Understanding ANA Test Result...1:640a staining pattern hom/sp?
I am not new to Healthboards, but am new to the lupus discussion. I recently had an ANA test performed and received the results this morning. I have an appt. in a little over two weeks, but in the meantime I am trying to understand as much as I can about my test results. Is there anyone who might help me to understand what these results might be suggestive of? From what I have gathered it certainly doesn't look favorable although I am certainly not an expert when it comes to this. Any information you could provide me would be greatly appreciated.
anti-nuclear antibody test (ref. less than 40)
My result- 1:640a, staining pattern hom/sp
Thank you very much,
Last edited by Old Hollywood; 08-26-2005 at 02:20 PM.
Hi, Jennifer. Check out the the first "sticky post" at the top of the thread list---the mdoerators gave permission for one of the regulars to post the link you'll find there.
There are also several other "stickies" that speak to diagnostic criteria, plus info on antiphospholipid syndrome, a blood clotting disorder seen in lupus (and also seen "standalone").
I think the "staining pattern hom/sp" may mean "homogeneous/speckled". The lupus hardcover I have at home here seems to state that while "rimed" patterns are "specific" for lupus, homogeneous patterns "correlate generally" with lupus. Apparently "speckled" patterns are seen in lupus AND in other autoimmunes. For what that's worth...
The ANA is only a "threshold" test. It can be positive in several autoimmunes, or because of a passing virus, or a familial tendency. In other words, it alone may raise a flag---but WHICH flag? And was it a REAL flag?
Were tests other than ANA done? Meaning for specific autoantibodies, such as anti-DNA, anti-Sm, anti-Ro, anti-La, anti-RNP, etc? For rheumatoid factor? Etc., etc.?
Anyway, some food for thought. I hope you get some good leads that help & that you get some answers quickly. It can be such a frustrating process to track down lupus & other somewhat similar conditions!
Thank you very much for writing. It sure can be a frustrating process I have been trying to chase down the "unknown" for quite some time now.
Yes, I did have subsets done as well as an RF. The SSDNA, DSDNA, ANTI-SM, SM AND RNP, ANTI-SSA, ANTI-SSB, HISTONE, ANTI SCL70 were all within the reference range used by the lab. The RF was normal as well.
It has me very puzzled as to why my ANA titer would be so high, but yet all the other values are within normal range.
Do you or others have any possible explanations for this? I have been very stressed by the results and am trying to make sense of all this the best that I can.
Dear Jennifer, Do you have a fairly clear set of symptoms & complaints? I ask because I also found the diagnostic process slippery, confusing, subject to different interpretations doctor to doctor, not to mention drs. don't necessarily agree with one another.
My bloodwork was not helpful for some years, but I had lots of very colorful, bizarre rashes = nonscarring, nondepigmenting circles on my upper arms, back & underarm area. I gradually became aware that I felt the worst at the point a new rash was building up. I had numerous skin biopsies done... and found out later the answers had been there all along. (Grrrrrr!)
I finally switched to a teaching hosp. rheumie who basically took one look before Dx'ing. Of course he did all new tests before he confirmed, though. I have the SCLE "subset" and did finally test positive for anti-Ro (but was always ANA-negative, which can happen with anti-Ro, I was told).
So... what do *you* notice about *you*? And do you have anything else like rashes that might be strong leads in the right (capable) hands? With my best, Vee
I just read more about the virus FIFTH'S DISEASE, typically seen in *children*. Very interesting! Article high points: (1) fever, (2) facial rash that may come & go for awhile, them fade into a lacy pattern; (3) red round bumpy rash on arms, etc.; (4) bloodwork, if done, ought to show Parvovirus 19; and (5) should resolve within a week or so.
This list really makes me wonder! Why? In lupus (1) fever can occur, especially as a flare starts up, and it can persist for weeks, often as a low-grade; (2) in SLE, many people, but not all, get a malar facial rash; (3) in the SCLE subset of SLE, people may get an annular (circular) rash, which for months or years, in its immature form, looks like red raised mosquito bites---then over time, those same bumps reappear and expand into circles. Another rash is possible in SCLE, tiny bumps that create an overall look like psoriasis.
But I have no idea whether ANA can be postive in FIFTH'S DISEASE.
Questions: (1) Were you tested for Parvo 19? The results? (2) How long have your rashes been going on? (3) Did anyone ever tell you how long this so-called "Fifth's Disease" ought to take to resolve?
FYI, I had the SCLE "annular" form of rash for 4 years of bumps, like raised mosquito bites but not itchy; then for another 4 years the bumps arrived & expanded into circles. This rash was mainly on my upper arms, also some on back & underarm area. I was never ANA-positive but *finally* turned positive for anti-Ro (SS-A), was anemic, etc.
Look for pictures & info on this SCLE form of lupus & see what you think. If you find info that seems possible to you, you could PRINT IT OUT, TAKE IT TO YOUR DOCTOR(S), and ASK (polite & innocent tone of voice, maybe), "Is this a possibility?"
If doc says NO WAY, because your anti-Ro is negative, that would be wrong-headed, from what I've been told. Only roughly 70% of people with SCLE test positive for anti-Ro. (I finally did but it took YEARS to turn.)
