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Old 02-04-2013, 03:59 PM   #1
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Positive ANA 1:40 Nucleolar Pattern

Just received my lab results and will be discussing with the doc tomorrow. I got a positive ANA 1:40 with a nucleolar pattern. Has anyone had this and received a diagnosis?

 
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Old 02-04-2013, 04:05 PM   #2
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Re: Positive ANA 1:40 Nucleolar Pattern

Hi there,

I have ANA 1:>1280 nucleolar pattern. I went to a rheumatologist and he said that if I have no other symptoms other than extreme fatigue, that he can't do anything and he can't diagnose me.
He requested a whole new set of lab tests. I should have the results in a week. He said that the only thing I can do is follow-up every three months because the titer is really high.
Hope you have better luck. It's so frustrating not to have a diagnosis...

 
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Old 02-06-2013, 01:43 PM   #3
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Re: Positive ANA 1:40 Nucleolar Pattern

Quote:
Originally Posted by aleyfre View Post
Hi there,

I have ANA 1:>1280 nucleolar pattern. I went to a rheumatologist and he said that if I have no other symptoms other than extreme fatigue, that he can't do anything and he can't diagnose me.
He requested a whole new set of lab tests. I should have the results in a week. He said that the only thing I can do is follow-up every three months because the titer is really high.
Hope you have better luck. It's so frustrating not to have a diagnosis...
Thank you and the same to you!

The rheumy was concerned about the nucleolar pattern but did mention the positive ANA @ 1:40 was "borderline positive". He did an ultrasound on my hand and saw inflammation in my wrists and swelling in my finger joints (symmetrical). He wasn't comfortable making a diagnosis and said there's a chance it could still be viral as I've had body/joint aches for over 2 months (viral can take 3-6 months). He did order additional labs, one of them being SCL 70, of which I haven't received the results yet (I'm guessing it will be negative though). He prescribed Meloxicam 15mg. So, it's wait and see at this point. Next appointment is in 6 weeks.

 
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Old 02-08-2013, 05:20 AM   #4
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Re: Positive ANA 1:40 Nucleolar Pattern

Hi. In addition to performing ultrasound on your hands, did your rheumatologist run *lots* of tests for specific auto-antibodies? (i.e., I hope he ran the whole gamut, not just SCL-70...) I think ANA pattern is actually rather subjective, because the lab tech assigns a pattern as best he can. Thus you woudn't want the array of diagnostic possibilities narrowed based solely on pattern.

I hope your latest tests provide good info. Wishing you good luck, Vee

 
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Old 02-08-2013, 10:41 AM   #5
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Re: Positive ANA 1:40 Nucleolar Pattern

Yes, he ran other tests like SSA, SSB, RNP, anti-dsDNA, RF, CRP and a bunch of others...all negative/normal. SCL-70 hasn't come back yet among some other ones. Positive ANA with the nucleolar is the only thing that has stood out so far as well as the ultrasound findings and other symptoms I'm having.

I'm completely baffled as this has never happened to me. I woke up with swollen hands and joint pain one day and it's gone downhill from there.

I had really severe symmetrical shoulder pain in the beginning, to the point where I couldn't move my arms without it hurting, couldn't sleep and then it went away.

Generally I ache all over but mainly in the hands, fingers, knees, ankles. I've had these weird sharp pains in my head that last for a few seconds that have happened more frequently lately. I get pain and stiffness in my neck. Yesterday I had severe arm pain after filling out forms at an appointment and then it went away. My smaller toes on my left foot hurt when I walk sometimes. Pain is worse at night. I have TONS of random stuff that is going on in my body and it makes no sense. The one thing that has been constant is the general aching. I can't tell if the Meloxicam is working at all. I really would like some answers but I've heard this could take a while. Still hoping it's just viral (and will go away soon!).

 
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Old 02-08-2013, 01:39 PM   #6
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Re: Positive ANA 1:40 Nucleolar Pattern

Yes, I'm afraid it can take awhile for some of the AI's to build enough steam to be "trapped" by tests, or for additional "useful" symptoms to erupt. People vary so much. I was very slow to develop sufficient signs for lupus. On one hand, that meant I was "subacute" and not in grave danger; on the other hand, I had years of life-disrupting problems with no answers.

