Toll-like receptor 9 (TLR9) often known as CD289 (cluster of differentiation 289), is a member of the Toll-like receptor family that recognizes pathogen-associated molecular pattern. TLR9 was first cloned and identified as a receptor for unmethylated CpG-DNA as well as for bacterial DNA. It is essential not only for pro-inflammatory cytokine production and other inflammatory responses, but it also plays a role in the induction of T helper 1 (Th1) acquired immune response and in the proliferation of B cells. Like all other members of the TLR family, TLR9 is composed of an extracellular domain containing multiple leucine-rich repeats (LRRs), a transmembrane region, and a cytoplasmic tail containing the conserved TIR domain. The TLR9 sequence encodes a 1032 aa protein containing 27 N-terminal LRRs with a calculated molecular weight of 116 kDa . The gene for TLR9 has been mapped to human chromosome 3p21.3. TLR9 is most closely related to TLR7 and TLR8 with 36% and 35% overall amino acid sequence identity, respectively and thus along with TLR7 and TLR8 constitutes a new sub-family of the TLRs.

13 thoughts on “Lab Tests For Systemic Lupus Erythematosus

  1. Song_bird

    Systemic Lupus Erythematosus or Rheumatoid Arthritis?
    My symptoms are: Extremely painful to walk, rashes, blood in urine, Anemia (had to get iron infusions), headaches, extreme fatigue, ect. I seen a doctor who did some x-rays, blood work & a physical exam. She recently called me & told me from my lab results came back & said i have either Systemic Lupus Erythematosus or Rheumatoid Arthritis. She said my blood work showed alot of abnormalities & even infection. She wanted me to start on a steroid right away. She put me on (10 mg pills of Prednisone) for 10 days until my follow up with a Rheumatologist. Okay my question: What is Lupus & Rheumatoid Arthritis?
    Are these 2 illnesses simular? She will be calling me back within 5 days with the other test results. Has anyone personally experienced this? She said my illness is treatable but not cureable. I’m still pretty young & this is a shock to me & i’m having a hard time dealing with not knowing what i’m dealing with i guess my new doctor will be able to answer alot of questions later.
    Thanks for the advice i will go look there.

  2. Anonymous

    Protein in urine and persistant uti’s?
    I went to the health department today and they said I have high levels of protein in my urine and that I should go see a specialist because it could be something serious. I have a past history of urinary tract infections and kidney stones. I am scared that this could be something serious. What does it mean and should I be worried?

    1. EROS7776

      I found the following and hope it helps you with your question:

      What does the test result mean?
      NOTE: This test has no single number that identifies an abnormal result. Your lab report (see a sample report) should include a range of numbers (reference range) that identifies what is expected for you based on your age, sex, and the method used in that laboratory. You can find more information about expected results at Reference Ranges and What They Mean. Lab Tests Online strongly recommends that you discuss the meaning of your test results with your doctor.

      Protein in the urine is a warning sign. It may indicate kidney damage or disease or it may be a transient elevation due to an infection, medication, vigorous exercise, or emotional or physical stress. In some people, it may be present during the day and absent at night when the patient is lying down (orthostatic proteinuria). In pregnant women, elevated urine protein levels can be associated with pre-eclampsia.
      When kidney damage is present, the amount of protein present is generally associated with the severity of damage, and increasing amounts of protein over time indicate increasing damage and decreasing kidney function. Proteinuria is associated with many diseases and conditions, including:

      Bladder cancer
      Congestive heart failure
      Drug therapies that are potentially toxic to the kidneys
      Goodpasture’s syndrome
      Heavy metal poisoning
      Kidney infection
      Multiple myeloma
      Polycystic kidney disease
      Systemic lupus erythematosus
      Urinary tract infection

  3. FutureRN

    For experienced physicians: what diagnostics tests would you order if you suspected a patient had lupus??
    I’m currently completing a case study for Systemic Lupus Erythematosus and it would really help if I knew the correct tests. Please help!

    1. Linda R

      There are no definitive tests for lupus. In order to arrive at a diagnosis of lupus, one must first eliminate other disorders that can cause similar symptoms. After that, a combination of lab tests, medical history, and symptoms matched against the American College of Rheumatology’s 11 criteria for lupus and finding a match for 4, some carrying more weight than others.

      Tests for ANA, anti-double stranded DNA, sed rate, C reactive protein, ro and la, CBC, CMP, and 24 hour urine with protein excretion and creatine clearance can all provide clues.

      Dr. Sam Lim and the CDC are involved in the National Lupus Patient Registry in an attempt to find a specific, definitive biomarker for lupus.

      The link below can take you to common diagnositc tests for lupus.

