As I
peered into Facebook this morning there was something on one of the
haematology-related pages that made me think. Someone was talking about LE cell
preparations…
Compared to
the technology of today, LE cell preparations were somewhat laughable.
Back in
the day we would take ten millilitres of blood into a glass jar which contained
several glass beads. We would then seal the jar with a tight cap and shake. I
say “shake” – we would thrash the thing as vigorously as we could with
all of our might. And at the point of exhaustion we would pass the jar to a
colleague who would carry on thrashing the thing. And when they were worn out
someone else would take over.
After
fifteen minutes it would go into an incubator for half an hour or so. The
contents would then be poured through a muslin cloth (which made a real mess
and spilled blood everywhere) into a tube, gently spun, and a blood film
prepared from the buffy coat.
We would
then look under the microscope for neutrophils which had engulfed other cells –
these were the LE cells. Seeing the cells was diagnostic of systemic lupus erythematosus,
and not seeing them excluded the condition. In the three years that I did this
procedure (whilst working in a long-since bulldozed hospital) we never
had a positive result. Not one. And neither had anyone else with whom I spoke
about them at day release college.
It would
seem that lupus is on the
rise. And has been for the last few decades Is this because the disease is
really becoming more prevalent, or because nowadays there’s a much
more involved diagnostic process which employs tests which are nowhere near
so medieval.
Did we
miss cases of lupus back in the day because they really were less common? Are
we finding more these days because the condition is more prevalent. Or because
the technology is better? I don’t know, but I can remember doing at least one
LE cell preparation a week for three years and never getting a positive result.
At the time I was only a trainee, and the frankly bullying atmosphere in which
I worked actively discouraged comment, but surely someone would have thought there
was something wrong in a test which was *always* negative.
Unless it really was
always negative?
No comments:
Post a Comment