ANA titter increasing but Complement C3 high??

[MrsRN]

Hey guys,

I wanted to get some insight from some of you who have a diagnosis of SLE or other CTD’s.

Have any of you experienced an elevated (versus decreased) Complement C3 level along with increased ANA ?

If so, what was your diagnosis? Did your SLE diagnosis change?

[Pussbella]

Hi,

Not sure my reply will be much help but I too have a very high Ana - greater than 1:1280 and I have an elevated complement. I have not had the C3 tested individually but my Ch50 levels which covers a broader range (I think and probably includes C3) is well above the normal range.

Several consultants have commented about this unusual state of affairs! I was asked to ask my immunologist which I did. He just said it was odd but not worth worrying about things which could not be changed. I will ask again when I see him in June.

I do have immune deficiencies both Mbl and specific antibody deficiency as well as autoimmunity, Uctd and poss Sjogren's. Maybe this combination has something to do with it?

Hope this is of some use.

Bw

Pb

[MEGS53 in reply to Pussbella]

Hi. This is very interesting. May I ask which specific IG you're lacking? I ask because my IgM is chronically low (but not the other Ig's) and I have very high C3 (but not C4). Thank you.

[Pussbella in reply to MEGS53]

Mine is a subclass deficiency of IgG. (I think!). It is a specific antibody deficiency (pneumoncoccal). I have done several vaccines challenges to try to spark an antibody response but very little happens. I had a similar one for Hib but I responded to the vaccine.

Hope this helps.

Bw

Pb

[MEGS53 in reply to Pussbella]

Again, I find this very interesting. But I don't know what it means nor whether it has any relevance to SLE or Sjogrens's. Perhaps someone can help??

[MrsRN in reply to MEGS53]

Meg, that is interesting. My rheumatologist didn’t run labs on all my immunoglobulins so I’m not sure where I stand there. However, I know that elevated complementC3 can point to chronic inflammation, UC, cancer and other things. It can also point to a deficiency in the Complement system ( a Ch50 lab should be drawn). I’m going to ask for the fore mentioned lad to be drawn at my next appointment.

[MEGS53 in reply to MrsRN]

Gosh, the (auto)immune system is sooo complicated! I admit to only having a working knowledge of the basics, but I do think my sero-negativity for Sjogren's (lip biopsy tomorrow!) and SLE reflects my inability to produce the relevant antibodies. In support of this, I've had sero-negative glandular fever (diagnosed clinically and on typical blood picture) and also mycoplasma pneumonia in my early thirties when I was very fit.

BTW, I thought that C3 was an 'early response' inflammation marker that returned to normal levels later in the disease process? At the time of the raised C3, my ESR and CRP were only very mildly raised. Any comments/clarification would be very gratefully received! Thank you.

[Hidden in reply to MEGS53]

I think it depends which disease process perhaps? For instance I’m told that my always very high PV (ESR) and raised CRP are caused by high immunoglobulins and are a permanent feature of Sjögren’s rather than sign of active or flaring autoimmunity. Guessing same applies to raised compliments.

Unless you have other autoimmunity such as Addisons or primary immune deficiency or both that is. But neither of these are particularly associated with Sjögren’s any more than other autoimmunity as far as I know. They may make the diagnostic process harder though.

My Sjögren’s is classed as seronegative ie lip biopsy positive and thought to be primary. I think Hashimoto’s TPO antibodies come into this as IgG related but I’m afraid this is all I know. There are no treatments to reduce the high viscosity of Sjögren’s I’m told - hence intractable systemic fatigue.

[MrsRN in reply to Pussbella]

Pussbella,

Your answer does help shed some light on things. Typically, when the Complement system shows elevations it can mean a host of things. One of those things you mentioned ( a deficiency). It can also point to chronic inflammation, cancer, acutely urticaria, ulcerative colitis, and has been linked to MS...

I believe your immunologists is wrong to tell you not to worry about. Are you being treated for your other disorders and has the treatment helped or eased the symptoms?

[Pussbella in reply to MrsRN]

Mrs RN,

Thank you for your reply and concern. I am fortunate as my immunologist is a world expert in his field. I am lucky to receive very very good care and am being treated for both immune deficiency and autoimmunity. On the autoimmunity front he works with my rheumatologist. They know and respect each other. I probably do have chronic inflammation which is typical with autoimmunity but not the other diseases you mention. At the moment I take HCQ and am also on a pred taper to counter this. I also take a couple of other minor medications. Due to the immune deficiency my immunologist has sanctioned on demand antibiotics which makes life easier for my other doctors if I get a minor infection and more pleasant for me. If my immunologist has concerns or I report symptoms he takes them seriously so if he says I do not need to worry, or there is little that can be done so we need to focus on the bits of my immune disregulation which can be treated, I am happy to believe him - however my situation could be very different to yours.

Unusually he also takes a holistic approach and always asks about my sleep, diet and liquid intake. He even mentions these factors in his clinic letters along with the more complicated stuff. My rheumatologist is similarly keen on light exercise as well as medication and puts this into my 'prescription'.

I am hoping that as my immune system stabilises with my regime that I will be able to reduce some of my medication and I think this is the goal of my immunologist, too.

It is an interesting area and a complicated one. Hopefully you will get some more useful answers from those who have more expertise than me! When I see my immunologist in the Summer I can ask again if I get an opportunity but I think it depends a little on what joys or not my recent blood tests have revealed as he normally starts off with his findings.

Best wishes

Pb

[Hidden in reply to Pussbella]

I have raised compliments, +ANA, IgG and IgA plus very high inflammation markers. I’m told all these are all typical of Sjögren’s - which is my main autoimmune disease.

[Hidden]

Yes I always have elevated C3 apart from when on steroids. I have Sjögren’s and hypothyroidism.