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Old 08-02-2011, 09:10 AM   #1
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Need help understanding lab results

Hi folks. I am currently in the process of getting diagnosed. Right now they are leaning towards a lupus diagnosis but it is not certain yet since I do not have most of the common symptoms. The only real symptom I have is systemic inflammation of tendons all over my body. I also have unspecified thyroiditis (tested negative for Hashimoto's antibodies, but thyroid is inflamed on ultrasound and I need meds for it). The tendon problems got severe in the past, then seemed to pretty much go away for a couple years at the same time I got diagnosed with hypothyroidism, then came back recently.

In terms of lab tests, I have had normal or elevated ESR, and I have tested negative for Lyme disease, HLA-B27, RF, and hemochromatosis. My first ANA test was negative several years ago, and a recent ANA test from a new doctor came back negative but just barely negative. He ordered some other tests based on the borderline ANA result, and these are the ones I need help with.

My lab results were:
Anti-dsDNA negative
Anti-Sm positive
SM/RNP IgG Ab positive
RNP IgG negative
SSA (Ro) Ab IgG negative
SSB (La) Ab IgG positive

I've been trying to look up what this means but I'm pretty confused. It sounds like testing positive for Anti-Sm means that I probably have lupus? My rheumatologist is going to put me on a 25 day tapering prednisone course to see if it helps, and I guess is going to try to diagnose me based on whether or not the prednisone helps anything. I am currently taking Lyrica and Tylenol to reduce the pain level.

Have any of you seen labs like this before? Do you know what they mean? I could use all the help I could get! Thanks!

 
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Old 08-03-2011, 03:36 AM   #2
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Re: Need help understanding lab results

Hi & welcome, Paperclippy. I think I've read that certain lupus labs (not sure which) can elevate BEFORE symptoms become dramatic. Another possibility: do both ANA and anti-Sm rise & fall with flares? (If YES, maybe your earlier labs were done when you were already on the upswing?)

While no one wants any of this, seems like your dr. is proactive, which is good, as early diagnosis and treatment could really work in your favor. I hope you keep posting. Let us know how you're doing! Warm wishes, Vee

 
Old 08-03-2011, 07:36 AM   #3
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Re: Need help understanding lab results

Thanks for the response Vee! I don't know if my ANA level has risen and fallen because when I had it tested years ago all they told me was that it was negative. This is the first time I've had the Anti-Sm and such tested. Also this time around my ESR is still normal (18) whereas before it had gotten elevated (36). Maybe that is because this time I was much quicker to seek out a rheumatologist rather than going for standard orthopedic treatment for tendon issues.

 
Old 08-03-2011, 09:13 AM   #4
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Re: Need help understanding lab results

Hi. I think ESR rises & falls in inflammatory conditions, so that might explain why ESR was positive prior, yet negative in your most recent tests.

Have you seen the sticky posts (permanent info posts) at the top of the thread list? One contains diagnostic criteria. You generally (but not always) have to meet at least 4 of the 11 to be diagnosed with systemic lupus. But as you wrote earlier, I've also read that anti-Sm is about as specific as it gets for lupus... As my dr. explained it, envision checking off each criterion you've met in indelible ink. Once met, it's a permanent checkmark.

Fo the record, in subsets OTHER THAN systemic, one can meet fewer than 4 criteria, e.g., drug-induced and discoid. And there's another, SCLE, where people can meet less than 4, or more than 4. Clear as mud, huh?

You'll meet lots of nice people here, so stay in touch, OK? Best wishes, Vee

 
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