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Old 11-25-2012, 01:10 PM   #1
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AI Diagnosis Question - 1:640 ANA+ Speckled Pattern

What does speckled ANA mean?
I have questions concerning recent tests. I have been feeling severe fatigue and malaise off and on for the last three years. I have had infertility...no medical explanation, I have had three severe tonic-clonic seizures...no medical explanation except low threshold...now I have felt BAD extreme fatigue for two years...no explanation...

I have recently been diagnosed with lichen sclerosis, and morphea type skin disorder on my chest. White patches with a slight red rim. My TSH was 7.88 (reference (0.49-4.67). Free T3 and T4 were in the limits. I have been diagnosed with sleep apnea and now wear a CPAP machine. Still tired. I have had negative Brain MRI and MRI of neck some spinal stenosis in C6-C7. I have median neuropathy or mild carpel tunnel.

My fingers/toes are ice cold...they turn pale and then red when they are warmed but never blue..so I dont think it is Reynauds. My Ferratin/Iron levels are okay. My body temp is 97.2 and my blood pressure runs low. My ANA is positiive 1:640 speckled.

Looking over past medical records with my neurologist - I have listed fatigue, rash also on my chest, chills/fever as symptoms. My friends tease me cause I always dont feel well and our joke is do you want to go or do you have the "flu",

Other bloodwork...taken on 6/15
Neut% 79 (53-62)
Lymph% 12.5 (35-43)
Mono% 5.7 (3-5)
Lymph# 0.90 (1.58-4.73)

Going to RA in a month so just consumed with questions...what diagnosis have been found with 1:640 speckled ANA? Does it sound like Hashi or RA or Lupus?

Last edited by pcbc11; 11-25-2012 at 03:38 PM.

 
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Old 11-26-2012, 02:50 AM   #2
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Re: AI Diagnosis Question - 1:640 ANA+ Speckled Pattern

Hi & welcome. I'm really sorry you're having these problems. I think many of us here know that "flu-like" feeling that didn't explain what was really going on. (Mine turned out to be lupus.) Here are some things that came to my mind, but please read in the light of my being just a patient.

ANA is a threshold test that's positive in multiple conditions, thus can't diagnose anything in & of itself. Patterns correlate somewhat to certain conditions but, once again, can't diagnose. I think speckled is seen in lupus but in other AI's as well.

You asked if Hashimoto's, lupus, and RA might be possibilities, I imagine all could. But I also thought of several conditions in the scleroderma-like group. CREST syndrome, for one. That may be an outdated name that's been split into multiple new names, all forms of localized scleroderma (not sure, sorry).
Another might be Mixed Connective Tissue Disease (MCTD), which features a positive ANA plus a specific autoantibody called anti-RNP.

I believe when ANA is positive and symptoms are present, rheumatologists automatically test for *everything in the ballpark* by running a whole slew of specific autoantibody tests. Because people can have multiple autoimmunes or rare combination conditions called "crossovers", it makes sense look for all at once. But possible Hashimoto's might mean a trip to an endocrinologist...?

I believe Raynaud's can turn skin red, white, blue, or any combination of the three. So I think Raynaud's is possible even though you've never turned blue.

Re: your seizures, I know so little about them, but I think that seizures & seizure-like events can occur in various AI's. Lupus (SLE), for one. Also in antiphosphplipid syndrome (APS), a AI blood clotting disorder that occurs in some percent of lupus patients but can also occur "standalone".

If anyone knows of more AI's that can cause seizures, I hope they'll post.

You could also check out the lupus board. There are "sticky posts" there (permanent info posts) with basic info: diagnostic criteria for lupus and common symptoms, plus diagnostic criteria and common symptoms for APS. And there are MCTD patients there, maybe some scleroderma patients, too.

To learn which conditions have been discussed on which board, you could
1. do an "advanced search" (in blue bar above board title) across ALL boards
2. go onto both boards and do "Search Board" from the blue drop box above the user posts
3. just start new threads on either board.

I'm glad you're reading. To be honest, reading the horrible number of things that can occur in lupus alarmed me at first. But then I realized that most would likely not transpire, and that I needed some basic education fast.

