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Old 03-02-2011, 07:24 PM   #1
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jrlaguna HB User
Elevated ANA after breastfeeding and Pregnancy-Hormonal Issues cause False Positive?

Hello,

My wife has been back to back pregnant and nursing for the last 5 years, with 3 kids. She just finished breastfeeding 2 weeks ago and had some blood work done last week for some mild Post Partum Depression. The tests came back with an ANA of 1:160 Speckled. The doctor (neurologist/psychiatrist) is having her run more tests, but, she said that she "tested positive" for Lupus, but, it is most likely a "false positive"

I have been doing much research but haven't seen anything regarding hormonal issues post pregnancy leading to False Positives. Is this possible due to hormonal issues? Is this likely?

We just came back from a tropical vacation and she was in the sun all day with no reaction or rashes etc. She really has had none of the symptoms with the exception of Fatigue and Mild Depression, but this is consistent with having 3 kids 4 and under and working a full time job. She has had the below too, but no muscle or joint pains to speak of.

She had a canker sore in her mouth, once a few years ago, but no other mouth or nose issues.

When she took the blood test she had a sinus infection, most likely from the kids who have all been sick the past couple of weeks. I have heard infection can cause elevated ANA.

She had shingles a few weeks ago and took an antiviral and it cleared, but the Derm attributed this to being stressed and overwhelmed.

My question is, her hormones are really changing right now and her body has been through alot, and she just started her period again for the first time in 5 years; does this really sound like a possible Lupus condition, or is it more likely just the hormones and body changes etc.

BTW, she is doing more specific Lupus blood test tomorrow.

Thanks so much!

Last edited by jrlaguna; 03-02-2011 at 08:18 PM.

 
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Old 03-03-2011, 10:52 AM   #2
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Re: Just finished breastfeeding and have elevated ANA

Hi & welcome. What your wife's doctor said seems somewhat misleading to me. First, there's no one blood test for lupus. Instead, the diagnosis is made when patients fulfill 4 or more of 11 ACR criteria; and only SOME of these are blood results, but many aren't. Look for these ACR criteria in a "sticky post" (permanent info post) at the top of the thread list. They may be met over time, meaning not all at once.

Second, ANA is positive in conditions other than lupus. And as you pointed out, sometimes due to a passing virus. (And isn't shingles viral? I don't know if it could elevate ANA, though, sorry...) Also, family tendency & aging (but I doubt that last is germane). Also, as your dr. suggested, I understand the test is difficult to perform & thus subject to false positives.

I'm just a (dumb) patient, but if she's worried, her better bet would be to have a *rheumatologist* perform the additional tests. They know the best labs & are better at nuance in this tricky area of medicine. Also, a rheumatologist knows how to review lifetime medical history, for early signs that are seen in people who later develop lupus. (There's a sticky post on that too, called "Alternative Criteria".) Finally, rheumatologists know lupus in all its wildly varying presentations---plus they know its "close cousins".

I hope this concern passes, but if it doesn't, know that many people who have lupus do pretty well in this day & age. Let us know how things are going, OK? Sending best wishes to you both, sincerely, Vee

Last edited by VeeJ; 03-03-2011 at 10:54 AM. Reason: spelling

 
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Old 03-07-2011, 05:19 PM   #3
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Re: Just finished breastfeeding and have elevated ANA

I had to reply to this because I am the mother of 3 children under 5, I'm breastfeeding, and I just had a positive ANA test!

I agree that it is very misleading (and very likely incorrect) for the doctor to call a positive ANA "positive for lupus". As the previous poster said, there are many reasons why one might get a positive result and lupus is only one of them. A small percentage of the healthy population will get a positive result and never go on to develop an autoimmune disease, for instance. Also, there are many autoimmune diseases beyond lupus. And finally, some things like chronic illness or infection can cause the result as well. I'm not sure about a sinus infection causing a positive ANA, but I imagine it could happen - this should certainly be brought up with your wife's doctor.

Your wife should see a rheumatologist to pursue further testing. He/she can test for a variety of specific antibodies in the blood and that will give you a direction to go in. She might also want her kidney function evaluated (blood and urine tests) because this can go hand in hand with some autoimmune diseases like lupus.

