduced can be enough to reduce the accrued damage to organs. This demonstrates the importance of early diagnosis and treating Lupus effectively.

How is a Lupus (SLE) Treated?

There is currently no way to prevent or cure Lupus (SLE). Treatment efforts are focused on relieving symptoms, controlling the immune system, and slowing down the worsening of inflammation. Unfortunately, due to the wide variety of symptoms of Lupus, and the fact symptoms can change over time, a Lupus patient may spend many years trying to find the right combination of treatments to relieve their symptoms.

Examples of medications commonly used to treat Lupus symptoms include:

  • Anti-inflammatories to help with pain and swelling
  • Antimalarials to control skin rashes
  • Anticoagulants for blood clots
  • Immunosuppressives and biologics to help control the immune system
  • Steroids to help inflammation

Lupus patients should also minimize the environmental factors that trigger their symptoms to flare, such as exposure to sunlight, exercise, and sudden stresses.

Benefits of Using Ulta Lab Tests for Lupus (SLE) Testing

One of the primary methods of diagnosing SLE Lupus is through blood tests that detect unusual antibodies in the blood, especially antinuclear antibodies (ANA). Because Lupus is so difficult to diagnose, multiple blood tests may be needed to look at a wide range of biomarkers. Ulta Lab Tests has individual panels of SLE blood tests available for purchase today. 

Ulta Lab Tests provide comprehensive and affordable laboratory testing and health screening services directly to consumers. Our mission is to enable individual consumers across America to take control of their healthcare by having direct access to the quality lab tests of their choice. Consumers are now able to be proactive in the early detection and prevention of disease and do so with complete control of their healthcare costs.

Our services are perfect for a wide variety of people, such as:

  • Anyone looking to proactively monitor their health
  • Those with high deductible insurance plans
  • People looking to use HSA/FSA funds
  • The uninsured and self-employed
  • Businesses looking to frequently test employees

We offer tests that are highly accurate and reliable so you can make informed decisions about your health. 

  • Secure and Confidential Results
  • No Insurance or Referral Needed
  • Affordable Pricing including Doctor's Order
  • 100% Satisfaction Guarantee

Order your Lupus lab tests today and your test results will be provided to you securely and confidentially online in 24 to 48 hours for most tests.

Take charge of your health with Ulta Lab Tests.