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    Old 02-14-2007, 05:59 AM   #1
    ljs
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    Cytoplasmic fluorescence on ANA test?

    I just got the results of my third ANA test back this week. The last one was a couple years ago and was positive >1280 Atypical speckled and homogeneous . This one is again >1280 Atypical speckled and homogeneous. What is different is that there is also a mention of cytoplasmic fluorescence. Has anyone else had this listed on their lab results? It suggests testing for tissue specific autoantibodies.

    I should note that I've not got any definite dx for lupus or Sjogren's syndrome but have some symptoms of both.

    Last edited by ljs; 02-15-2007 at 06:01 AM. Reason: spelling correction

     
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    Old 02-15-2007, 04:11 AM   #2
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    Re: Cytoplasmic fluorescence on ANA test?

    Hi, ljs. Personally I don't know anything about "cytoplasmic fluorescence" in ANA findings, but by searching I found some VERY scientific articles mentioning it in conjunction with ANCA, an antibody to (I think) white blood cells. Maybe you can search & find something more "readable" on ANCA---or better yet, ask your dr. what this phrase indicates.

    For what this is worth... Is your dr. running more tests? Has he run specific antibody tests beyond the general ANA yet? GOOD LUCK! Sincerely, Vee

    Last edited by VeeJ; 02-15-2007 at 04:15 AM. Reason: forgot something, then spelling

     
    Old 02-15-2007, 06:41 AM   #3
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    Re: Cytoplasmic fluorescence on ANA test?

    Hi VeeJ,

    My usual gp ran a bunch of tests and a few came back abnormal, namely glucose and thyroid. My TSH was above normal, my T4 was normal. Glucose was high...she ordered more tests. I asked if the thyroid problem could cause the high ANA...she said possibly it could. Anyway, she ordered glucose tolerance test, thyroid antibodies, ANA and anti ds DNA.

    Didn't hear back after a week so phoned. My gp was away but they seemed to think I should see another one. So I went in...mostly a waste of time with a dr who doesn't know me at all. I should have insisted on waiting for my regular one because I feel really comfortable with her. Anyway, I found out the GTT was abnormal but no definite dx of diabetes according to this dr...thyroid antibodies was 18, up from 14 last time...ref. range was <35.
    ANA as I mentioned was >1:1280 Atypical speckled and homogeneous with the cytoplasmic stuff. Anti ds DNA was 1.8, lower than two years ago..ref range<4.2.

    That's it so far. This other gp ordered a urine test wrt glucose but nothing else. She didn't seem too concerned about the ANA, especially when I said I had seen an specialist a couple years ago who couldn't find anything specifically wrong. I didn't see cyto. fluor. bit until I was looking over the results ( I had her print out everything).

    I will be following up with my regular gp in a week or so and I imagine she will run other tests since she did this a couple years ago when I was last in to see her.

    I better get my searching skills going again.

    Thanks again, VeeJ.

     
    Old 02-15-2007, 07:31 AM   #4
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    Re: Cytoplasmic fluorescence on ANA test?

    Hi, ljs. It can never hurt to browse & search! My sister was recently Dx'ed as hypothyroid. She learned, after lapsed years between tests, that T4 can be normal early on, even with elevated TSH. That's only an example, of course, because I have no idea what ELSE such findings could indicate (I'm only a patient). Thyroid problems can apparently exist "standalone", or in conjunction with other diseases (incl. lupus, etc.)

    Did your dr. run OTHER antibody tests in addition to anti-thyroid, ANA, and anti-ds-DNA? I finally tested positive for anti-Ro, but I don't think my ANA ever turned positive. The Dx was the lupus "subset" called SCLE. I also had years of very colorful, targetlike, nonscarring arm/torso rashes that were FINALLY deemed to be the "annular" form of SCLE rash. Plus all sorts of other problems...

    Anti-Ro is also fairly heavily associated with Sjogren's, which you mentioned in your first post. Also, I think some people with Sjogren's have very high ANA values.

