Lupus (Systemic Lupus Erythematosus or SLE)

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



Antinuclear antibodies are associated with rheumatic diseases including Systemic Lupus Erythematous (SLE), mixed connective tissue disease, Sjogren's syndrome, scleroderma, polymyositis, CREST syndrome, and neurologic SLE. 

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


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.


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


RPR (Monitor) with Reflex to Titer 

Reference Range(s)

  • Non-Reactive

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.

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.

Alternative Name(s) 

Syphilis


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.

A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

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

Comprehensive Metabolic Panel


Most Popular

Dipstick urinalysis is important in accessing the chemical constituents in the urine and the relationship to various disease states. Microscopic examination helps to detect the presence of cells and other formed elements.

NOTE: Only measurable biomarkers will be reported.


Useful in differentiating inflammatory and neoplastic diseases and as an index of disease severity. CRP is also useful in monitoring inflammatory disease states.

Increased CRP levels are found in inflammatory conditions including: bacterial infection, rheumatic fever, active arthritis, myocardial infarction, malignancies and in the post-operative state. This test cannot detect the relatively small elevations of CRP that are associated with increased cardiovascular risk.

C-Reactive Protein Cardiac (hs CRP) Useful in predicting risk for cardiovascular disease.


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
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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.