Lupus erythematosus in the blood
LE cells in the blood are normally absent.
Lupus cells serve as a morphological manifestation of the immunological phenomenon characteristic of SLE.They are formed as a result of phagocytosis by neutrophilic leukocytes( less often monocytes) of nuclei of cells containing depolymerized DNA.The phagocytosed substance
is an immune complex consisting of a lupus factor( antinuclear factor - AT class IgG to DNA-histone complex), leukocyte core and complement residues. Detection of LE cells is a specific sign of SLE.The study should be carried out before the beginning of GK therapy. A negative result of the study does not exclude the possibility of this disease. LE cells are detected in the early period of the disease, as well as with a pronounced nephrotic syndrome and a loss in the urine of a large amount of protein. The lupus factor may be present in the punctate of the red bone marrow, in protein fluids( exudates, urine protein in renal lesions).The frequency of detection of LE cells in patients with acute SLE varies from 40 to 95%.In patients with SLE, first, lupus cells can be found, secondly, free nuclear matter( hematoxylin bodies, Hargraves corpuscles) and, thirdly, rosettes-the accumulation of neutrophils around the lupus cells. Most lupus cells are found when the disease worsens. Their appearance in large numbers is a prognostically unfavorable sign. When the patient's condition improves in the course of his treatment, the number of LE cells decreases, and sometimes they completely disappear.
From true LE-cells it is necessary to distinguish so-called tart-cells and false lupus B-cells. They differ from LE cells according to morphological features and have no diagnostic value in SLE.
LE phenomenon is observed, although rarely enough( up to 10% of cases), with plasmacytoma, severe liver damage, acute leukemia, acute rheumatic fever, erythrodermia, miliary tuberculosis, pernicious anemia, with intolerance to antibiotics( penicillin), nodular polyarteritis, hemolytic anemia, thrombocytopenic purpura. In these diseases, as a rule, lupus cells are found in small numbers and unstable.