It sounds to me as though your rheumatologist is thorough and is covering all the bases. Anyway, I hope you learn more soon & can get some relief from your pain. Hang in there, Vee

 
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Old 02-12-2013, 09:32 AM   #7
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Re: Positive ANA 1:40 Nucleolar Pattern

Quick update. Here are all my labs so far:

ANA - positive, titer 1:40, pattern nucleolar
RF - negative (<10, normal is <14)
Cyclic Citrul Pep Ab, IGG - 5 (Normal is 0-19)
Anti-DSDNA - 2 (normal is 0-19)
SSA - negative
SSB - negative
Smith Ab - negative
RNP - negative
SED Rate - 18 (normal is 0-20)
CRP - 0.2 (normal is <0.5)
C3 - 144 (normal is 90-180)
C4 - 24 (normal is 10-40)
Hepatitis B Surface Ab - 0
Parvovirus B-19 Ab IGG - 0.34 (normal is <=0.89)
Parvovirus B-19 Ab IGM - 0.11 (normal is <=0.89)
SCL-70 - 0

My current symptoms:

aching in fingers, hands, wrists, knees, and toes
pain in heels and sole of foot sometimes
low back pain sometimes
stiffness in the morning
pain better during the day, worse at night
difficulty sleeping
slight peeling on my palms (put lotion on and it seems to help, haven't had this problem before though)
some pain in the shoulders (this was worse on the onset of all of these symptoms and then it went away but now it just aches sometimes)
a lot of cracking and popping in the arms, hands, elbows, shoulders, feet, ankles, thumbs
had weird shock-like headaches for a while but for the last few days, none
fatigue
a couple times I've had a snapping sensation in the knee when bending down or going downstairs (it's really painful when it happens)
not usually in severe pain just mild aching mostly, it limits me in some ways but I'm sure it's not as bad as some people get with RA or Lupus.

I'm not sure if it's viral now, I'm starting to think based on googling my symptoms and the positive ANA that it might be RA. At least when I do google, OA, RA and Lupus come up. It would be pretty rare that a 32 year old would have OA. Also with the nucleolar, through blood tests anyhow, scleroderma seems to be ruled out as well as Lupus.

Taking meloxicam 15mg. Anyone use this before and have side effects? Just wondering if some of my symptoms might be because of the meds.

 
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Old 02-13-2013, 03:55 AM   #8
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Re: Positive ANA 1:40 Nucleolar Pattern

Hi. From what you posted, your labs seem unrevealing: is that what the dr. said?

Did your dr. at least set up a follow-up appointment, to check whether your symptoms have resolved &/or do another set of labs? Wishing you well, Vee

 
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Old 03-24-2013, 10:18 PM   #9
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Re: Positive ANA 1:40 Nucleolar Pattern

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Originally Posted by VeeJ View Post
Hi. From what you posted, your labs seem unrevealing: is that what the dr. said?

Did your dr. at least set up a follow-up appointment, to check whether your symptoms have resolved &/or do another set of labs? Wishing you well, Vee
Thank you. So far my rheumy is stuck on the positive (though borderline) ANA and the nucleolar pattern along with generalized joint pain (more specifically in the hands-especially the hands and wrists, knees, ankles and toes). Also the swelling he noted in the ultrasound between my knuckles and inflammation in my wrists. I also started having frequent heart palpitations-where I felt faint a couple times, paresthesia (tingling, *****ling, burning sensation skin in my arms and hands), frequent muscle spasms and other weird, random stuff.

He believes it's either RA or Lupus and said it's most likely NOT viral as symptoms haven't improved but has not given a diagnosis yet. He just redid all of my blood tests and I'm waiting for the results. I see him in a month.

Praying for anyone else, like me, with no diagnosis but tons of symptoms. It's so hard to wait and feel like people don't understand because there isn't a "label" for what you're going through.

Last edited by slr42404; 03-24-2013 at 10:19 PM.

