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Old 07-18-2013, 03:18 AM   #1
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Exclamation Blood results, Positive ANA

Hi everyone. I am new.
Can anybody please help me with my blood results. My ANA was positive 1 : 640, homogeneous pattern but everything else was negative. Including a RA screening and lupus anticoagulant test.
I am suffering from joint and muscle pain, severe fatigue, dizzy spells. The most terrible headaches and my hands and feet are extremely cold all the time. I get mouth ulcers and recurrent nose bleeds. But no rash anywhere. After being in the sun I feel feverish and sick, but no rash. Just a red and white pattern under the skin that disappear after a while, after staying out of the sun.
The first doctor diagnosed me with SLE but the second doctor told me that it isn't Lupus, but he also don't know what it is. So I am not on any medication because I don't know who or what to believe.
Please help. Lately the symptoms are getting worse and I have more sick days. I'm afraid I will lose my job. And I can't afford to.
Regards

 
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Old 07-18-2013, 03:29 AM   #2
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Re: Blood results, Positive ANA

A diagnosis of lupus is based on certain symptoms and signs plus a positive ANA. Your ANA is positive at a significant level, ie., not borderline. Your symptoms are suggestive of SLE as well. I would work with the first Dr. and see if you can get referred to a rheum, unless he is one. If so, discuss your treatment options so you can get some relief and feel better. RA and lupus anticoagulant testing is not usually positive in lupus by itself. It is characteristic, the reaction you have to sun, so important to avoid sun exposure as much as possible. Be sure to wear sunscreen, protective clothing, hat or visor, and seek shade to prevent exaccerbations. Rashes are not always present in lupus, as everyone's symptoms are unique to them and vary. You might also be able to find a support group that will help you learn and cope with having an illness like this. There are lots of good resources online as well. I hope with treatment you are feeling better soon. The meds take time to work, so be patient, but have faith. It will get better.

 
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Old 07-18-2013, 05:16 AM   #3
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Re: Blood results, Positive ANA

Hi. Do you have copies of your recent labs, to see *which* autoantibody tests were run? I hate it when doctors rattle off what you don't have without explaining which tests support their statements.

I imagine (but am only speculating) that the doctor was looking for Rheumatoid Arthritis and antiphospholipid syndrome (due to the lupus anticoagulant test). That said, I think there are other tests sometimes used to check for RA, like X-rays to look for characteristic "mouse bites" where bone has eroded. Actually, diagnosis of RA is generally made using 6 accepted criteria, not just RF, which may not even "have" to be positive.

For antiphospholipid syndrome (APS), anticardiolipin antibody and syphilis* test are usually done as well (*syphilis only because it can be false-positive in APS). FYI, there's a sticky post (permanent info post) on APS, located above the user threads, containing useful info. BTW, I believe nosebleeds can be seen in APS.

The tests you list could leave many tests for antibodies seen in lupus unaccounted for (maybe they were done, maybe not), such as anti-ds-DNA, anti-Sm, anti-Ro, anti-La, anti-RNP, etc. There are a bunch.

Also unaccounted for: antibodies seen in other conditions that I call "close cousins" to lupus, like MCTD (mixed connective tissue disease), Sjogren's syndrome, etc.

Also unaccounted for: thryoid disorders. Those can also cause a positive ANA and many of the same symptoms as early lupus & early RA.

I too see ANA of 1:640 as pretty likely to be meaningful, in the context of your symptoms.

As for the red/white pattern under your skin after sun: that might be livedo reticularis, a disrupution in blood circulation. Unfortunately it doesn't help diagnose any of these conditions because it's not speciffic to any one(s). I get that reaction, too (but eventually got lupus-specific rashes, too).

Another thought---and maybe someone else here can comment on it: I think I've read that ANA can turn positive *in advance of* the more specific autoantibodies. Maybe that's what's happening here, that your dr. really DID DO all the usual specific "anti tests", but they just haven't turned positive yet. Anyway, I hope you can get lab copies & post whatever additional questions you have on the tests done, that you keep trying, and that you post more soon. Unfortunately these conditions really are hard to diagnose, so please hang tough & know you're not alone. Best wishes, Vee

 
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Old 07-19-2013, 08:00 AM   #4
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Re: Blood results, Positive ANA

Hi.
Thank you so much for your reply. I got some of my bloodtest results. But it's in afrikaans so I'm not if it's going to influence the abbreviations.
Thyroid test for T4 and TSH was in normal range
Anti-DNA Neg 8
Specific Anti body test Positive High 2.4
Anti-SM, Anti RO, Anti-La, Anti RNP, Sklerodermia, RNP/U1, SS-A, RO52, SSB, PM-scl, JO-1, CENP, PCNA, Nukleosantigen, Ribosome, AMA M2 All Negative
Hemostasis All in normal range
APS All negative

I have also been using Trileptal for 6years now. In the pamphlet it says that it can cause SLE.
But the doctor said that it's not under the drugs that can cause Drug induced Lupus.
He also said with Drug induced lupus you will always get a POSITIVE - HISTONE. But mine is negative.
Hope this is helpful. Thanks for all your help.
Regards

 
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Old 07-19-2013, 08:01 AM   #5
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Question Re: Blood results, Positive ANA

I recently read up on neurological lupus. Almost all of the symptoms apply to me. The lupus fog, confusion, mood changes, headache, short term memory loss. Sometimes when I am busy writing I suddenly forget how a word is spelled. I constantly forget where I put stuff and sometimes I start with a sentence but halve way through I forget what I was saying. Don't know if this is relevant at all.
Regards

Last edited by Sooooconfused; 07-19-2013 at 08:14 AM.

 
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Old 07-19-2013, 08:15 AM   #6
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Re: Blood results, Positive ANA

Hi.
Thank you so much for your reply. I got some of my bloodtest results. But it's in afrikaans so I'm not if it's going to influence the abbreviations.
Thyroid test for T4 and TSH was in normal range
Anti-DNA Neg 8
Specific Anti body test Positive High 2.4
Anti-SM, Anti RO, Anti-La, Anti RNP, Sklerodermia, RNP/U1, SS-A, RO52, SSB, PM-scl, JO-1, CENP, PCNA, Nukleosantigen, Ribosome, AMA M2 All Negative
Hemostasis All in normal range
APS All negative

I have also been using Trileptal for 6years now. In the pamphlet it says that it can cause SLE.
But the doctor said that it's not under the drugs that can cause Drug induced Lupus.
He also said with Drug induced lupus you will always get a POSITIVE - HISTONE. But mine is negative.
Hope this is helpful. Thanks for all your help.
Regards

 
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Old 07-19-2013, 08:46 AM   #7
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Re: Blood results, Positive ANA

The neuro symptoms you describe are quite relevant. They are very typical of what many lupus patients complain of in their cognitive changes. The anti-DNA antibody of 8, even though it falls in the negative range may be significant as well, as most people have zero. It is found in lupus and relates at higher levels to kidney involvement. It will probably be tested again and over time you will see the range in which yours fluctuates. As for the Trileptal, I don't think anti-histone antibodies are always positive in DILE. I think it is more like 70-80-% of time. Do you have a family history of autoimmune diseases? It might be worth discussing with your Dr. whether there is another drug similar that could be used instead, just in case. Anti-SS DNA can be positive in DILE and I don't see that that was done and perhaps should be. Sounds like your Dr is very thorough in testing, which is excellent.

 
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Old 07-19-2013, 03:41 PM   #8
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Wink Re: Blood results, Positive ANA

There's no family history of lupus. I will ask the doctor to do that test as well.
And I will keep you updated. Thanks so much for your advice and concern.

 
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