Low complement levels? worried

[mollie carey]

Hello,

I have been in a flare since my son's weeding a few weeks ago, had PsS, lupus, hashimotos, and CVID, since I was 32, now 54. When Dx. I had high ANA, High SSA, and moderate SSB, rheumatoid factor, and low white cells, low red, an elevated sed rate, low platelets, and a low c4 like 13 I think. Dr Fox the doctor I saw has written alot about this disease

Now I read those people with initial low c4 or c3, have the most aggressive course. I am scared, had alot going on, trying to tell myself worry does nothing. But I read that is the prognosis for people who manifest with low complements have the worst prognosis and most aggressive disease.

Do others on here have this, and if so, what have you had as manifestations that were more aggressive or not?

Thanks so much for the your help!
Mollie

[irish]

I have to admit that with all the research I have done over the years I have never seen that bit of information. These complements are often affected in autoimmune disease and I think the docs like to monitor them and keep tract of things. Some people with lupus will have these low values so this fits in with your diagnoses.

Do not panic and worry about this as most of the stuff we worry about never happens. Remember that when you are in a flare your body is basically out of control and trying to kill you off. Basically, rest, fluids, etc and any other things the doc can do for comfort helps. Many times prednisone is needed short term to slow the body down. I would be on the doctors trail to treat me and if you don't get enough attention try to find a doc who will be more aggressive. It really wears us down when we are in a flare. I am beginning to think much of my life is spent in a flare. My blood work gets so screwed up and my hg drops, creatinine get goofy and seems lilke all I do is have blood work and then for no reason at all things will straighten out.


It just dawned on my last week that I now have 11 specialists I see...some routinely and some once or twice a year. That is my social life. Sort of sneaks up on a fella doesn't it. Try to rest and get treatment and be patient. A wedding is so hard. Every time one of our boys got married I ended up sick and missed work and got put on Medrol packs. Back then I thought it was asthma but later found out my breathing was affected cause I had myasthenia gravis. Good luck and hang in there girl. Irish

[markt]

Compliment speaks with regards to the "classical pathway" of your innate (genetically hardwired, or born with) immune system.  Here is a great summary article.

https://www.sciencedirect.com/science/article/pii/S0161589015000383

2. The complement system off balance
An imbalance in complement, either by insufficient or excessive complement activity, can have important pathological consequences. Antibody-based treatments can be employed to restore the balance in the complement network in order to achieve therapeutic effects (Fig. 3). Complement inhibition can be beneficial in pathologies where the system is hyperactivated (e.g. sepsis, transplant rejection, ischemia and reperfusion (I/R) injury) or where it is chronically activated and attacks or damages healthy tissues (e.g. autoimmune disease). It is envisioned that such inhibition can be achieved by targeting key components of the complement cascade mediating the initiation, amplification, and/or termination steps of the system (Table 1A).

2.1.1. Autoimmune and inflammatory diseases
Increased complement activation plays an important role in the pathogenesis of several autoimmune and auto-inflammatory diseases. This can result from gain of function mutations in complement activation components or dysregulation of CRPs leading to chronic inflammation and tissue damage.

Systemic lupus erythematosus (SLE) is another autoimmune disease associated with numerous immune-based abnormalities including, paradoxically, both complement deficiency and complement activation. Deficiencies within the early classical pathway components (C1q, C4 and C2) predispose for development of SLE, whereas complement also takes part in the auto-antibody inflammatory reaction in the disease leading to tissue and organ damage (Bryan and Wu, 2014, Truedsson et al., 2007). Reducing complement-related inflammatory responses with antibody therapeutics, potentially via the simultaneous inhibition at multiple levels could, therefore, be incorporated in future treatment regimens for SLE, RA and other autoimmune disorders.

^ included because SLE and Sjs have similar (but subtly different) characteristics with regards to Compliment deficiency...