Autoantibodies and Autoimmune Diseases

Q: What Do SM Ab 26, RNP Ab 23, and ANA 160 Speckled mean in my lab test results?

Question: Hello, and thank you for letting me join. I’ve been in horrible shape for over 4 yrs now. Seen many doctors. Finally I saw a young doctor in my gps group, and she sent me to a Rheumatologist. He did a multitude of tests including an ANA panel. After the initial appt, and the Rheumatologist sending me for my bloodwork, I had to wait a month to be seen to discuss the results. That appointment lasted about 10 minutes, and that was the first time he was looking at the results himself. As I’m trying to ask questions he’s standing up to walk out of the room. I had more questions to ask in one of them was the results of the tests I’m showing you.

Your results show Positive Anti-sm antibodies which means high probability of Systemic Lupus Erythromatosus SLE, Also results include high concentration of RNP antibodies which is consistent with a connective tissue disease (including SLE). in addition to Positive speckled ANA antibodies which usually indicate the presence of active SLE episode.

To conclude your results findings suppose you’re under attack of SLE disease complications which need urgent and continuous follow-up with corticosteroids and medical testing panel. Other complications include anemia due to hemolysis of red blood cells, fever, and all-over body aches.

SLE is a systemic disease which mean it can cause pain in all over body, in other words the antibodies produced by SLE mechanisms inside the body will hurt almost all organs such as heart, brain, blood vessels, muscles, bones, lungs, and kidneys.

show these results: ANA is Negative ESR is mildly elevated CRP is mildly elevated

For 8 years my GP said I have fibromyalgia but is now swaying towards RA she said some results indicate yes some no ?

The full question:
Can anyone please help me with these results?? For 8 years my gp said I have fibromyalgia but is now swaying towards RA she said some results indicate yes some no ?? I’ve no idea what they mean but I’ve so much pain everyday

Hello, Cheryl. Your reports show these results:
ANA is Negative
ESR is mildly elevated
CRP is mildly elevated

ANA is not specific for a disease but can be used as a screening marker for many autoimmune disease, however we can’t depend on ANA solely to diagnose such diseases because it can be negative in the same time the patient suffering from whole body’ pain.
Thus Negative ANA doesn’t exclude that you carrying autoimmune disease.
ESR and CRP tell how extensive the inflammation you have but also they can’t indicate a specific disease, rather they are mildly increased while in most autoimmune disease show markedly elevated (i.e. ESR 100).

I can tell that nowadays there’s an accurate test called “The FM/a Test” that’s 99% accurate for Fibromyalgia which eliminate the confusion.
Also, There’s a more accurate and specific test for Rheumatoid Arthritis called “Anti-CCP antibodies“.

Sickle RBCs and high platelets clogs the blood vessel and block blood flow

High platelet count in sickle cell disease Explained “from real case studies”

What is this post talking about? to answer many questions like:
Do blood platelets elevate in patients with sickle cell disease?
How many platelets in patient of SCD? or To which level the platelets increase of a sickle cell disease person?
When to worry about high platelets if you’re a SCD person?
Why do PLTs of the SCD patient elevate? is this bad or good?

In a patient suffering of Sickle cell disease these results are often arise in the blood test results.

  • Low hemoglobin “e.g. Hgb 4-7”
  • Low Red blood cells and hematocrit “e.g. RBCs count# 2.0-3.5”, “HCT, PCV% 10-20”.
  • High platelets count and become low after platelets count after a few period of time.
  • Reticulocyte count may be elevated “2.5-15.0%of RBCs”.
  • Bilirubin test level may be elevated “Jaundice” if the hymolysis of blood occur “e.g. blood bilirubin 2 to 30”.
  • Iron levels in the blood may be depleted “e.g. free iron less than 5 and ferritin test less than 10 “
  • Hemoglobin type-S is present in Hemoglobin Electrophoresis test “e.g. Hgb S >zero”.

