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Old 12-20-2012, 06:41 AM   #1
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A.N.A (anti nuclear antibody)

good morning,

A few months ago I started feeling sluggish and achy and so I went to my doctor and had some blood work done. When she called to give me the results she tild me my ana was elevated to 1:646. so she referred me to a rheumatologist who I did see twice, but it got quite expense, since my joint pain and level were the only symptoms he suggested that I go for a sleep study, but it would have been very costly so I never followed through with it. I still have the joint pain and feel sluggish on most days but no other symptoms have come up. Anyone ever level like this and was anything diagnosed?

 
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Old 12-20-2012, 12:48 PM   #2
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Re: A.N.A (anti nuclear antibody)

Hi & welcome. Give your ANA of 1:640, did your rheumatologist run *more specific* antibody tests? That's usually what rheumatologists do next when ANA is meaningfully elevated & joint pain and fatigue are present. Examples are anti-dsDNA, anti-Sm, anti-Ro, anti-La, anti-RNP, antiphospholipid, rheumatoid factor, etc. (There are a bunch.)

Thyroid tests are also often done when patients report fatigue, sluggishness, sleep disturbances, and joint pain, since these can also be symptoms of hypothyroidism.

Did you get copies of all your labs? In your shoes, I'd want to see what tests were run, so I'd know what was ruled out before heading to that sleep lab! I'd just want to know why sleep disturbance was the only diagnosis currently left on the table, so to speak.

My sister had similar labs & symptoms, including severe sleep apnea; she was dx'ed with Hashimoto's thyroiditis. I had joint pain, fatigue, and other problems and was diagnosed with systemic lupus.

I hope others chip in & that you post again soon. Warm wishes, Vee

 
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Old 12-21-2012, 06:46 AM   #3
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Re: A.N.A (anti nuclear antibody)

I had similar labs with fatigue, vague joint paints, and some other problems and was diagnosed with Hashimoto's, sleep apnea, APS and limited progressive systemic scleroderma. I second what Vee said and Happy Holidays!

 
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Old 12-25-2012, 07:41 PM   #4
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Re: A.N.A (anti nuclear antibody)

Thanks.. Not exactly sure what route I will go but I will go back and have my blood tested again in January

 
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Old 12-25-2012, 07:42 PM   #5
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Re: A.N.A (anti nuclear antibody)

How long of a process was it to get your diagnosis?

 
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Old 12-25-2012, 07:46 PM   #6
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Re: A.N.A (anti nuclear antibody)

I will have to go back and look at all the labs. I think I still have the copies somewhere. My guess is he went straight to sleep apnea since I do not have any swelling in my joints only some pain. HOw long did it take for you to get a diagnosis? They made it seem like it was going to be a really long process to get things excluded and narrow it down to something.. if anything. The rheumatologist said lots of people have an elevated A.N.A for no real reason

 
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Old 12-26-2012, 04:21 AM   #7
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Re: A.N.A (anti nuclear antibody)

Hi. My understanding is that people can have elevated ANA for such reasons as a passing virus or infection, a family tendency, aging, and "false positives". That said, I think the odds at your level (1:640) tilt to there being some "real" reason. (I'm assuming the lab used is good at doing AI titer tests. Not all labs are equally good; the tests are tricky to perform.)

It took me many years to get answers. Knowing what I know now, I think there were multiple reasons I struck out so often, such as---
  • My dx was lupus, which is hard to diagnose, plus mine was slow-evolving (had problems from childhood).
  • I didn't have the best-known lupus rashes (discoid or malar). I had a different rash (SCLE), defined only in the late 1970's. My rash wasn't even mentioned in most articles, and my suburban drs. hadn't ever seen it.
  • My lab results were low-odds for lupus (anti-Ro & anti-La autoantibodies).
  • My timing was bad. Labs are most revealing when flares are "on the rise".
  • My first 8 (yikes!) dermatologists were subpar and did half-baked biopsies.
  • My first rheumatologist was subpar.

I broke the stalemate by taking myself to a teaching hospital rheumatologist. This doctor took all of 10 seconds to scribble down his theories & what he should retest, plus the name of an expert skin specialist. Judging from how many symptoms I'd had, I suspect I could have had a dx perhaps 4-8 years earlier, had I picked doctors at his skill level. But that's guesswork. To be honest, I'll never know at what point I could have been dx'ed. Hope this helps some. Let us know what you decide & how it goes. Warm wishes, Vee

P.S. If there's no swelling, I think the word is "arthralgia". But pain is pain, meaning something is likely wrong if it recurs, esp. if it's symmetrical (like both elbows, both wrists, etc.). I think the problem is that drs. doubt when they don't see visible swelling, or don't find inflammatory markers like elevated sed rate, CRP, etc. It's a nasty dilemma!

 
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Old 01-10-2013, 10:23 PM   #8
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Re: A.N.A (anti nuclear antibody)

Hi, VeeJ

I'm going thru a lot of the same things right now. I need to find a different lab, tho, to run my ANA tests. The hospital that just ran mine doesn't report titer levels. That tells me that I need different lab. I've taken a huge crash course in all of this over the week.

The other thing that I'm having an issue with is that my SSA/Ro came back at 52. The hospital lab range says it isn't positive until it is over 90. But, from what I'm seeing on the 'net the value for being positive is 40. Do you have anything to add here? Lab suggestion / comment on the positive value?

Scott

 
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Old 01-11-2013, 06:00 AM   #9
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Re: A.N.A (anti nuclear antibody)

Musicscott, my last labwork shows a completely different range for SSA/Ro. There may indeed be different tests out there.

BTW, SSA/Ro can be seen in systemic lupus, in Sjogren's syndrome, *maybe* in drug-induced lupus (not sure). And I'm not sure if it's seen in any other conditions in addition to those I just listed (sorry).

You could check out both the Sjogren's Board & the Lupus Board.

But in your shoes, I wouldn't look for a lab to run tests, I'd look for a doctor to evaluate me! First reason: you need a doctor to evaluate you for signs, symptoms, and diagnostic criteria OTHER THAN bloodwork & urinalysis results. Second reason: what if values did come back hinky? Because labs don't diagose, you'd be back to square one = needing a real doctor.

I hope this gives you something to ponder. Let us know how you're doing & what happens, when you have time, that is. Sending best wishes, Vee

 
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