    I hope you bring things to a head quickly. The right dr. can make all the difference, as I found after YEARS of fruitless appointments. Let us know how you're doing, OK? Take good care, Vee

     
    Old 02-15-2007, 06:44 PM   #5
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    Re: Cytoplasmic fluorescence on ANA test?

    Hi VeeJ,

    My gp said that the fact t4 was normal didn't mean there wasn't a problem. My t4 was 13 (ref 10-23) but said for me, normal is probably around 20. She seems more cluey than most about these type of things. Seems the protocol is we have to wait and retest tsh and t4 if antibodies are normal...then I guess I'll start medication. At least something specific is finally showing abnormal. (Btw, the dr I saw this week didn't seem to feel ANA would be so high with just thyroid...she just didn't seem interested in further investigations.)

    Anyway, gp didn't run any other antibodies first time or second time. I brought up the ANA again wrt the thyroid, which is when she decided to retest that and the ds DNA as an afterthought. I feel almost certain she will order several other tests when I go in again.

    As to this cytoplasmic fluourescence, I searched quite a long time last night and don't feel I know much more than going in. I did find some stuff that mentions autoimmune liver diseases, which sounds a bit scary and possible since 3 of the enzymes on my liver function were above normal (but not majorly high). But I also saw mention of vasculitis (although I've not had any signs of that as yet). I think the term must be used differently in some situations. So better to ask my doctor, I think.

    I have more problems with the Sjogren's symptoms than lupus ones but my main worry a couple years ago was that something was developing that could be treated earlier and prevent later problems. After being given the run around by specialists and shifted from one to another, I decided to quit at that point (too many really hard issues with my two kids at the time) as it was adding more to my anxiety. I'll be pushing for more investigations...Seems like since I hit my 40s it's all starting to hit me...sigh...and I'm still waiting for my first mammogram results so hopefully that will come back normal.

    Last edited by ljs; 02-18-2007 at 04:35 PM. Reason: reduntant wording

     
    Old 02-18-2007, 04:57 PM   #6
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    Lightbulb Re: Cytoplasmic fluorescence on ANA test?

    I think I've figured out what is meant finally. I did lots of searching and eventually found a description of ANA patterns where it mentions cytoplasmic patterns, which must be what is being described. I found one site that shows the different nuclear and cytoplasmic patterns (and some others) with photos. Another one mentions cyto patterns again...Seems it's usually associated with autoimmune liver diseases like auto. hepatitis and primary biliary cirrhosis. There are other cyto. patterns, including one that seems to have some associations with SLE and Sjogren's. I'm hoping to see my gp by early next week for further clarification. I had some elevated liver enzymes on LFT (which could be related) so I am curious where this will lead me.

     
    Old 02-18-2007, 06:45 PM   #7
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    Re: Cytoplasmic fluorescence on ANA test?

    I just wanted to mention to you that I had some liver results out of whack prior to starting my thyroid medication. It really upset me (you know, when the doctor looks at you sideways and says "HOW much alcohol did you say you drink?"). It worried because I knew alcohol wasn't a factor and thought maybe that meant something really serious was going on.

    BUT after a few months of thyroid medication all my liver results were back to perfectly normal. There is quite a lot of reading on the net about how thyroid affects liver function - though I don't pretend to understand it all

    regards
    Georgie

     
    Old 02-18-2007, 11:29 PM   #8
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    Re: Cytoplasmic fluorescence on ANA test?

    Hi Georgie,

    I did see how thyroid seems to affect so many things, including liver function. It's like getting through a thick jungle to determine what is causing what. I haven't started on thyroid meds at the moment but hopefully will have blood tests to confirm dx of low thyroid in a couple weeks. I'm still curious about this pattern which is in addition the nuclear patterns (atypical speckled and homogeneous).

    Speaking of liver tests out of whack...a couple years ago, I asked about the GGT, which was the only one high at the time. The gp, who was fairly new to the job, said it was due to alcohol...I rarely drink so I knew that wasn't the case. I was pretty shocked by that too...I think doctors need to be careful about assumptions. I've also read elevations of some enzymes can be due to obesity (which is one of my problems) so it's possible that's the cause too...But this time the GGT was over double normal and the ALT was nearly double....plus AST, which was slightly elevated.