Explanation of Sickle cell in a glance

Sickle cell disease defined as a chronic inflammatory condition that increases the acute phase reactants blood levels and of course activation of more platelets which means abnormally high demand of platelets, thus how the platelets count high in the blood test of patients with sickle cells disease.

What happens in your blood if you have sickle cell disease?

The fluid that fills red blood cells and carries within it oxygen and nutrients is the “Hemoglobin”, If you have a genetically defect in the manufacturing process of hemoglobin, the red cells become sickle-shaped and not like a disk as the normal, and therefore, the red blood cells that contain this distorted hemoglobin are unable to serve your body well in providing its needs from Oxygen and the necessary nutrients, accordingly, the body suffers from pain crisis, wasting and severe weakness, whether over a long period time or suddenly.

The lack of oxygen and food as a result of the rapid death of distorted red blood cells makes their number decrease, thus leaving your body exposed to all kinds of severe pain, swelling, poor vision, and weak or stunted growth.

Shows how Sickle RBCs and high  platelets clogging the blood vessel and block the blood flow

The complications of sickle cell erythrocyte malformation include:

When unhealthy red blood cells are distorted, it slows down the blood flow, and if the blood slows down, it can stop anywhere in the body and the cells clump over each others, thus a clot occurs in any organ, followed by ischemic necrosis or atrophy of the organ that the blood stops from enriching it. Actually that is the cause of all accompanying diseases to the sickle cell disease, e.g. acute chest disease, strokes as a result of slowing the flow of blood to the brain thus the blood may stop and clot may occur which may lead to cerebral edema and death occur.

The Blindness occurs as a result of poor blood circulation as well, Gallstones, and ulcers in the legs are among the complications that occur as a result of sickled RBCs.

What is the role of platelets in sickle cell disease?

Platelets are one of the types of blood components that gather and clump to form the clots “thrombosis” which occur as a result of the slow flowing of blood inside the blood vessels, and therefore the body thinks that the platelets are decreasing and consequently tries to produce more platelets and release them into the blood circulation more than the normal to compensate for the deficiency, and therefore a temporary increase in the number of platelets may occur in the test, but after a period of time, the bone marrow cannot produce more platelets which causes decline in platelets count to appear in the platelets blood test.

What does high platelets and low hemoglobin mean in sickle cell disease?

It is scientifically known that sickle cell disease mainly affects red blood cells and the reason is the manufacture of defective hemoglobin that cannot perform its function in transporting oxygen and nutrients, nor can it even support the red blood cells to become normal in shape, and then the red blood cells break faster than their normal rate of breaking Thus, the number of red blood cells in the blood count test decreases.

It is not common for other blood cells to be affected by sickle cell anemia, unless there are major complications such as peripheral or pulmonary clots, etc., then platelets are caught in the clots, and thus the number of platelets in the blood test decreases, low platelets is medically named Thrombocytopenia.

Also, when clots occur in peripheral parts of the body, atrophy or ischemia may occur to the next organ that follows the clot location, and thus the white blood cells move of all kinds to deal with the resulting inflammation, that’s why you may show high WBC count in the white blood cell count test. And therefore, doing the full blood count (CBC&deff test) is better to follow-up sickle cell episode than the blood test for platelets count only, because the CBC test measures the count of all blood cells which helps the doctor make the right decision.

Are platelets increase or decrease in the sickle cells disease?

In fact, at the beginning of blood clots, the number of blood platelets may increase as a result of the increased demand for them at the site of clotting in the body, but when the clots grow and increase with time, the platelets are consumed in abundance, and therefore platelet deficiency appears in the blood count test.
Interestingly, many of the Medicines for sickle cell disease can also affect the levels of blood cells in the blood test.

If your child has sickle cell disease, testing for full blood cells count in the nearest laboratory can tell the doctors and staff about your child’s disease progression and how to effectively treat it.

Why does the SCD patient have low RBCs? Do you know why breath shortage is common in SCD patient?

