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Old 10-02-2012, 09:39 AM   #1
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scared and confused... any ideas on these differing ana patterns?

Hello,

I've been tooling around on these boards for 3.5 months now trying to see if anyone here would have some insight on what is going on with me.

Here we go.

1. Legs (shins and calves) begin to ache continually and I had major fatigue, went to see my GP.
2. ANA shows a 1:640 centromere pattern
3. Get sent to sclero clinic to see what the dealio is (I also have lichen sclerosis and morphea)
4. Doc determines she sees no outward manifestations of CREST and sends me to an endocrin for metabolism issues?
5. GP determines I have fibromyalgia.
6. Go to endocrin, he says he doesn't see anything other than the high ANA, sends me to a rheumy he suggests.
7. See new rheumy. Does a VERY thorough exam and says no arthritis but he wants to do more...testing.
8. All blood tests come back normal except for ANA which NOW come back as 1:1280 with speckled pattern.
9. legs and arms are still painful. Feel like I've run a marathon most days.

So...how do you have a centromere pattern one time and speckled the next?

The rheumy is going to do more detailed tests to try to determine what form of whatever I have.

I'm scared to death of both lupus and sclero. Slero especially...

Can a person have both a centromere issue and a speckled? I know centromere points to CREST, but what does speckled point to? Is it typically one thing over the other???

 
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Old 10-10-2012, 03:02 AM   #2
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Re: scared and confused... any ideas on these differing ana patterns?

ANA's are only used to SCREEN for lupus, not DIAGNOSE, plus an ANA can change from positive to negative and vice versa. A negative does not necessarily meant you DON'T have lupus and a positive does not necessarily mean you DO. It's also worth noting that lots of elderly people have positive ANA's, even when they don't have any health problems. Bloods are not a 'solid' diagnose alone as they can change all the time. Hope you get a proper diagnosis soon :0)

 
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Old 10-10-2012, 05:13 AM   #3
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Re: scared and confused... any ideas on these differing ana patterns?

Hi. I agree with what ANA can "mean", but I think 1:1280 is meaningfully high. I'm sort of surprised that, with your shins (etc.) hurting, the rheumatologist said "no arthritis", as I think arthritis is a possibility. My shins have hurt forever, it seems, since age 13 (on & off, that is). My pain tracks with barometric changes, which I think is common in arthritis.

Re: ANA pattern, isn't that a judgment call, meaning the lab technician assigns the pattern? As such, I imagine different techs could interpret the same sample differently? *I hope others comment on this.*

Did your last round of tests come back? Let us know how you're doing, OK? Sending warm wishes, Vee

 
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Old 10-10-2012, 08:01 AM   #4
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Re: scared and confused... any ideas on these differing ana patterns?

VeeJ is absolutely correct. The staining pattern is subject to interpretation by the lab technician and the interpretation can be very difficult with certain tests, depending on the substrate used. Plus the morphea itself actually can raise the titres of ANA. Is your shin pain due to any sort of vasculitis, maybe? I also believe that staining patterns are not used as diagnostic criteria because of that subjectiveness. Sclero is diagnosed on symptoms with lab backup. Plus, nowadays, there are very specific blood tests that can be performed for the presence of the antibodies themselves rather than relying on a pattern. It is good that your Rheumy is performing more tests. I CAN tell you that titre doesn't matter so much in sclero. It doesn't have much to do with flairs and such, unlike lupus, in which a rising titre might indicate an onset of disease activity but I defer to VeeJ's expertise in that. You also need to remember that staining patterns only point in directions but only generally. In systemic sclero, SED rates and CRP rates are elevated but I don't know about morphea and lupus. Have you gotten your new results back? Let us know how you are doing and best wishes!

 
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Old 10-10-2012, 08:13 AM   #5
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Re: scared and confused... any ideas on these differing ana patterns?

Your positive ANA titers are in the high range, and a speckled pattern is most often seen in lupus. I would disregard the diagnosis of fibromyalgia at this point, until you see what your rheum thinks when all the other results are back. You may find the sticky notes on lupus criteria for diagnosis helpful on the lupus board. I have seen patterns on ANA change and do agree that it is somewhat up to lab tech's judgment call. There are many other lab clues that can support a diagnosis, and the next batch may help to clarify this for you. Lupus can be treated (not cured) and treatment can help improve symptoms greatly, so it sounds like your Dr is thorough and you will get answers and help to feel better soon.

 
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