Lupus, on many levels, can make one’s blood boil. That may be a little dramatic, but not far off from how one feels when there are problems with the concoction of blood cells coursing through his or her body. And sadly, 85% of lupus patients will experience issues associated with abnormalities of the blood. In one of our earlier blogs, we addressed the connection between lupus and vasculitis. However, we feel it was important to get back to the blood-pumping heart of the matter, and delve further into the different ways that lupus can affect the blood, and what treatments are available for those who are suffering from such problems.
Before we talk about blood disorders, let’s explain what your blood is all about. Blood makes up about 7% of the weight of the human body. It is made up of three main components: red blood cells, white blood cells and platelets. Red blood cells have the heavy responsibility of carrying oxygen around the body. They also carry iron-rich protein called hemoglobin that is responsible for giving blood the wonderful “red” hue and helps carry oxygen from the lungs to the rest of the tissues in the body. White blood cells are an essential asset to the body’s immune defense. They are the soldiers that fight against cancer cells, viruses, bacteria and other unwanted infectious diseases and materials. And lastly, platelets are your internal “band-aids®” that help blood clot when your skin is cut. Plasma is another blood component and it contains electrolytes, glucose, hormones and various nutrients.
With all the stuff whirling around those arteries, veins and capillaries, it is no surprise that things can go wrong from time to time. So lets break down what problems may be running through YOUR veins, shall we?
Anemia is one of the most common blood disorders with lupus patients. In fact, anemia is known to affect up to half of all lupus sufferers at one point or another. Anemia is classified by having too little hemoglobin in the blood. There are several types of anemia including: iron deficiency anemia, vitamin deficiency anemia, anemia of chronic disease, aplastic anemia, bone marrow disease anemia, hemolytic anemia, sickle cell anemia and thalassemia anemia. If you are suffering from anemia, unusual fatigue and weakness is one of the first symptoms to present itself. Other symptoms include: paleness, irregular heartbeat, chest pains, dizziness and cold hands and feet. It can be temporary or long term and can range from mild to severe. Treatments vary from taking supplements for mild cases to more invasive medical procedures (like blood transfusion or bone marrow transplant) for severe cases. Sometimes it can be prevented from sticking to a healthy, iron-rich diet. If you have an inherited anemia like sickle cell or thalassemia, talk to your doctor about any future risks. Back to top
The body’s blood is normally in a liquid state (plasma is made up of 90% water). When a person experiences an injury or has surgery, blood thickens and clots (through a normal process called hemostasis) in order to stop the bleeding.
With lupus, sometimes the hemostasis process is too active and a blood clot forms where it shouldn’t. This results in a condition called thrombosis. If a thrombus (fancy word for blood clot) detaches and travels somewhere else in the body, it is then called an embolus, and can be dangerous. Blood clots in the veins can travel to the lungs (pulmonary embolus), legs (DVT), arms, and brain (stroke). This can be particularly dangerous during pregnancy, and some women who are unaware they have this issue can lose several pregnancies.
Thrombosis in lupus is usually associated with antiphospholipid antibodies. There are two different blood tests used to detect antiphospholipids: the anticardiolipin test and the lupus anticoagulant test. Before starting a family, it is always good to have both blood tests done so you can determine if you are at risk for lupus thrombosis. Back to top
Vasculitis is an auto-immune lupus overlap disease. It is classified as inflammation and damage to the walls of the blood vessels. It can disrupt the blood flow in the arteries, veins and capillaries. Vasculitis can be mild or disabling, and in severe cases, fatal. Vasculitis can occur in lupus when the immune system mistakenly attacks the blood vessels. Additionally, it can also occur as a result from an infection, reaction to a medication, or from another disease or condition.
The symptoms of vasculitis can vary depending on where the inflammation is. Doctors usually diagnose vasculitis from doing a complete blood workup, and sometimes biopsy or angiography. Treatment is directed toward increasing inflammation of the blood vessels and may include glucocorticoids (prednisone or others) or immunosuppressants. For more information, see our blog on vasculitis. Back to top
Thrombocytopenia. In thrombocytopenia, antibodies attack and destroy blood platelets. This causes bruising and bleeding from the skin, gums, nose, or intestines. (This condition can also occur in antiphospholipid syndrome).
Neutropenia. Neutropenia is classified as a drop in the number of white blood cells. Patients with SLE often experience neutropenia, but the condition is usually harmless unless the reductions are so drastic that the individual becomes vulnerable to infections. It can be caused from viral infections, certain medications, cancer, auto immune disorders or congenital disorders.
Acute Lupus Hemophagocyte Syndrome. Primarily found in people with Asian ethnic backgrounds, this is a rare blood complication of SLE that is characterized by fever and a sudden drop in blood cells and platelets. It generally of short duration and is treated with high-dose corticosteroids, cyclosporine, and high-dose intravenous immunoglobulin.
Lymphomas. SLE patients and people with other autoimmune disorders do have a greater risk for developing lymph system cancers such as Hodgkin’s disease and non-Hodgkin’s lymphoma (NHL). Back to top
Blood involvement with lupus can occur with our without other symptoms. So it is important for lupus patients to have their blood checked periodically in order to detect any problems. Lastly, don’t run from what is running through your veins, seek medical advice if you feel something is off or are symptomatic.
Sources: lupus.org/answers/entry/blood-disorders, sciencekids.co.nz/sciencefacts/humanbody/blood.html, mayoclinic.org/diseases-conditions/anemia/basics/definition/con-20026209, my.clevelandclinic.org/health/diseases_conditions/hic_Systemic_Lupus_Erythematosus, nytimes.com/health/guides/disease/systemic-lupus-erythematosus/complications.html
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