It was shown that, even if it seems hard to believe, the initial signs of lupus may appear in the blood, a blood disorder can be the first sign that comes in patients having systemic lupus erythematosus.Systemic lupus erythematosus can show hematological symptoms like anemia, thrombocytopenia, low white blood cell counts and clotting disturbances. That is why, specialists in disorders of the blood can be of real help.
One of the most usual hematological abnormalities that can appear in persons having lupus is anemia. Anemia consists in a reduction in the number of red blood cells and it is recognized by some tests, such as, the hemoglobin concentration in blood, the hematocrit and the red blood cell count.It is known that anemia can have many causes, and in what concerns persons with lupus, anemia can appear because of a chronic inflammation, iron deficiency, prolonged uremia or hemolytic anemia. It is also known that fatigue, which is suffered by many patients having lupus can contribute to the apparition of anemia.
Prolonged uremia, which appears because of an impaired kidney function can lead to anemia. Anemia caused by prolonged uremia can be treated with androgens or erythropoietin, a recently developed hormone having role in the stimulation of red cell production. Sometimes, chronic uremia can determine the apparition of more severe forms of anemia, and that requires blood transfusions.
Prolonged inflammation, which is an important cause of anemia in patients that have lupus, hinders the production of red blood cells by the bone marrow. Because of this inflammation, iron, which is very important in the production of hemoglobin accumulates unused in the marrow tissue. The solution to restore normal red blood cell production is to ease the inflammatory condition.
Iron deficiency is another cause of anemia that can appear because of the blood loss from the body. Drugs that are used in the treatment of lupus can irritate the stomach and produce bleeding and from there results iron-deficient anemia. Iron deficient can become also women that have heavy or frequent menstrual periods.Anemic patients should take some tests for blood loss from the stomach or intestines. It is important to do that, because the source of bleeding must be found and treated.Iron deficient anemia can be corrected in a short time by taking iron tablets.
Hemolytic anemia is a condition that can appear in some people with lupus, usually due to antibodies directed against red blood cells. In this condition, auto-antibodies interact with the red blood cells, and the result is that the red blood cells are removed in the spleen or liver by scavenger cells.Usually, steroids like Prednisone are effective into treating this type of anemia, but there are cases of patients that do not respond to the treatment, and surgical removal of the spleen may be required. Also in severe cases, it is needed a blood transfusion.It is known that a deficiency of thrombocytes, which are tiny particles in the blood, essential for blood clotting causes thrombocytopenia. This leads to bleeding from the gums, nose, or intestines and excessive skin bruising. As some typical signs of thrombocytopenia, we can mention petechiae and pinpoint hemorrhages in the skin.In person with lupus, usually occurs immune thrombocytopenia. This appears because antibodies destroy the platelets, similarly with the destruction of the red blood cells in the autoimmune hemolytic anemia. As a treatment, we can mention steroids like Prednisone and in severe cases splenectomy may be needed.
It was discovered that patients that have lupus produce an antibody called the lupus anti-coagulant. It was seen that some patients with the lupus anti-coagulant tend to form clots abnormally condition called venous thrombosis. That is a paradox that science can’t explain yet.Sometimes, venous thrombosis can associate with pulmonary embolus, and particularly that situation requires treatment with anti-coagulant drugs such as heparin and Coumadin. Lupus anti-coagulant was also detected in cases of recurrent fetal loss, but it is not known if it causes the so-called habitual spontaneous abortion.
Patients with lupus can experience also some abnormalities , like granulocytopenia, which means there is a low granulocyte count, and lymphocytopenia- when there is a low number of lymphocytes. Usually, these abnormalities are harmless and without symptoms, but there can occur severe granulocytopenia, which is usually caused by a reaction to medication. In this case, there must be stopped the intake of the causative drug, and if there is an infection, treatment with antibiotics is required.
Nowadays, there is a great concern about the risk of getting AIDS by blood transfusions. It is good to know that there were developed tests for antibodies against the virus that causes AIDS, and all the blood donors are screened for such antibodies.Of course, the safest thing that can be done is to store your blood for later transfusion, but this is not always practical.It is also possible in some blood banks to designate a member of the family to donate blood for you, but it must be taken in consideration the possibility of blood incompatibility.