Blood, 1957, Vol. 12, No. 7, pp. 657-670.
© 1957 American Society of Hematology, Inc.
A Comparative Evaluation of the Sensitivity of the
L.E. Cell Test Performed Simultaneously
by Different Methods
EDMUND L. DUBOIS 1 and
VIVIAN FREEMAN 1
1 Department of Internal Medicine, University of Southern California School
of Medicine and the Los Angeles County General Hospital, Los Angeles, California.
1) A group of at least three types of L.E. cell tests should be performed in order
to adequately screen strongly suspected cases of SLE. This battery consists of
the sieved two hour clot, the Snapper-Nathan ring method and the Zinkham-Conley rotary glass bead technic. Utilizing these three methods in studying a
group of 47 proven cases of SLE both treated and untreated, 63 batteries were
performed. In 42 of these batteries there was at least one positive test. In 5
batteries only the rotary method was positive, in 4 the clotted method and in 2
the ring method. The largest numbers of L.E. cells and hematoxylin bodies were
found by the rotary method. If only one test is to be performed this latter
technic is the method of choice.
2) The use of excessive amounts of heparin over 0.75 mg./10 cc. of blood resulted in a depression of the L.E. phenomenon. The technic of adding "small
amounts" of heparin to blood or "heparinizing a syringe" to draw specimens for
L.E. studies is to be avoided.
3) The explanation for the augmentation of the L.E. phenomenon by clotting
or rotation with glass beads seemed to be the production of leukocyte trauma
by either method. This explained the poor results obtained when the clotted
blood specimen is broken up with wooden applicator sticks rather than macerated
through a fine sieve. The clotting mechanism itself probably has little to do with
the increased numbers of L.E. cells.
4) With adequate treatment the L.E. cells disappeared in many patients.
Forty patients with positive L.E. cell tests treated two months or more had a
simultaneous battery performed on them as described above. All the tests were
negative in eighteen patients, seven patients had fewer than 5 L.E. cells per 500
leukocytes and fifteen patients had more than that number.
Submitted on August 27, 1956
Accepted on February 2, 1957