  4. Anonymous

    Need help for my biology assignment?
    A 45 year old man came to the emergency department complaining about shortness of breath, chest pain which is came to the emergency department complaining about shortness of breath, chest pain which is severe by deep breathing of one week duration. he had generalize easy fatigability, malaise,skin rash that worsens with sun exposure, fever and joint pain for about three weeks prior to his current complaint. Physical examination revealed the following:
    General appearance: Acutely sick looking, in sever cardiorespiratory distress
    Respiratory rate 32 , Heart rate 112, Blood pressure 110/68, Temperature 37.8 C
    He has erythematous malar rash, decreased air entry on both sides of the lung, there is pericardial friction rub on the pericardium.
    The knee and wrist joints are swollen and painful.

    The attending physician ordered the following lab tests with the impression of Systemic lupus erythematosus.
    White blood count elevated, ESR (Sedimentation Rate) very elevated, Xray bilateral pleaural and mild pericardial effusion
    ANA and Anti Ds antibody positive.
    Then the patient was started with high dose prednisolone by the intravenous route and responded well to treatment after a couple of weeks.

    .What are the organ systems affected in this patient
    do you think the prednisolone helped the patient?
    What is the pathophysiology behind this illness?

    1. Anonymous

      Lupus is an autoimmune disease. Autoimmune diseases are when a persons own immune system messes up and doesn’t recognize part of the patients body and then attacks it as if it were an invader. This means, that the pathophysiology is that antibodies are created against the part of the patients own body. Normally, (normal physiology) antibodies are only created to recognize intruders, like viruses and bacteria. In systemic lupus erythematosus, the immune system generates antibodies against connective tissue, which is the stuff that holds your body together, like collagen, and cartilage.

      Prednisone should help the patient because it is a corticosteroid, which are drugs that regulate the immune system to reduce inflammation.

      If you want to read more, check out the Mayo Clinic’s website. It is a great resource for easy to understand info.

  5. sekhmet179

    SLE and/or TB?
    I have an ANA titer 1:320 speckled and anti-SSA/RO strong positive and a red slightly raised and sore TB skin Tests (not sure if its positive/border line positive/negative-will be getting a call later though) of about 18mm/1.5cm

    I have all the symptoms and test results but not enough time to call what I have Systemic Lupus Erythematosus although it is suspected but some of the symptoms do overlap with tuberculosis so can What I have just be TB or can it be Lupus with Tuberculosis

    Is it a combination of the two or is it really TB?

    I also Have a rheumatoid factor of 36 (don’t really know what this means-so if you do help!), normal is anything under 20 and a`slightly raised erythrocyte sed rate

    All other test Anti-dsDNA,Sm,La, etc came back negative

    1. Dynamite

      You have a dysfunctional immune system. You may have an autoimmune condition yet to be given diagnostic label. It may change with time and it is causing a false positive PPD and rheumatoid factor positivity
      YOU do not have TB
      Keep a chronologic profile of your history and summary of lab tests for the rest of your life

  6. sporad01

    Malar Sun Face Skin Rash – Not Lupus ?!?
    For most of my young life, i’m now 23 female, i have had a sun rash that a doctor has recently said is the malar rash that is associated with Lupus. My mother also has severe rheumatoid arthritis, I had a lab testing done last week, ana test, that showed negative for Lupus. I have this skin sun rash that develops on my checks & across the bridge of my nose, whenever i’m out in the sun, it stays for about a week, before fading out. It’s not itchy-has no bumps, no pain, etc. Just is a very red-burnt look. I have also been experiencing chronic headaches, i have an appointment made with a dermatologist soon to determine what else the cause might be, is it possible to test negative for lupus & still have it?, what other testing may be done? what other possible solution to my sun rash is there? Thank You.

