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is positive ANA 1:80 nucleolar nothing to worry about?

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Old 08-24-2010, 12:57 AM   #1
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is positive ANA 1:80 nucleolar nothing to worry about?

After negative 3 negative ANAs I've now got a positive one 1:80 nucleolar. But noone contacted me about it. I had the tests done organized by a rheumatologist and noone got back to me so I assumed they were negative. I eventually phoned just to check and was shocked to find my ANA positive (all other tests negative). The secretary told me the rheumy checks all results and would have contacted me if it were anything to worry about. I told my GP who said an ANA of 1:80 is common and doesn't mean anything. Really no doc seems bothered by my result. Should I just relax and trust the docs or does my test show that something is wrong. I can't see how it is normal to suddenly develop antibodies to myself!

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Old 08-24-2010, 02:03 AM   #2
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Re: is positive ANA 1:80 nucleolar nothing to worry about?

Tammy, hi. I'm just a patient, so please read in that light, OK? I think there are multiple things an ANA result might mean.

1. In people who *don't* have lupus or any close cousin, ANA can elevate simply due to a passing virus, to a family tendency, etc. For this reason, without accompanying symptoms, I think drs. don't worry about a slight elevation. So you could ask your GP whether an ANA of 1:80 is considered to be only slightly elevated.

2. In people who *do* have lupus or some close cousin---

a. ANA can rise & fall as flares appear then recede. So timing of tests is important, and it may take multiple tests to "catch it" higher than 1:80. But if a patient doesn't have meaningful recurrent symptoms, there'd be no reason to perform this test again & again.

b. ANA is a general test. Some drs. order it alone, without additional tests for *more spcific autoantibodies*, such as anti-ds-DNA, anti-SM, anti-Ro, anti-La, anti-RNP, etc. (There are as many as 16 seen in lupus!) But there's a small "subset" of anti-Ro lupus patients whose ANA remains negative. However, such ANA-negative lupus is rare, perhaps only 5% of all people with systemic lupus---plus these people have ongoing symptoms that should make a dr. "see through" the fact that ANA has stayed negative.

c. ANA stays negative in the mildest group of people with lupus = those with discoid lupus (DLE). DLE is not considered systemic. It's characterized by skin lesions that scar &/or depigment, posiibly with some fatigue & joint pain.

Given the above, ANA must be viewed in the context of SYMPTOMS. So... do you have persistent symptoms? And do you have anything "objective", meaning visible & impossible to ignore, such as recurrent rashes? I ask that because dermatologists can biopsy rashes and test them with immunofluorescent stains to determine if they're lupus-specific rashes.

I hope this gives you ideas for questions you could ask your dr., to get further clarification of his earlier remarks. Good luck. Warm wishes, Vee

Last edited by VeeJ; 08-24-2010 at 02:11 AM. Reason: spelling

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