I. General examination
1.Blood routine May have three series of blood cell reduction
2.Urinary routine Proteinuria, hematuria, tubular urine
3.Blood sedimentation is often increased
Autoantibodies
(A) Anti-nucleosome (ANA) and ANA spectrum
1. ANA: It is a general term for autoantibodies against nuclear antigen components of cells, and is positive in more than 90% of SLE patients.
2.Anti-nucleosome antibody profile (ANA profile)
ANA consists of more than 10 kinds of autoantibodies, which become ANA spectrum.
(1) Anti-nuclear insoluble component antibodies.
①Anti-double-stranded DNA antibody (anti-ds-DNA antibody) is specific for SLE, and its titer is positively correlated with SLE disease activity, and anti-ds-DNA antibody positivity is prone to complicate lupus nephritis
(2) Anti-histone antibody (AHA): more than 95% are positive in drug lupus.
(2) Anti-nuclear soluble component antibodies (anti-ENA antibodies) Extractable nuclear antigen (ENA), an acidic nuclear protein extracted from the nucleus of cells such as liver and spleen of animals using saline. Anti-extractable nuclear antigen antibodies are called anti-ENA antibodies. Currently, commercially available anti-ENA antibody kits include the following tests.
①Anti-Sm (Smith) antibody
②Anti-RNP (anti-ribonucleoprotein) antibodies
③Anti-SSA antibody (anti-Ro antibody)
④Anti-SSB antibody (anti-La antibody)
⑤ Anti-r-RNP (anti-ribosomal) antibodies
⑥Anti-Jo-1 antibody (seen in dermatomyositis)
(vii) Anti-Scl-70 antibody (seen with scleroderma)
(II) Anti-phospholipid antibodies
1.Anti-cardiolipin antibody (ACL antibody)
2. False-positive syphilis serologic test
3, Lupus anticoagulant (LAC)
4, antiphospholipid syndrome: seen in habitual abortion, arteriovenous thrombosis and thrombocytopenia
(iii) Rheumatoid factor (RF): SLE patients may be positive
(iv) Other autoantibodies
1, anti-histone antibodies (AHA), see the previous
2, anti-RBC membrane antibodies such as (Coombs’ test positive)
3, Platelet-associated antibodies (PAIgG)
4, Anti-lymphocyte membrane antibodies
5. Anti-neuronal antibodies – related to lupus encephalopathy
III. Complement
Decreased total complement (CH50) and C3 and C4 suggest lupus activity
Lupus banding test (LBT): detected by immunofluorescence, there are fluorescence (immunoglobulin) deposits in the skin at the junction of epidermis and dermis.
V. Kidney biopsy: It can both diagnose SLE and pathological typing.
Other examinations (such as head CT. lung X-ray plain film. Cardiac ultrasound, etc.).