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Monitoring disease activity of lupus with blood tests


Regular blood tests are essential to monitor how active the disease is and whether treatment is working.

Tests will include -

Full blood count
Sedimentation rate
Kidney and liver tests [creatinine, liver enzymes]
Tests for protein in urine
Antibodies to double stranded DNA - rising levels often predict a relapse
Complement proteins [C3d]

Monitoring for side effects of drugs

Prednisolone and other steroids
     - Blood glucose
     - Fats in the blood
     - Full blood count (toxic to lymphocytes)

Azathioprine (Imuran)
     - Can damage liver - regular liver enzymes tests (can require a biopsy)
     - Toxic to bone marrow - regular full blood counts to look at white blood cells (can require a bone marrow biopsy)
     - Antibodies (can become very low)
     - Enzyme test now available that predicts whether side effects are likely with azathioprine (thiopurine methyltransferase - TPMT)

     - Toxic to white cells - regular full blood counts
     - Antibodies (can become very low)
     - Urine (can cause bleeding from the bladder)

Cyclosporin and Tacrolimus [FK506]
     - Very powerful immunosuppressives
     - Can damage kidneys and liver - check kidney and liver function
     - Blood levels can be measured in the laboratory to help adjust dose




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