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LE cell test

Blood
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Report in 48Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Historically used as a diagnostic marker for Systemic Lupus Erythematosus (SLE),

₹459₹605

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LE Cell Test - Comprehensive Medical Information Guide

  • Why is it done?
    • Detection of lupus erythematosus and autoimmune conditions - The LE cell test detects the formation of characteristic LE cells, which are neutrophils that have phagocytosed damaged nuclei from other cells in the presence of antinuclear antibodies (ANAs)
    • Diagnosis of systemic lupus erythematosus (SLE) - Primarily performed to support the diagnosis of SLE, particularly in patients presenting with clinical manifestations such as arthritis, photosensitive rash, or constitutional symptoms
    • Investigation of serositis and pleuritis - Used to evaluate patients with unexplained pericarditis, pleural effusions, or peritonitis that may be related to autoimmune disease
    • Screening for other autoimmune conditions - May be ordered in suspected cases of drug-induced lupus, discoid lupus erythematosus, or other connective tissue disorders
    • Monitoring disease activity - Historically used to assess disease progression or response to treatment in established SLE patients
    • Typical timing - Performed when autoimmune disease is clinically suspected or as part of initial diagnostic workup for unexplained systemic symptoms
  • Normal Range
    • Normal result (Negative) - Zero LE cells per 100 white blood cells examined; typically reported as 'LE cells not seen' or 'Negative LE cell preparation'
    • Positive result - Presence of one or more LE cells in the preparation; typically reported as 'LE cells present' or with a semi-quantitative count (1+, 2+, 3+, or 4+)
    • Interpretation framework - Positive results indicate the presence of circulating antinuclear antibodies; however, the test can be negative in 20-30% of SLE patients (false negatives)
    • Units of measurement - The test is reported as a presence/absence or as a count of LE cells per low power field (LPF) or per 100 white blood cells examined
    • Clinical significance - A negative result does not exclude SLE or other autoimmune diseases; a positive result is suggestive but not diagnostic, requiring correlation with clinical findings and other laboratory tests
  • Interpretation
    • Positive LE cell test - Indicates the presence of antinuclear antibodies (ANAs) capable of causing immune complex formation; consistent with systemic lupus erythematosus (SLE) or related autoimmune disorders, though not pathognomonic
    • Negative LE cell test - Argues against active lupus but does not exclude the diagnosis; false negatives occur in approximately 20-30% of confirmed SLE cases, particularly in inactive disease
    • Factors affecting results - Test sensitivity varies with disease activity; inactive or well-controlled SLE may show negative results; medications such as corticosteroids and immunosuppressants may reduce test positivity
    • Clinical correlation essential - The LE cell test is not specific for SLE; false positives can occur in other autoimmune conditions, malignancies, and certain medications (procainamide, hydralazine, isoniazid)
    • Comparison with modern testing - The LE cell test has been largely superseded by more sensitive and specific tests such as ANA panel, anti-dsDNA antibodies, and anti-Smith antibodies; however, it remains useful in resource-limited settings
    • Result patterns - Semi-quantitative results (1+ to 4+) may correlate with disease activity, but interpretation should always include clinical presentation, other serological markers, and organ involvement assessment
  • Associated Organs
    • Primary organ systems involved - The test reflects systemic autoimmune dysfunction affecting multiple organ systems; particularly relevant to immune system function and production of antinuclear antibodies
    • Systemic lupus erythematosus (SLE) - Most commonly associated condition; characterized by autoimmune attack on multiple organ systems including kidneys (lupus nephritis), heart, lungs, and nervous system
    • Renal involvement - SLE commonly affects the kidneys; presence of LE cells correlates with increased risk of glomerulonephritis and progression to renal failure
    • Cardiac manifestations - Abnormal LE cell test associated with increased risk of pericarditis, myocarditis, and valvular disease in SLE patients
    • Pulmonary involvement - Positive results may indicate increased risk of pleuritis, pulmonary hemorrhage, and lupus pneumonitis
    • Neurological complications - Associated with central nervous system (CNS) lupus, manifesting as cognitive dysfunction, seizures, or cerebrovascular events
    • Other autoimmune conditions - Test may be positive in discoid lupus erythematosus, drug-induced lupus, Sjögren's syndrome, rheumatoid arthritis, and other connective tissue disorders
    • Potential complications - Positive LE cell test indicates presence of circulating immune complexes that deposit in tissues, leading to inflammation, tissue damage, and potential organ dysfunction
  • Follow-up Tests
    • Antinuclear antibody (ANA) panel - Recommended as primary confirmatory test; more sensitive and specific than LE cell test with fluorescent patterns (homogeneous, speckled, centromere, nucleolar) aiding diagnosis
    • Anti-dsDNA (double-stranded DNA) antibodies - Highly specific for SLE; elevated levels correlate with disease activity and lupus nephritis risk
    • Anti-Smith (anti-Sm) antibodies - Highly specific for SLE; presence indicates active disease and potential for more severe manifestations
    • Complement levels (C3 and C4) - Decreased complement levels indicate active disease and immune complex formation; useful for monitoring disease activity
    • Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) - Non-specific markers of inflammation; elevated in active lupus
    • Renal function tests - Serum creatinine, blood urea nitrogen (BUN), and urinalysis; essential for detecting lupus nephritis or other renal involvement
    • Complete blood count (CBC) - To assess for cytopenias (anemia, leukopenia, thrombocytopenia) common in SLE
    • Urinalysis and 24-hour urine protein - Important for detecting proteinuria and hematuria associated with lupus nephritis
    • Anti-Ro/SSA and anti-La/SSB antibodies - If Sjögren's syndrome or neonatal lupus suspected
    • Antiphospholipid antibodies - If thrombosis or pregnancy complications present
    • Imaging studies - Chest X-ray, echocardiogram, or renal ultrasound based on clinical presentation and organ involvement
    • Monitoring frequency - For established SLE patients, repeat testing every 3-6 months or as clinically indicated to assess disease activity and treatment response
  • Fasting Required?
    • Fasting requirement - No, fasting is not required for the LE cell test
    • Blood sample collection - Blood can be drawn at any time of day without prior fasting; typically collected in EDTA (ethylenediaminetetraacetic acid) tube (lavender-top tube)
    • Medication considerations - No specific medications need to be discontinued; however, immunosuppressive medications and corticosteroids may reduce test sensitivity
    • Patient preparation - No special preparation required; patient should avoid excessive stress if possible as it may influence immune system function
    • Sample handling - Fresh blood specimen preferred; test should ideally be performed within 4-6 hours of collection; delayed processing may result in false negatives
    • Timing of test - May be performed at any time; however, test sensitivity may be improved during periods of active disease rather than remission

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