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Old 12-10-2010, 01:39 PM   #1
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Anyone's ANA normally read in IU/ml instead of ratios?

I was wondering how many of you have had your ANA results determined in International Units instead of the historically used ratios (i.e. 1:80, etc). If you have, how has your doctor accepted those results as indicative of rheumatic disease?

I have a history of chronic cutaneous leukocytoclastic vasculitis (mainly on ankles these days, comes and goes, but when it first came on 5 years ago it was in other places, too). I have a significant family history for lupus, Sjogrens, etc. and I have a continual problem with hypothyroidism (currently controlled). When the vasculitis first appeared I was tested with all the usual rheumatic labs. My ANA first came back at 1:80 speckled, then 1:40. Everything else was negative.

I haven't been tested for ANA again until just recently because the vasculitis still wants to hang around, although mildly, and I have other skin issues. My PCP wanted to do another to see if anything's changed. This time the ANA, done by Specialty Labs (or at least with their test), came back at 30 IU/ml, speckled. According to their results, the 30 can also be roughly interpreted through traditional ratios as from 1:160 to 1:640. In traditional ratios, these numbers would indicate a possible problem, but the 30 seems to basically indicate a low positive without much concern, according to what little literature I could find.

I realize any ANA is only screening and the actual numbers don't mean a lot, but there seems to be some confusion. My dr has requested an ANALyzer panel considering my and my family's history. But has anyone had both the IU and ratio results and found that they were relatively similar, or a large discrepancy?

 
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Old 12-10-2010, 06:40 PM   #2
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Re: Anyone's ANA normally read in IU/ml instead of ratios?

friedpasta, hello and welcome to the group. I'm only a patient, so please read the following in that light. As for what ANA level is considered high, one of the standard texts written for patients says anything greater than 30 IU's, or 1:1280 or greater. (BTW, I always thought these are two entirely different systems of measurement. I've never seen how to translate one result into the other.) The author also adds that speckled pattern is seen in lupus and other autoimmune conditions.

You mention having other skin issues. Skin can actually be another pathway to a lupus diagnosis, because deep punch biopsy plus immunofluorescent stain tests can yield results that prove a rash is a lupus rash. (I'm always curious about skin, because I had a less common lupus rash that my local dermies all failed to recognize, for years.)

Have you read the sticky posts (permanent info posts) at the top of the thread list? There are several excellent hardcovers on lupus that most libraries have. One thing I especially found useful was that one of the authors discusses "close cousins" to lupus, and how each is differentiated.

As you said, ANA is only a general test. Were more specific tests ever run for specific autoantibodies, such as anti-ds-DNA, anti-Sm, anti-Ro, anti-La, rheumatoid factor, etc.? In your shoes, I'd ask for copies of all labs. (The thing that fooled me was being told that my tests were all OK. Well, they may have been, but the RIGHT tests hadn't been ordered. I turned out to be in that very small percent of ANA-negative lupus, so my local drs. basically hung me out to dry for years.)

I have substantial cutaneous vasculitis on my ankles, and it certainly worsened as my other symptoms evolved. I was told that as long as the skin doesn't ulcerate, I shouldn't overworry it.

Has your PCP suggested that you see a rheumatologist? I found it eye-opening when my new rheumatologist saw the same medical history and lab results my local doctors had reviewed---but saw them in a totally different light. He was astonished, as it all added up to lupus to him, subject to new test results, of course.

I hope you post again soon. Meanwhile, sending you my best wishes, Vee

 
Old 12-10-2010, 09:10 PM   #3
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Re: Anyone's ANA normally read in IU/ml instead of ratios?

Thanks, Vee, for your information. Actually, I am a librarian but the Wallace and other books are checked out right now at work. My mother owns the Wallace and refers to it frequently. However, I don't want to ask her anything as she will become concerned - she is, as she calls herself, a "lupus nightmare" so her greatest hope has always been that none of us kids ever had to deal with it. Considering family history on many levels, however, I've just felt like it was a matter of time!

I'm just curious about the IU and ratios, and if something at 30 really gets looked at seriously. The lab results "compare" the IU and ratio measurements, but very clearly state that it is *only* relative for their particular ANA test and that ratios from other lab's tests cannot be equated. As far as I can tell, my ANA is still basically considered borderline, in general, regardless of looking at IUs or ratios.

When I first had the cutaneous vasculitis appear (dx'd through biopsy; rash was on lower extremities and waist), they ran just about every rheum related lab one would expect. I actually think this "ANALyzer" is less comprehensive and that the labs I had several years ago were more thorough. I don't expect anything to come back positive. I don't really have any signs or symptoms that seriously bother me or disrupt my life - the vasculitis, the skin issues, sometimes joint aches and pains - and I am thankful for that.

I know how difficult it can be, as my mom has many difficulties, some very serious, related to her condition(s). All of you posters on here are so informative. While looking up my own concerns, I found several things which will my mom will find interesting. Thanks for your helpful response!

 
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