Blood test results: investigation Lupus/Mixed Connective Tissue Disease

[Michellear]

Hi all,

Currently under investigation and received requested blood tests ahead of next appointment.

My immunoglobulin M is below range and so is complement 3 & 4.

I’m also confused by the other results for different antibodies and have no idea what it all means!

6 months ago tested ANA 1:80 titre speckled but this has since come back negative.

Is anybody aware if the results are inductive of Lupus or Mixed Connective Tissue Disease (along with a list of symptoms)?

Thank you in advance for your time.

[Rosills1]

Take a careful look at the units and normal ranges.

[miccika1]

Why do you think your complement levels and IgM are low?

[Michellear in reply to miccika1]

I’m not sure, could it be linked to Lupe or mixed connective tissue disease? Have all the other symptoms: fatigue, painful symmetrical joints, discoid eczema in ears and scalp, red rash on face, problems swallowing, frequent UTIs, low grade temperature and anaemic. Thinks that’s it

Thank you for your reply

[miccika1 in reply to Michellear]

I mean from the picture you posted your ranges are all normal. Your symptoms are quite extensive but it's hard to say what is causing them only looking at your labs as your labs are all normal. Hope your doctor can figure something out and help you.

[Michellear in reply to miccika1]

Thank you. Hope so too 👍

[Hidden in reply to Michellear]

As I just wrote - it’s possible to have seronegative rheumatic autoimmune diseases but more likely with Sjögren’s, Vasculitis and RA, which can cause all these symptoms - as can others such as psoriatic arthritis. But from what you’re describing I’d suggest you look at Sjögren’s. X

[Michellear in reply to Hidden]

Thank you for your long message and explaining ‘seronegative’. I will look into Sjogrens’. Sounds like you’ve been on quite a journey! Thanks again

[Michellear in reply to miccika1]

Seeing rhemo in May. Be good to finally get some answers and medication to help with the symptoms

[LisaSnow]

Low C3 and C4 are frequently found in patients with SLE.

[Roarah in reply to LisaSnow]

Hers are in range according to the above figures.

[Michellear]

Thank you for your message and confirmation that it possibly is linked to lupus👍

[WinterSwimmer]

Low C3 and C4 are diagnostic for lupus. Lupus can be part of mixed connective tissue disease as far as I know.

[Michellear in reply to WinterSwimmer]

Hi, thank you for your Message and for Confirming

[Roarah in reply to Michellear]

Your numbers are all well within normal ranges not low. C3 reference range is .75 to 1.65 yours is on the higher side of normal at 1.4g/l. Your c4 is .27 in normal range of .15 to .54 and Immoglobins are both also with in normal range.

[Michellear]

Thank you for your reply. Am I reading it wrong, I thought the range for c3 is 10.75 to 1.65 mine is 1.4. C4?range is 10.14 to 0.54 mine is o,27. IGM range is 10.5 to 2.00’mine is 0.8. I think it says results first then the range. It’s confusing

[Roarah in reply to Michellear]

No the measure is in g/l you are miss reading the liter (l) in your results as a 1. The low c3 is . 75 for the first number is always lower than the second number in a range scale.

Luckily all your labs are in normal ranges.

[Roarah in reply to Roarah]

Some of the other negative serum were testing for vasculitis, RA and APS.

[Michellear]

Thank you

[Hidden]

It’s quite possible to have normal results and still have a rheumatic autoimmune disease. Lupus is just one of quite a few.

However with these results I’d say that you’re very unlikely to be diagnosed with Vasculitis, RA and APS. This doesn’t exclude seronegative versions but it does make them more unlikely. But apart from a consistently weakly positive ANA (it was high initially) I don’t have any of these antibodies on your sheet.

Yet I do have definitely diagnosed seronegative Sjögren’s and am now very antibody positive for systemic sclerosis. Sometimes it takes many years for people to get diagnosed especially with seronegative rheumatic diseases. My C3 and 4 are always elevated when I’m untreated which is very atypical of Sjögren’s.

But there we are - rare exists and very rare exists too!

[Hidden in reply to Hidden]

Sorry I'm chiming in! New on here and being investigated for a long time now for my labs. Seeing a rheum and saw a hematologist one. Slightly elevated platelets. Positive ANA and elevated crp and esr. Anyway is it true that even if my bloodwork is good that I can still have an autoimmune disease?? I have many symptoms too go along. So frustrating its so hard and it can take so long too be diagnosed. Thank you!

[Hidden in reply to Hidden]

Yes it’s true but just less likely that you have something autoimmune with normal bloodwork. But positive ANA and raised inflammatory markers isn’t normal so keep pushing.