 
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Old 03-25-2013, 12:53 AM   #10
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Re: Positive ANA 1:40 Nucleolar Pattern

Yes, it's frustrating. Forgot to ask, are you on any meds? Certain prescription meds have been implicated in a milder subset of lupus called DILE = drug-induced lupus erythematosus. I believe joint pain & fatigue are the top symptoms in it (major organs are hardly ever affected). ANA is positive, plus, 95% or more of the time, anti-histone.

Maybe you could read more while waiting for your next appt. and next round of tests? Most libraries have books on lupus & RA. (I found reading very helpful in understanding why some dx'es can take so long.) Hang in there, best wishes, Vee

 
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Old 03-30-2013, 03:30 PM   #11
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Re: Positive ANA 1:40 Nucleolar Pattern

Thank you

Yes, I do research a lot. I don't think that's it. My latest round of blood tests came back. All of them negative or normal, including ANA. What's weird is I've had more flare ups and pain now. When I was initially tested it wasn't that bad. Seems like I'm back at square 1.

The doc is going to see if there is still swelling next time I see him and then he's going to put me on the hydro-something rather, forget the spelling.

 
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Old 03-30-2013, 06:31 PM   #12
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Re: Positive ANA 1:40 Nucleolar Pattern

Is the "hydro something" drug he's considering maybe hydroxychloroquine? If YES, that's the generic for Plaquenil, which is the drug of choice for milder lupus, RA, etc. I've taken it for years. I love it because it's helped so much. Hang in there! Bye, Vee

 
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Old 04-08-2013, 10:32 AM   #13
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Re: Positive ANA 1:40 Nucleolar Pattern

I think so. Thanks

 
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Old 04-12-2013, 09:49 AM   #14
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Re: Positive ANA 1:40 Nucleolar Pattern

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Originally Posted by slr42404 View Post
Praying for anyone else, like me, with no diagnosis but tons of symptoms. It's so hard to wait and feel like people don't understand because there isn't a "label" for what you're going through.
Hi there. I can relate. I've had knee pain and joint issues since I was around 13 or 14 (I'm about to turn 28), and recently decided I was sick of feeling like an old person*. I'm active (hiking, biking, kayaking, etc.), but I always seem to have swollen knees after a workout and tend to limp more than my friends at the end of the day. In addition to knee pain, I have toes that dislocate frequently, feet prone to stress fractures, hip pain, and shoulder issues (general inflammation, which I've managed with physical therapy). I'm always achy and fatigued. It's pretty lame. I had knee X rays come back normal and an MRI of one knee showed nothing except effusion.

My doctor just ran a bunch of tests:
CBC, DIFF
SED RATE
CRP, HIGH SENSITIVITY
RHEUMATOID FACTOR
ANTI C. CITRULLINATED PEPTIDE2
ANA REFLEX COMP PNL BTY
VITAMIN D (25 HYDROXY)
ANA REFLEX ID PANEL BTY

Everything was normal, except the ANA and Vitamin D. ANA was positive with IF, nucleolar pattern at 1:40. Vitamin D is deficient, but I live in the Pacific Northwest (home of Stephenie Meyers' vampires), so that isn't surprising.

I also have Celiac disease, which may or may not be related. Before my Celiac diagnosis, my CRP was 8. Now (after 3 years gluten-free), my CRP is 0.5. Interesting to think that if I was still exposing myself to gluten, my CRP might be high enough to indicate to the docs that something else was going on, potentially unrelated to the joint issues I'm having.

Ultimately, I share your frustration. I don't want lupus or RA, but I want something I can point at and say, "This is what's wrong with me." I feel like I'm too young to have all these aches and pains for no reason. Sorry, can't go for a hike today, my old-person-itis is acting up.

*no offense to old people, I hope to be one someday, but I want to earn my joint pain and fatigue the old-fashioned way.

 
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Old 04-29-2013, 09:35 PM   #15
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Re: Positive ANA 1:40 Nucleolar Pattern

Hang in there! Have you been checked for Hypothyroid, Diabetes, PCOS?

I saw a gyno and she thinks the pain could possibly be related to one of the above and I just had an ultrasound done (I've also had pelvic pain along with body pain). Crazy how so many diseases can mimic others.

Praying you find answers soon!

 
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