I hope above helps a little (give a holler if you need clarification) and that you post more soon, here or elsewhere. Good luck & warm wishes, sincerely, Vee

 
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Old 11-26-2012, 07:59 AM   #3
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Re: AI Diagnosis Question - 1:640 ANA+ Speckled Pattern

My guess is that you may have lupus, or a cousin to it, with the ANA that high. Speckled is a pattern that often occurs in lupus. Even though your fingers don't turn blue, Raynaud's can cause red or white color changes as well. I think you have hypothyroidism, based on high TSH. It may be Hashimoto's, but you need anti TPO and anti thyroglobin antibodies run to tell for sure. Hashi's and lupus can go together, as both are autoimmune. Lupus can cause seizures from brain inflammation. So can hypoglycemia, which often occurs in lupus. The rash on chest should be biopsied with immunofluorescent studies done. It may help confirm a diagnosis, as rashes of all sorts occur in lupus. I would talk to your Dr now about staring some thyroid treatment and getting thyroid antibodies checked. I would also keep a daily diary of symptoms on a one page calendar before you see rheumatologist so he/she can see the gamut of symptoms and frequency over time. Fevers and sleep apnea are also common in lupus. We can't diagnose, but Vee and I both have lupus (I just now saw her post after writing all this), so sorry for the duplication.) You are on the right track and should be getting help and feeling better soon. The thyroid replacement alone will help your energy. Let us know what transpires, and we'll try to help. These are very complicated illnesses and they take awhile to diagnose, get treatment underway, and respond to treatment, but there is hope and you are on your way to feeling better!

 
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Old 11-26-2012, 05:30 PM   #4
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Re: AI Diagnosis Question - 1:640 ANA+ Speckled Pattern

Thanks so much to both of you. I had a follow up to a Thyroid ultrasound and they have found a 1.7 cm nodule. Scheduled for biopsy. Started .25 mg of Sythroid (sp?) so I hope I start feeling better. The doctor took blood today to check for the two tests you recommended above. Thanks replying it means a lot to talk with someone about these issues. I appreciate your insight.

 
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Old 11-27-2012, 01:45 AM   #5
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Re: AI Diagnosis Question - 1:640 ANA+ Speckled Pattern

I'm sorry you're headed to thyroid biopsy for nodules, but on the other hand, that's progress, so yay! Don't let the word "biopsy" send you into a tailspin, it's standard for nodules. From the reading my friends & I did before their biopsies, odds of more serious things are VERY low. (All 4 of my friends were dx'ed with only hypothyroidism and are doing well on Synthroid.)

You could check out the Thyroid Disorders board... but of course you could post here as well, any time you want! Wishing you good luck, Vee

 
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Old 11-27-2012, 10:30 AM   #6
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Re: AI Diagnosis Question - 1:640 ANA+ Speckled Pattern

Hashi's itself may caused an elevated ANA. It is also assocciated with sleep apnea. Speckled is found in a large number of AI diseases. Raynaud's can be diagnosed in the office by a cold test, and VeeJ and ladybud are quite correct in that you do not always see a classic triphasic colour change in Raynaud's. That being said, if you are indeed diagnosed with Raynaud's, make sure that a nailfold capillaroscopy is performed. It involves the Dr looking at your fingers near the cuticle with a drop of oil on them under magnification. That test can aid in determining primary from secondary Raynaud's. And ditto ladybud's suggestion of getting your rash biopsied as it does not sound like telangiastia, which is associated with limited progressive systemic sclerosis, formerly known as CREST. (I think they should just give it a symbol as it's name, like the singer formerly known as Prince. It would be so much easier to spell, LOL) Umm, again, as both ladies have said, getting your thyroid disease treated will help a lot in feeling better. I might also could be playing a role in your seizures but your doctor would know for sure. Fevers and seizures are not usually associated with either form of progressive systemic sclerosis, FWIW, and more specific antibody tests are run in the suspicion of them. I have the limited form of progressive systemic sclerosis, with Hashi's, and sleep apnea, and APS, and Raynaud's and sjogren's, but those last 2 are really part of the scleroderma, so they really don't count . I also think that the lupus board has a great deal of general info and is a great resource! I wish you the best and good luck!

 
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hashimoto thyroid disease, lupus, scleroderma



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