    And talk of that gp reminded me also that he was the one who was discussing the positive ANA with me and he said it in a way that it was fairly certain I had lupus developing. I'm pretty sure he was recently graduated so didn't have the experience in that area because he was good in many other areas. Anyway, hearing the word lupus really scared me. Now that I've done a lot of reading, I'd prefer lupus to be developing than some of these other problems.

     
    Old 02-19-2007, 05:18 AM   #9
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    Re: Cytoplasmic fluorescence on ANA test?

    Hi ljs,
    I ,too, had some abnormal liver results although I don't have a definitive Dx of lupus. It seems I have a "fatty " liver which indicated to my gp that I consumed high amounts of alcohol. I may have a few drinks once a year. LOL
    As for the "cytoplasmic fluoresecence": cytoplasm is the stuff inside cells and fluoresecence means capable of producing light under some form of radiant energy, like X-ray. I read on this board that some tests "light up" in relation to finding an autoimmune disease like lupus. Right, VeeJ?
    I'll have to do some searching for myself about the autoimmune liver disease.
    Thank you for posting, ljs.

     
    Old 02-19-2007, 08:24 AM   #10
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    Re: Cytoplasmic fluorescence on ANA test?

    Hi, ljs. You mentioned your youthful dr. & your concern that he didn't have years of experience in autoimmunes. Maybe that's an advantage sometimes?
    My "old-guard" drs. missed nearly every salient point. In contrast, I just saw a young (early 30's) dermie a few weeks back on an unrelated matter. On the basis of my medical history & description of the rashes I USED to get, she trilled out her "take"---the correct one---without even seeing old lab results, etc. I looked at her pert, unlined, eager little face---and felt like applauding & saying, "Bless you, my child."

    But I suspect that with your reading, etc., you'll be able to sense quickly who makes sense to you & who doesn't. I hope you keep making progress towards answers. Hang in there! Sincerely, Vee

     
    Old 02-19-2007, 09:59 AM   #11
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    Re: Cytoplasmic fluorescence on ANA test?

    Not to get too chicken and egg on you ljs, but thyroid also causes weight problems, in my case an extra 12 kilos that would not budge despite a healthy diet. That too, is history once I started thyroid medication.

     
    Old 02-19-2007, 07:54 PM   #12
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    Unhappy Re: Cytoplasmic fluorescence on ANA test?

    Hi yesmetoo. I feel like I have a better understanding of this cf stuff now. I won't know reasons until I have further tests, if they happen to illuminate anything. Btw, I read somewhere online that something like 20% of adults have fatty liver at some point. I think it said this is currently due to so many being overweight.

    Hi VeeJ. You are probably right about the young gp picking up on something that might have been ignored...funnily enough, the gp I saw last week didn't pick up lots of things...Both my kids had some blood tests done recently and I asked her to just check if they were okay so that I could follow up if required. Both had some abnormal results. One of those I was expecting but the other I wasn't too sure. Anyway, she actually said the younger ones' tests were fine so I figure she didn't look at them properly. Both see a different doctor. In her case, youth and inexperience turned out to be a negative. Or maybe it was just her attitude.

    I should also add that my regular gp is fairly young, probably early thirties. But she is thorough and caring and listens to what I say. And she never shrugs off concerns about other issues.


    Hi Georgie. I'm sure my thyroid has some effect on my weight but honestly I've had a diet full of too many sweets and not enough exercise. I think thyroid does affect my energy levels, which in turn means it's hard to get exercising...Plus stress and anxiety...I've got two boys with various issues, eg. autism, ocd, anxiety, possible bipolar, etc. So dealing with that makes it harder. I'm pretty sure to get a type 2 diabetes dx and I wonder if all the stress along with the other stuff has contributed...of course thyroid, I think, also can affect glucose levels...or so I recall reading somewhere. I probably should be posting this in the thyroid forum...maybe tonight when I have more time.

    Rambling post finished!

    Last edited by ljs; 02-19-2007 at 07:54 PM. Reason: misspelled word

     
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