09-10-2007, 10:15 AM
Hope all's well with you today. I have been laid out since a flare which occured over a month back. My sed rate is currently way up (70), RBC count very low etc and my strength very limited.
I just wanted to tell you I brought my brother with me to the doctors appointment last week as he wanted further information about my condition since we both work together. The rheumatologist really impressed him and then proceeded to tell him that I had lupus which targets and destroys red blood cells. Have you heard, read and know of any links about this form of lupus.
I only ask because you seem to be an expert in this disease.
Look forward to your reply on this issue.
09-11-2007, 07:37 AM
Anemia is the most common blood problem in people with SLE. It is the lack of red blood cells, or the presence of red blood cells that do not have enough oxygen-carrying capacity due to a deficiency in iron or vitamins. In lupus patients, anemia can be caused by chronic inflammation, iron deficiency, prolonged uraemia, or hemolytic anemia. Many Lupus patients suffer from hemolytic anemia, what we have is usually called autoimmune hemolytic anemia because of the malfunction of our immune system that produces autoantibodies which attack red blood cells as if they were substances foreign to the body. Autoimmune hemolytic anemia is gnerally caused by or occurs with another disease, such as systemic lupus erythematosus, and, on rare occassions, can be caused by certain drugs, such as penicillin.
The destruction of the red blood cells that is caused by autoantibodies can occur suddenly, or it may develop gradually. In some people, the destruction may stop after a period of time. But, in other people (especially those with SLE), it becomes chronic.
There are two main types of autoimmune hemolytic anemia: warm antibody hemolytic anemia and cold antibody hemolytic anemia. In the warm antibody type, the autoantibodies attach to and destroy red blood cells at temperatures equal to or in excess of the normal body temperature. In the cold antibody type, the autoantibodies become most active and attack red blood cells only at temperatures well below the normal body temperature.
The term for destruction of red blood cells is hemolysis. Red blood cells normally live for 120 days, but in hemolytic anemia, they only live for about 10-15 days. In lupus patients, this is caused by the antibodies that are made against the red blood cells. Like Lupus, hemolytic anemia can become chronic with periods of remissions and recurrence. The bone marrow is unable to compensate for the premature destruction of red blood cells by increasing their production. When the marrow is able to compensate, anemia does not occur. If other substances such as complement are present, the antibodies can pop the red cells. This is usually treated with corticosteroids or cytotoxics, but in very serious cases, the spleen may have to be removed. There is no known prevention for hemolytic anemia.
Red blood cells are produced by the bone marrow, but because lupus causes chronic inflammation, this inflammation can hinder the production of red blood cells. When there is inflammation, iron is not handled properly and it accumulates in the bone marrow tissue. But iron is needed to produce hemoglobin (red pigment in the cells), and if it is accumulating in the marrow tissue, it can't be used to produce the red cells. For Lupus patients, treating the anemia with iron is pretty much useless if the anemia is caused by inflammation. So, for Lupus patients, the production of red blood cells can only return to normal when the inflammation is treated.
Other causes of anemia in lupus patients are:
* Iron Deficiency
* Uraemia: This is a dysfunction of the kidney in which wastes, which are normally excreted by the kidneys, remains in the bloodstream. Uraemia can also cause anaemia in lupus patients. Uraemia is generally treated with androgens (male hormones), or with a hormone called erythropoietin.
I hope that I've answered your question. Let me know if you need anything further.
Peace and Blessings
09-11-2007, 11:58 AM
That was a very informative reply and it makes me think for the moment, "No wonder!" Awhile back during a heatwave here in Sn Mateo I got nailed by a flare and it laid me out flat. Went from feeling the best in a year to the worst. In addition to all the muscle and joint pain I was quite alarmed at the tremors. They were so bad I had to hide all the toothpicks for a day. The docs didn't want to up the dose of methotrexate but they did begin using prednisone as an adjunct.
In any case my I will be away from work for awhile and may have to go on disability-still up for negotiating. Since I cannot travel to Indonesia on biz for the forseeable future, I may cash out. Just thinking out loud. For the time being its rest and recuperate.
Your knowledge of this disease is amazing and I learn from you just as much as I do from my doctors, if not more.
09-13-2007, 09:06 PM
Thank You Juanred :lol:
I'm sorry to hear that you will not be able to go to Indonesia. That sounds so fascinating! But, it is very important that you take care of yourself and that you do, indeed, rest and recuperate!
I wish you the best of luck with your disability...I hope you are approved the first time!!
Peace and Blessings