Normal red blood cell compared to the shape of the sickled red blood cell
Normal RBC Vs Sickled RBCs as seen under microscope not by auto-counting machines

People with sickle cell disease have abnormal type of hemoglobin, called sickle hemoglobin or hemoglobin S, the red blood cells contain that defected hemoglobin which is unable to carry oxygen to other parts of the body leading to hypoxia or shortage of breath. Also SCD hemoglobin is the reason why red blood cells are damaging shortly and appear low RBC count in the blood test. That was the reasons of SCD patients have low hemoglobin or Anemia, and low RBCs count.

The Hemoglobin electrophoresis in sickle cell anemia is the best diagnostic test for “Hemoglobin S”, the defected hemoglobin in the sickle-shaped RBCs, thus if the hemoglobin electrophoresis test is positive for “hemoglobin S” it means the person has the sickle cell anemia and must start treatment plan, but if the blood test results of “hemoglobin S” is negative or “zero” it means that the anemia isn’t due to sickled red blood cells.

A blood smear examination is one of best tests to know if there’re sickled RBCs or not, a blood smear is made in the laboratory from a small blood sample, then examined under the light microscope, if the RBCs appear like the sickle, the examiner write down how many sickle cells per red cells count and report it as a percentage

Do platelets elevate in all kinds of sickle cell crisis?

There are three main types of sickle cell crisis, vasoocclusive, aplastic, splenic sequestration, and hyperhemolytic. The vasoocclusive is the commonest sickle cell crisis type which may be occur suddenly (but lasts about 5 days) on a specific location of the body or can be occur in many organs.

Also, the causes of four main types of sickle cell anemia are different mutations in the below genes:

  • Hemoglobin SS disease.
  • Hemoglobin SC disease.
  • Hemoglobin SB+ (beta) thalassemia.
  • Hemoglobin SB 0 (Beta-zero) thalassemia.
  • Hemoglobin SD, hemoglobin SE, and hemoglobin SO.
  • Sickle cell trait.

Explanation of platelets count in the most common clinical manifestation of SCD, the vaso-occlusive crisis.

“Vaso” means in the vessels, occlusive means “obstruction”, therefroe vasoocculative crisis means the blood clots that occur in the smallest blood vessels anywhere in the body because the circulation is being obstructed by the sickled RBC, the next organ will be painful ischemic (i.e. the organ that didn’t get supply of blood because the flow is reduced or restricted), treatment of choice are the sufficient vigorous intravenous hydration fluids and analgesics and Normal saline and 5% dextrose in saline, to correct dehydration and to compensate continuing blood loss, both insensible and due to fever. Normal saline and 5% dextrose in saline may be used.

Do platelets high or low during acute chest syndrome?

Acute chest syndrome (ACS) is a deadly complication results of sickle cell disease in patients hospitalized with blood clots of the type “vaso-occlusive” crisis. Patients may have high platelet counts during steady state of the ACS, but platelets usually decrease during the acute vaso-occlusive crisis of the ACS. Doctors may aim on the platelets count to predict the development of ACS during admission in the hospital.

Low Platelets level during Vaso-occlusive crisis is a predictor of acute chest syndrome during sickle cell disease, because the increased active platelets increase the platelet-derived molecules for cellular adhesion which they’re important markers of inflammation. Acute vaso-occulsive crisis will cause decline in platelets count in the blood test due to sudden blood loss, platelets increase at the beginning or during steady state as the demand of platelets increases at the first of the blood clots. Therefore, the patient with acute sickle cell crisis usually has low platelets count in the blood test results.

The aplastic crisis is a condition where the Red blood cell production is stopped leading to low platelets number not a high platelets number. Because the bone marrow is not producing red blood cells.

In the Splenic sequestration crisis, the sickled RBCs stay inside the spleen and can’t go out which lead to enlargement of spleen “splenomegaly” and appear as large spleen, therefore the spleen traps more and more blood cells and platelets causing a big decline of platelets count in the CBC test. Because of that the blood platelets appear low not high during the Splenic sequestration crisis.

