Lupus erythematosus cell phenomenon in synovial and peritoneal fluids in systemic lupus erythematosus: smoking guns, crime scenes and a twist

Tay, Sen Hee; Nga, Min En; Koh, Dow-Rhoon; Mak, Anselm

doi:10.1111/1756-185x.12546

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…LE cells are mostly granulocytes with phagocytized cellular material of unknown origin. They were also found in the peripheral blood and body fluids [2][3][4][5][6] of patients with SLE. Before the era of autoantibody testing for SLE, identification of LE cells was considered the most specific test for the diagnosis of SLE for decades.…”

Section: Introductionmentioning

confidence: 88%

Is Identification of Lupus Erythematosus Cells Still Useful? A Case Report

MacNeal

Wittman

et al. 2016

Pediatr Dev Pathol

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A 13-year-old girl presented with significant weight loss, depression, anemia, and neutropenia. The preliminary diagnosis was anorexia nervosa combined with depression. Due to peripheral cytopenia, a bone marrow biopsy was performed to rule out leukemia. Lupus erythematosus (LE) cells were found in the bone marrow aspirate, which prompted autoantibody testing, although clinically it was not suspected the patient had systemic lupus erythematosus (SLE). Further testing demonstrated very high levels of antinuclear antibodies (ANA) (>12 U) and anti-double strand DNA (dsNDA) (>1000 IU/mL), which confirmed the diagnosis of SLE. The patient was treated with steroids for SLE, and symptoms improved quickly. In conclusion, although the identification of LE cells as one of the diagnostic criteria for SLE has been obsolete, careful examination of bone marrow to identify LE cells is still very important in the diagnosis of unsuspected SLE.

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Section: Introductionmentioning

confidence: 88%

Is Identification of Lupus Erythematosus Cells Still Useful? A Case Report

MacNeal

Wittman

et al. 2016

Pediatr Dev Pathol

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“…However, the finding of LE cells in bone marrow and body fluids in previous reports has prompted the testing of autoantibodies and resulted in the diagnosis of unexpected SLE. [8][9][10][11][12][13] In our recent case report, 14 LE cells were identified in the bone marrow aspirate of an adolescent girl who was thought to have anorexia nervosa and depression. The bone marrow biopsy was performed to rule out leukemia, suspected due to anemia and neutropenia.…”

Section: Introductionmentioning

confidence: 88%

Hematoxylin Bodies in Pediatric Bone Marrow Aspirates and their Utility in the Diagnosis of Systemic Lupus Erythematosus

Chisholm

Fan

et al. 2017

Pediatr Dev Pathol

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In our recent case report, the finding of lupus erythematosus (LE) cells in a bone marrow aspirate led to the diagnosis of systemic lupus erythematosus (SLE) and appropriate treatment, although the patient was not clinically suspected to have SLE. To determine whether LE cells are present in the bone marrow aspirates of SLE patients, but overlooked in routine bone marrow morphology review, bone marrow aspirates from 30 pediatric patients (15 with SLE and 15 with other diagnoses) evaluated by rheumatologists were reviewed. LE cells were found in the bone marrow aspirates of only 1 SLE patient and none in non-SLE patients. However, hematoxylin bodies were identified in 53% (8/15) of SLE patients. Neither hematoxylin bodies nor LE cells were found in the aspirates from patients with other disorders. Three additional pediatric patients identified prospectively were found to have hematoxylin bodies in the bone marrow aspirates. Although the diagnosis was not initially suspected, 2 of the 3 patients were subsequently diagnosed with SLE. All patients with hematoxylin bodies and SLE had antinuclear antibody titers ≥1:640 with a homogeneous staining pattern. In addition, bone marrow aspirates of 9 adult patients were reviewed, and neither LE cells nor hematoxylin bodies were identified. In summary, hematoxylin bodies were present in the bone marrow aspirates of many pediatric SLE patients, while LE cells were rare. The finding of hematoxylin bodies in pediatric bone marrow aspirates is a helpful and specific diagnostic clue that may lead to the diagnosis of SLE when other clinical features are nonspecific.

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Lupus erythematosus cell in body fluids: A case report and review of literature

Ningombam

Sarkar

Acharya

et al. 2020

Diagnostic Cytopathology

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The diagnosis of systemic lupus erythematosus (SLE) has undergone radical change after the development of serological techniques. The in vitro demonstration of lupus erythematosus (LE) cell has less significance for the diagnosis of SLE in the present scenario. Although over the years, the spontaneous in vivo occurrence of LE cell in numerous body fluids as an initial presentation of SLE has been documented. The report of the presence of the LE cell can not only aid in the further workup of the patient but also suggest the involvement of a particular organ or body cavities by SLE. The morphology and mimickers of the LE cell should be cogitated and meticulous search of such cells should play an important role in the evaluation of body fluids. In our case, the patient presented at emergency with pericardial tamponade and cytological evaluation of the pericardial fluid demonstrated in vivo presence of LE cells. The serological work‐up then confirmed the case to be SLE. This report and review of literature wish to highlight the fact that this cell still plays a significant role even in the era of immunoassays.

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Lupus erythematosus cell phenomenon in synovial and peritoneal fluids in systemic lupus erythematosus: smoking guns, crime scenes and a twist

Cited by 4 publications

References 18 publications

Is Identification of Lupus Erythematosus Cells Still Useful? A Case Report

Is Identification of Lupus Erythematosus Cells Still Useful? A Case Report

Hematoxylin Bodies in Pediatric Bone Marrow Aspirates and their Utility in the Diagnosis of Systemic Lupus Erythematosus

Lupus erythematosus cell in body fluids: A case report and review of literature

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