Just a tip - instead of asking this here why don’t you post and ask the community? You’ll get many more replies that way hopefully. There is a pen sign on right hand corner so you can write your own posts 😊

[Hidden in reply to Hidden]

thank you!!!! Great idea really appreciate it!!!

[DJK99]

Hi. Looks like both your c3 and c4 ARE below range. I have this too. What were your neutrophils (white blood cells?). Please read my recent posts on low complement. Or just google for med papers on hypocomplementemia or low complement and lupus or sjogrens. I had seroneg mod SLE for 3yrs til rheumy decided to downgrade to “lupus like syndrome” last autumn due to covid issues I feel. Made no sense after being emphatic for years I was SLE. Now been rediagnosed with Sjogrens. You can also search for the guidelines for diagnosis for SLE and also Sjogrens on Rheumatology association etc sites. All the best D x

[Roarah in reply to DJK99]

Her numbers are all in range. The G/l after her ranges is being misread as a 1.

Wait until you see the rheumatologist to speculate what might be going on.

[Roarah]

This is a few years old but a very clear explanation of how lupus is a diagnosis of criteria ( a point system) and exclusion. hss.edu/conditions_does-ana...

[KayHimm in reply to Roarah]

This is the best article I ever read. I have recommended to people here but my iPad won’t post links. Really allows us into the mind of a rheumatologist. Michael Lockshin is a prominent lupus specialist - known for his expertise on lupus patients and pregnancy. He either worked with or trained under Graham Hughes.

[Roarah in reply to KayHimm]

My Yale rheumatologist works along side with this hospital and I am enrolled in some studies in collaboration with HHS and Yale. They are all great! You likely have a connection too!

[KayHimm in reply to Roarah]

No, I am actually not plugged in to the Cornell/ HSS system. I still go to the rheumatologist who diagnosed me with UCTD forty years ago! We have grown old together. 😅

That article describes you as the unequivocal lupus patient. What is unusual is how the steroids completely reversed your kidney disease and you went into remission. Does anyone ever comment about that?

🥰 k

[Roarah in reply to KayHimm]

My present rheumatologist and hematologist believe I might not have lupus but maybe primary APS caused clotting in my kidneys when I was in my twenties. I had the positive Ana so my doctors at that time assumed lupus but never tested my APLs back than. Kidney function improved on steroids but if a clot broke up they would improve also. I had some kidney clots during my stroke which is why they believe this now. And the last three antibody panels have all been normal for apls and other antibodies. Just my factor 8 and VWF antibodies were elevated. My last positive ANA was in the hospital when I stroked. Maybe APS clotting not lupus causes my positive ANA and kidney issues.

[KayHimm in reply to Roarah]

Interesting. I don’t recall how long ago your first episode was. The aPL testing

was not round when I was diagnosed.

Lupus rarely goes into clear remission

like you did, so it all makes sense now.

You could be used as an example of re-thinking case as knowledge improves. APS was not even a thing when

I was young.

[Roarah in reply to KayHimm]

My lupus diagnosis was almost 25 years ago so they did likely have knowledge of it but not like today. I really should have been tested though when I was having multiple miscarriages starting 12 years ago. They blamed my age( I had many MCs between the ages of 38 through 40)

[KayHimm in reply to Roarah]

It sure sounds like it. That is sad about the miscarriages.

All these years and they finally know the total picture.

[Michellear]

Thank you to all for the helpful information. Very much appreciated! Late reply a first day back at work after time off. Thank you DJK99 Roarah and Hidden xxx

[Jmiller623]

Hi Michelle. All of your labs are in normal range. A once positive ANA can mean many things. Speckled pattern can also mean a lot of things. Lupus diagnosis requires both fulfillment of lab and clinical criteria. You were tested for a slew of things that sometimes can be indicative of a connective tissue disease. Your physician should correlate your symptoms with your lab findings. Some may even treat you with Plaquenil just based on symptoms and physical exam findings without positive labs.

SLE and aPL positive here. My dsDNA has never been positive. My ANA has only ever been positive once but my complement, white cell counts and immunoglobulins are always low. There are some things that can be indicative of evolving lupus but your labs look stone cold normal. What symptoms are you having that warranted the labs being drawn?

Please keep us in the loop. ❤️xx

[Michellear in reply to Jmiller623]

Hi Many thanks for the message. I have had many symptoms for the last 4?years. Fatigue joint pain low grade fever headaches discoid eczema cold feet hands swallowing problems current uti infections rash on face pose butterfly rash brain fog to name nearly everything I think!! Will keep u updated. Thanks for the help xx