If a child has rapid drop in RBCs count “e.g. RBCs 3.0 while the normal is 5.0-7.0”, the reticulocyte count test is high “e.g. Retics result is 8%, the normal 0.2-2.0”, and hemoglobin Hgb 5.0, normal 11-14, severely low”, they’re clear indicators of hemolytic Anemia especially if the blood smear examination revealed that there’re sickled cells RBCs, Hyperhymolytic crisis is another name for that complication of sickle cell anemia. Hyperhymolytic crisis due to infection, toxins, certain drugs, or blood transfusion will lead to acute loss of blood cells, that’s why the RBC, WBC, Platelets appear low in the CBC test if the Hyperhymolytic crisis occurs.

When to worry about high platelets if you’re a person has sickle cell disease?

If you or your child has sickle cell disease, his platelets count is probably normal in the steady state, then platelets count might increase “Thrombocytosis” at the beginning of the crisis, but platelets will decrease “Thrombocytopenia” later as the complications progress. therefore the count of platelets in the blood count test can be used as a good indicator of sickle cell disease complications which is of good news to know. Thus you may worry about platelets is they rapidly drop or elevated.

Thus, the platelets count in the different types of sickle cell disease is well explained, but if you have lab results that need to be cleared, we can do it for you, the service is still free yet.

is that normal crp 14

Q: Is CRP 14 mg/L a normal level if I’m having joint pain?


I’m having joint pain and the CRP test value is 14 mg/l. Is it a normal level?


The short answer is No, CRP value of 14 mg/l is not normal but it is not high enough to tell that you have ongoing chronic inflammation, but can tell that the inflammation is fading or weak infection or just a false value that is should be higher, and details are below…

If you test high-sensitive-CRP the normal level is up to 3, hence the 14 is 4 times higher than normal
but if the CRP test is done with the latex method the normal is up to 10, hence 14 is mildly elevated.

CRP levels will rise rapidly within the first 6 to 8 hours after the onset of acute infection and inflammations and CRP reading decrease quickly about 19 hours (a half-life) after initiation of a successful treatment course, and therefore it is a better helpful tool for bacterial infections and antibiotic treatments.

Another thing is that the CRP test may go up too much if there is a tissue inflammation flare-up like in rheumatoid arthritis flare-up.

What causes CRP levels to be slightly higher than normal without inflammation?

  1. Obesity
  2. Lack of exercise
  3. Cigarette smoking
  4. Diabetes

Because CRP is not specific to RA, some people with RA may have normal CRP levels, many other tests can predict the reasons for joint pain better than the general inflammatory markers like the CRP test, such joint pain tests may include:

  1. ACCP and RF tests: which used for investigation if the joint pain is due to rheumatoid arthritis disease.
  2. Sed Rate test: is a better indicator for chronic inflammatori episodes than CRP test.
  3. Uric acid test: which indicating how high is the uric acid in the bloodm which means their are too much uric acid in the blood that can deposit in the joints and cause inflammation and painful sensation, medically called Gout.
  4. Thyroid tests: to investigate if there is Hypothyroidism (underactive thyroid) which responsible for some kind of joint inflammation.
  5. ANA test: to predict if you have any sign of abnormal immunity behaviour or not?
  6. LE cells and dsDNA tests: used for predecting the lupus erythromatosus disease.

X-ray imaging is the first step for diagnosis of joint pain, and using the blood tests comes after that to complete, approve, or exclude the etiological causes.

What causes false-negative CRP levels?

What causes a mild increase in CRP levels while it should be higher?

Certain medicines can falsely cause CRP levels in the blood to be lower than normal or become lower than they should be. These include taking antibiotics, aspirin, steroids, and nonsteroidal anti-inflammatory drugs (NSAIDs) {which are widely used for relieving pain, reduce inflammation, and bring down a high temperature}.

Types of NSAIDs include:

  • ibuprofen.
  • naproxen.
  • diclofenac.
  • celecoxib.
  • mefenamic acid.
  • etoricoxib.
  • indomethacin.