As for the hormonal connection, I don't think hormones affect ANA results. It is very common for women to have a flare up of an autoimmune disease after the birth of a baby though. The connection between hormones and lupus (for example, but other autoimmune diseases too) isn't understood but it's clear that there is some relationship since it primarily affects women in their childbearing years and often becomes less severe after menopause.

In my personal situation, I had a 1:640 ANA with speckled pattern, but haven't yet tested positive for any of the antibodies. I'm waiting on the anti-dsDNA test which I've been told is most specific to lupus. I'm also waiting on kidney function tests, tests to determine if I have any muscle inflammation/damage, and some hematology testing about blood clotting. There is a condition called APS which is often related to lupus which causes abnormal clotting that my doctor suspects I might have. I don't have a diagnosis, but the doctor feels that I do have some sort of connective tissue disease.

I am still breastfeeding my youngest child (she is 7 months) and my symptoms really developed while I was pregnant with her, then become much worse when she was about 3 months old.

I hope your wife gets some answers soon.

Take care,

Zoe

 
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Old 03-07-2011, 06:35 PM   #4
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jrlaguna HB User
Re: Elevated ANA after breastfeeding and Pregnancy-Hormonal Issues cause False Positi

All,

So, the "Double Stranded DNA" test came back negative, or "less than 3" Also, her Thyroid was elevated in the last round of blood tests and that came back within normal ranges this time. We are still waiting on the ANA. She also had high cholesterol and low Vitamin D, but, don't think those are indicative of anything per the symptoms list in the sticky's. Once we get the rests of the tests back, we plan on reviewing them with a rheumotologist.

Zoealexis, thanks for the comments and congratulations on the newborn. The transition from 2 to 3 has been much easier than the transition from 1-2. I hope it is the same for you! Ours is nine months BTW, a little boy

I really appreciate everyone's support and comments. I wish you all the best and will post up here once we have some more definitive results.

Regards,

 
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Old 03-08-2011, 04:51 AM   #5
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Re: Just finished breastfeeding and have elevated ANA

jrlaguna, hi. Doubtless I'll have trouble finding words to convey this, but criteria and symptoms are different. The criteria speak to things that distinguish lupus from other conditions, and thus don't really constitute a definitive list of symptoms. To illustrate---

The criteria *appear* to say that only a few autoantibodies are possible in lupus (i.e., anti-ds-DNA and anti-Sm), but that's not really so. Other autoantibodies are possible but don't "make" the list, because those others are seen in both lupus AND other conditions. (To illustrate, I tested positive for anti-Ro, which is seen in Sjogren's syndrome, lupus, and certain complement deficiencies. For me, skin biopsy narrowed the Dx to lupus.)

The symptoms "sticky" also illustrates this concept: many symptoms are non-specific and don't point to any one condition. For example, thyroid problems can create many of the same early symptoms; so can vitamin deficiencies, anemia, etc. (My thyroid levels were OK; Vitamin D, B-2 & Folate were low.)

For the record, my doctors also told me (as your other poster writes) that lupus & other autoimmunes "love" shifting hormones. But I believe various other conditions do, too. (For example, I know women who had gestational diabetes, then later in life developed diabetes; or later developed Hashimoto's thyroiditis.)

CLEAR AS MUD, huh? Anyway, I hope your wife's remaining tests clarify what is/isn't going on. BUT if her tests don't reveal anything but her symptoms persist, I hope you take what you've learned and try again. (By that I mean by revisiting lupus & its close cousins, thyroid, etc.---meaning whatever conditions might still apply, per future symptoms & labs.) Sending warm wishes to you all, sincerely, Vee

 
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Old 03-17-2012, 07:29 AM   #6
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Re: Just finished breastfeeding and have elevated ANA

I too have a positive ANA. I have been pregnant or nursing for 4 1/2 years solid. I also had problems with having contractions early in pregnancy. Had to go on bedrest at 34 weeks with my first child then started having contractions at 24 weeks with my second. I have now stopped nursing, and continue to have a lot of joint pain, very sore feet and hands, it takes away function and is difficult to care for my children. it seems to lessen and then i will experience 'flares' and i'm not sure why. Sugar seems to be a possible culprit for the flares... so still trying to figure out whats going on and if/when it will go away. I went to a rheumatologist. My ana was positive with homogenous pattern but everything else towards lupus was negative.

 
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