Hi there!
I've been to the rheumatologist and had blood work done. I have received some results and not others. I am curious can you still have lupus with a normal esr, c3 and c4 level. I had a positive Ana ( not a high titer) and still awaiting for the rest of the results.
Thank you
Hi Sana78 ,
The erythrocyte sedimentation rate (ESR) is a test doctors most commonly use to check for inflammation. Most people who have active SLE have an elevated ESR; however, many do not. Some SLE patients who have no active disease can also have an elevated ESR for no apparent reason.
Complements are components of a complex group of important proteins in the immune system that work together with antibodies and white blood cells to attack and destroy invading organisms such as bacteria. C3 and C4 complement levels can increase due to any cause of inflammation (including SLE). When they are elevated, they are usually not very useful findings to follow. However, other people who have SLE will develop decreased C3 and C4 complement levels due to it being "consumed" during the immune activation process. In these individuals, if their C3 and C4 levels consistently drop during times of disease flare and improves during times of disease control, they can be helpful to monitor.
The ANA test is positive in around 95-98% of people with lupus. However, these antibodies are also positive in many other conditions (such as rheumatoid arthritis) and even around 10% of the healthy population. Therefore this test is not specific to lupus. Most labs consider a titre of 1:40 or greater to be a positive ANA. The higher the titre, the greater the chances are of that particular ANA result being associated with a disease such as SLE.
Thanks Paul, your post explains a lot!
Mine was a positive ANA for mild SLE. I was told straight away when I went back for blood results. I dont know about the other tests you mention, they werent mentioned at all, just the ANA
My gps had been treating me for RA without a diagnosis, prescribing a drug that gave me an ulcer. It wasnt till I was discharged from hospital after the ulcer repair and saw a locum gp that he sent me off for bloods, they came back 2 weeks later with the positive ANA
Good luck xxx
Just read Pauls post and the ESR test is one I had done recently. It came back very slightly raised but nothing significant the doc said, so no treatment needed
I'm sorry to hear that.. After, the positive Ana you were diagnosed with sle? Also, thank you for replying.
Yes I was and prescribed hydroxychloroquine over 12 years ago. I have yearly check ups to keep an eye on things and have been stable so far 
That's good. I hope soon enough things are stable for me as well. Waiting for test results feels like the hard part.
It is the hardest...I was convinced I had cancer as it runs in my family so if I'm honest, finding out it was a mild form of a very treatable disease that can be kept under control was a relief. I hope you get your results soon, try not to worry xxx
I have lupus and initially had positive ANA normal ESR and normal complement c3 and 4. But elevated CRP and anti RNP antibodies. A lot of the diagnosis is what kind of symptoms you have. And treatment is also based on symptoms, at least it should be. I hope you get a diagnosis because I know the waiting is the most difficult part. I hope this information is helpful. Xo Nan
Hi, My c3andc4 are normal. I was dx's with subcutaneas(sp) Lupus last September....My ANA was VERY high and I had a horrible rash(caused by the sun/lupus) So far my SKIN, joints, and FATIGUE is how I am being affected by Lupus......
I also had the rash but it does not remain on my skin for long. Fortunately, when I went to see the rheumatologist it was there. Thank you for replying.. 😊
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Test results
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