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Lupus erythematosus in the blood (LE cells)
Last reviewed: 18.10.2021
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LE cells in the blood are normally absent.
Lupus cells serve as a morphological manifestation of the immunological phenomenon characteristic of systemic lupus erythematosus. They are formed as a result of phagocytosis by neutrophilic leukocytes (less often monocytes) of nuclei of cells containing depolymerized DNA. Phagocyte substance is an immune complex consisting of a lupus factor (antinuclear factor - antibodies of IgG class to DNA-histone complex), residuals of the nucleus of leukocytes and complement.
Detection of LE cells is a specific sign of systemic lupus erythematosus. The study should be carried out before the start of therapy with glucocorticosteroids. A negative result of the study does not exclude the possibility of this disease. LE cells are detected in the early period of the disease, as well as with a pronounced nephrotic syndrome and a loss in the urine of a large amount of protein. The lupus factor may be present in the punctate of the red bone marrow, in protein fluids (exudates, urine protein in renal lesions). The frequency of detection of LE cells in patients with acute systemic lupus erythematosus varies from 40 to 95%. In patients with systemic lupus erythematosus one can find, firstly, lupus cells, secondly, free nuclear matter (hematoxylin bodies, Hargraves corpuscles) and, thirdly, rosettes-the accumulation of neutrophils around the lupus cells. Most lupus cells are found when the disease worsens. Their appearance in large numbers is a prognostically unfavorable sign. When the patient's condition improves in the course of his treatment, the number of LE cells decreases, and sometimes they completely disappear.
From true LE-cells it is necessary to distinguish so-called tart-cells and false lupus B-cells. They differ from LE cells by morphological features and have no diagnostic significance in systemic lupus erythematosus.
LE phenomenon is observed, although rarely enough (up to 10% of cases), with plasmacytoma, severe liver damage, acute leukemia, acute rheumatic fever, erythrodermia, miliary tuberculosis, pernicious anemia, with intolerance to antibiotics (penicillin), nodular polyarteritis, hemolytic anemia , thrombocytopenic purpura. In these diseases, as a rule, lupus cells are found in small numbers and unstable.
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