    1. christibro40

      Hi, Im sorry yor going through this. I am going to explain a few things. First Lupus is what is called an autoimmune disease, where our own healthy cells think somthing is wrong go into overdrive and start attcking our own cells. Next, there are several types of Lupus, the two I willl cover are Discoid (which only attacks the skin), the other is SLE (Systemic Lupus/entire body). For a diagnosis of SLE there are 11 critera that needs to be met. I will list them at the end. however most dr’s have not gotten that for some reason. they tend to just look at the blood work and look at the blood markers for antibodies, mainly somthing called ANA. The fact is healthy people can have a positive ANA all the time, and not be ill at all, and people with Lupus may have a positive ANA sometimes (I do sometiems) or never. But to doctors, that seems to be the end all, escpecially early on, and during the first couple of visits. A malar rash, just dosent happen to healthy people. Only if they dont sunscreen that area and they do sunscreen the rest of their face. It has been documented that 5-10% may never have the positive blood work. another 20% will have it occasionally, and it can change on a day to day basis. So while you where negative that day, you can be positive another. The critera and mindset most doctors still use is from a critera used and created in 1982 over 20 years ago, before you were born.
      Also Migranes run heavily in Lupus and other autoimmune paitents, and can fall under the Central Nervous System critera. A dermatologist, may want to biopsy that area of your face. a good one, will be able to take little skin, and leave little scarring. It sounds like you meet the photosensitivity part of Lupus as well. so thats three. You need to see a Rhumotologist, and they need to observe you over months. a diagnosis can take months or even a year. You need to get a good history of your health. write it down, to present to a doctor, you may not know what is relevant. I personally went through 4 rhuemotologists until I found 1 that actually listened took a life history (not all problems have to occur at the same time. As for a solution you should avoid the sun, or wear a 30 or more sun screen. and avoid the sun from noon to 4 pm. I have some issues with the sun, and have a pool. I try not to swim during those hours. I am going to provide you a list of the Lupus diagnostic critera, see if any of it applies to you, if it does now, or in the past, make sure you tell your dr. also your Blood test can change at anytime. Mine change all the time, depending of how active my Lupus is.
      Diagnostic critera from Yahoo health :
      Diagnostic criteria for lupus
      The following criteria are used to distinguish lupus (systemic lupus erythematosus, or SLE) from other autoimmune and rheumatic diseases.

      A person with 4 of these 11 conditions can be diagnosed with lupus; 3 symptoms suggest that lupus is probably present, and 2 raise the possibility of lupus. Symptoms may be present all at once or appear in succession over a period of time. 1

      Butterfly (malar) rash on cheeks
      Rash on face, arms, neck, torso (discoid rash)
      Skin rashes that result from exposure to sunlight or ultraviolet light (photosensitivity)
      Mouth or nasal ulcers, usually painless
      Joint swelling, stiffness, pain involving two or more joints (arthritis)
      Inflammation of the membranes surrounding the lungs (pleuritis) or heart (pericarditis). This inflammation is called serositis.
      Abnormalities in urine, such as increased protein or clumps of red blood cells or kidney cells, called cell casts, in the urine
      Nervous system problems, such as seizures or psychosis, without known cause
      Problems with the blood, such as reduced numbers of red blood cells (anemia), platelets, or white blood cells
      Positive antinuclear antibody (ANA) test
      Signs of increased autoimmunity (antibodies against normal tissue), as shown by laboratory tests

      I have had Lupus since my teens but was not officially diagnosed until my late 20’s, Im now almost 40. I also am a researcher, and own a Lupus and autoimmune support group
      Good Luck

  7. Marie

    Is this an immune difficiency?
    I’m 35 yrs old and my only health problem had been that I have PCOS and am obese as a result.

    12 yrs ago I had Epstein-Barr Virus & for the last 9 yrs I’ve had chronic swollen tongue & mouth ulcers. Suspecting food allergies (there are trigger foods), I went to an allergist. He found no allergies. I’ve had multiple infections the last few years: Mono, strep, ear infections, salivary gland infections, skin infections, sinus infections, tooth absess, etc. I’m always sick.

    Recently I was sent to a gastro md to see if mouth probs stem from digestive probs…negative. He referred me to a rheumatologist because my SED rate & CRP were high. The rheumatologist is sending me to a dermatologist because he suspects psoriasis (saw flaky elbows).

    IgM was low on my latest labs. I’m tired of having symptoms treated & want to get to the root of the problem. Seems like an immunity issue, but what should I do? This week I stopped taking all meds because I’m so tired and my body needs a break.
    ANA was normal, not sure about LE, rheumatoid factor was negative. I believe CBC with differential was done and was normal.

    Yes, my gastroenterologist did test for hep C rather than just liver panel and everything was normal. I have had elevated liver enzymes in the past, but may have fatty liver.

    I went ahead and made an apt to go to the immunologist in a few days, so we’ll see. I appreciate the information and can use more if anyone has suggestions.

    1. doktorangbaliw

      I would suggest the following tests: ANA, LE, Rheumatoid Factor. I agree with the other poster that it could be lupus, however, your condition is not classic systemic lupus erythematosus. It could be another auto-immune disorder, so don’t discount that possibility.

      IgM measures your acute response to an infection of any kind. So it’s most likely auto-immune.

      BTW, did you have a CBC with a differential count? You are supposed to have more neutrophils than any other kind of white blood cell. You might have a blood dyscrasia affecting your white blood cells. Ask your doctor about a bone marrow biopsy to check if there is something wrong there.

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