If doc says NO WAY because you've got multiple kinds of rashes, that would also be wrong-headed, from what I was told. Lupus rashes can cross "subsets". I've had 2 (maybe 3) kinds: SCLE annular & discoid , but no malar (and maybe "bullous" as a kid).
You could ask to be sent to a dermie, for a biopsy. I think biopsy results stand the best chance of being useful if done on a new (developing) rash, not an old rash. If you go this route, you want a dermie who knows autoimmunes, not someone whose practice is mainly cosmetic procedures.
I think you & I have chatted before, but earlier in the summer. Speaking of summer---were you in the sun much? Photosensitivity would be a very useful fact, if you think you are. Take care, from Vee
Presented in early summer with what I thought was Lyme and tested negative twice. Had a positive ANA test with a follow up of test of 1:640 ratio homogeneious pattern. GP felt this was Lupus and sent me to Rheumie. Saw the rhuemie yesterday and he tested me for EVERYTHING 15 vials and a urine sample. Now I am in waiting limbo again. Was wondering if I got all worked up for nothing. I also have a sore on my bang line that flares and hurts then feels better(always there though, thought it was a cyst but now I wonder).I guess I just have to wait! Thanks for the quick responses!
Not to get off subject rtmc but how long till your next app? I cant get in to see Rheumy for 2 months and if we start all over with blood tests who knows when I can get a second app. Is it really that hard of a diesease to diagnose. Or is it they just dont want to. If one has all the symptoms and blood work to support it what is the problem? Any help Veterans?
My next appt. is in 2 months. He said to call on Thurs. for my test results. I have read everything I can find on everything and he is testing for everything under the sun. It is very frustrating and I hope it is easier for you. Everyone says it is a long frustrating process, quess they were right. Good luck!
It truly must be such a frustrating time for you and everyone else who is in the process of trying to get diagnosed. This is just some helpful, I hope, information that might just shed a little light on why things can take so long. I know it won't help you personally, but if you think that a wrong diagnosis could lead to such a devestating impact on a persons life, then maybe it will help to know that all the care that has to go into making the right diagnosis is of the utmost importance.
SLE is a multi-system disease, & before a multi-system disease can be diagnosed, there have to be symptoms in many parts of the body & lab work (blood tests) that supports the presence of this.
SLE is also difficult to diagnose because it is a disease that does not typically develop rapidly, but develops slowly & evolves over time. Symptoms come & go, it can take time for the disease to show up in blood tests, which one time can be positive & the next be negative again. It can take months or even years for enough symptoms to show up for the doctor to be able to make an accurate diagnosis.
SLE is known as a great imitator, because it mimics so many other diseases & conditions, which often have to be ruled out. It is difficult to diagnose because there is no one diagnostic test for lupus, the doctor has to do a full examination of the patient & do various tests, before looking at all the evidence & coming to a conclusion.
Physicians have to gather information from a variety of sources- past medical history, lab tests & current symptoms. They use a list of 11 criteria to help diagnose SLE. Generally, a person needs to satisfy at least 4 out of the 11 criteria before a diagnosis can be made.
As I say it doesn't help to know that it might take time, but the care needed to "do it right" as it were, is admirable I personally feel.
Hope this bit of information helps to assure you that only the best care is taken when trying to make a diagnosis.
I am not a medical doctor, I only speak from my own experience of the illnesses I discuss here.
Last edited by goldenwings; 09-04-2005 at 10:34 AM.
You are always so helpful with your replys. I guess for myself I know I will be totaly devastated if this Rhuemy Dr Im about to see tells me something different. As you know Iv already been to see numerous specailists and not one has given me any hope for a proper diagnoses. This Nuero Dr I seen was the best thing to have happen to me. She is very confident SLE Lupus is what I have just from lots of blood and symtoms. I deffinetly have 4 or more, 6 to be exact of the 4 criteria to have Lupus. There is no doubt this Rhuemy will want to do tests of his own. I believe this cold or cough that I cant shake is Pluresy but havent found any one to diagnose it,remember my GP is the one who acted like the scorened women. 6 days into my 2nd antibiotic and Im no better.Does your blood titer differently if your not having a flare? How silly this must sound to disappointed to not have a disease.Im sure you all understand what I am trying to say
From what you have said about your chest and beathing problems, they sound the same as I had not so long ago, and I got a definite diagnosis of pleurisy. Just a bit of information which in this case ok does refer to lupus patients, but anyone who gets pleurisy has the same symptoms and problems with it.
Pleurisy is common in lupus - estimates vary between 30 and 60% of all patients at some time suffering from inflammation of the lining of the chest. The symptom is pain - often a 'catching' pain on taking a deep breath. More severe forms of inflammation and pleurisy produce fluid, so-called pleural effusions. Any fluid in the chest takes useful breathing space away, therefore causing shortness of breath. Pleurisy can be detected clinically and on chest X-ray. Fortunately, it usually responds rapidly to a short course of steroids.
If you are convinced, can you ask your doctor for some steroid treatment? A short sharp burst would most probably clear this up for you. You can't continue like this.
I do so understand that you want to know once and for all. As I have said before, once diagnosed then this gives us the way clear to working out how we are going to shape our lives and make plans for what we want to do and get on with living our lives to the best of our ability.
I am not a medical doctor, I only speak from my own experience of the illnesses I discuss here.
Last edited by goldenwings; 09-04-2005 at 03:50 PM.