Blood work + and - confusion

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crazykitty
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   Posted 7/25/2009 3:46 PM (GMT -7)   
 
   Hi, Hope someone has an answer for me.
 
   I was wondering if there others out there with negative ANA and test postive for
   other antibodies. A rheumy I once had told me if you have a negative ANA and
   test positive for RNP it is a false positive. She said you can only have positive
   RNP with positive ANA. She also believed you cannot have a connective tissue
   disease with a negative ANA. I only saw her once.
 
    My present rheumy treats symptoms. He believes I have MCTD.
   
   Thanks, Robin
  
 
   
 
  

MJLD
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   Posted 7/25/2009 4:56 PM (GMT -7)   
Robin,
As I told you in the other thread. I have never had a positive ANA. I'm not sure about the ANA/RNP connection. I do think it is rare to have a negative ANA with lupus, but i'm living proof that it happens. My lupus is biopsy proven and I have multiple organ involvement. What are your symptoms? Judy

crazykitty
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   Posted 7/25/2009 5:36 PM (GMT -7)   
Judy,

I have Raynauds. A year ago I had a skin biopsy that came back as a variant of
scleroderma. I get rashes but not the butterfly rash, my joints are stiff, ache and
swell. My muscles burn and ache and sometimes twitch. I have headaches and brain
fog. I do have degenerative disc disease, osteoporosis, osteoarthritis and fibromyalgia.
I know that all of these things have simular symptoms.
Robin

lucysgd
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   Posted 7/25/2009 7:54 PM (GMT -7)   
 
 I get rashes but not the butterfly rash, my joints are stiff, ache and
swell. My muscles burn and ache and sometimes twitch. I have headaches and brain
fog. I do have degenerative disc disease, osteoporosis, osteoarthritis and fibromyalgia.
I know that all of these things have simular symptoms.
Robin
 
Hi Robin - me, too - along with sun sensitivity, mouth ulcers, major fatigue and occasional fever flares that include extremely low white cell counts and elevated liver enzymes.   I also have a positive ANA but nothing else shows up on the labs.  Not for Lupus, RA, Sjogren's etc. etc.   Just the high positive ANA.  For now. 
I just don't think there is any one hard and fast rule that can be applied across the board.  It's the preponderance of symptoms and signs, along with response to treatment that matters, which is apparently what your current rheumy believes also, which is great!
Lucy
diagnoses:  mono 1972; postviral CFS 1997; fibro 1998; UCTD 2007
meds: Plaquenil 400 mg, occasional low dose xanax for sleep aid, artificial tears w/ ointment at night, Advil/aspirin prn
 
 


Bsime
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   Posted 7/26/2009 1:22 PM (GMT -7)   
Robin,
 
A connective tissue disease like mctd does not always present itself clearly.  Some patients have an undifferentiated version that never is clear but the patient is still sick and has symptoms.  Some uctd patients do develop into mctd or something else.  Strange diseases.
 
It took about 11 months for mctd to be confirmed in my case even though I was very sick and getting sicker by the day.  My docs guessed I had it before they got a lab confirmation.  Initial diagnosis was lupus then mctd.
 
 
 
 
These are not easy diseases to understand or to diagnose and every case is different.
 
Bill
MCTD (lupus, scleroderma, polymyositis).  Diagnosed 2005.  Kidney, liver, GI tract, dysphagia, raynauds, Barretts esophagus, quadriplegic in 2005.  Recovered and now active in skiing, tai, chi, hiking, golf.  Meds: prednisone 2.5mg, imuran 25mg, amlodipine, benazapril, omeprazole, potassium, folic acid, vitamins, maxide and various supplements and vitamins.
 
Remain optimistic and you can overcome the odds.


crazykitty
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Date Joined Jul 2009
Total Posts : 4796
   Posted 7/26/2009 2:56 PM (GMT -7)   
Bill, Thank you for the info links

I was first told I had UCTD. Then my rheumy believed I could have MCTD after the biopsy
came back as a scleroderma variant. I also had a EMG that came back negative although
I suffer from upper body weakness. Strange thing , the neurologist tested only one arm.

I have tested ANA negative and RNP and ssDNA positive a couple of times. This last test
everything was negative. I have been on Methotrexate since April.

Have you had negative tests since you were diagnosed?

Thanks
Robin

Bsime
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Date Joined Apr 2006
Total Posts : 1299
   Posted 7/26/2009 7:17 PM (GMT -7)   
Robin,
 
I had lots of negative tests.  Some people go through years of negative tests.  These are very difficult diseases, in most cases, to diagnose.
 
UCTD is not really a diagnosis...it is more of a transitory stage which usually develops into something else but not always.
 
To get a diagnosis of mctd you will eventually have a positive result on anti rnp antibodies.  My docs tested me for various things but this did not show up for 13 months.  Actually I had blood anomalies for 15 years before I got symptomatic so take you pick on how long it took.
 
If you say the neurologist tested one arm....how?  Biopsy?  Strength test?  Myositis is usually symmetrical.  
 
Bill
MCTD (lupus, scleroderma, polymyositis).  Diagnosed 2005.  Kidney, liver, GI tract, dysphagia, raynauds, Barretts esophagus, quadriplegic in 2005.  Recovered and now active in skiing, tai, chi, hiking, golf.  Meds: prednisone 2.5mg, imuran 25mg, amlodipine, benazapril, omeprazole, potassium, folic acid, vitamins, maxide and various supplements and vitamins.
 
Remain optimistic and you can overcome the odds.


elcamino
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Date Joined Sep 2005
Total Posts : 1744
   Posted 7/27/2009 5:00 AM (GMT -7)   

Hi Robin,

Your current rheumy doesn't sound like she knows what  she's talking about.  You can definitely have a negative ANA and have a connective tissue disease.  There are many AI diseases that don't have a positive ANA.  I don't have a positive ANA, but I am positive for RF.  the positive RNP antibodies you referred to, I believe, are associated with MCTD.  My mother had a negative ANA, but was also eventually positive for those same antibodies.  She had MCTD.  I would look for another opinion, if I were you.

 

El


Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Lupus
Current Meds: Enbrel, Methotrexate, nexium, tramadol, nasonex, Nifedipine, Folic Acid, Tylenol PM


crazykitty
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Date Joined Jul 2009
Total Posts : 4796
   Posted 7/27/2009 7:34 AM (GMT -7)   
Thank you everyone for your replies.

Elcamino, my current rhuemy does believe in having connective tissue diseases without
a positive ANA. The other rheumy I saw didn't, that is my confusion. My main confusion
is that I had negative ANA and positve RNP on repeated tests and now everything is
negative.

Bill, the test I had done at the neurologist was an EMG electromyography. That test
measures electrical activity in your muscles. Tiny needles are placed in your muscles.
The neurologist thought my muscles were working fine despite my complaints of burning
and weakness.

All I know for sure is that illness is crazy and frustrating!!!!!!!!! I have definately learned
to live one day at a time.

A BIG THANKS
Robin












weakness and burning.

Bsime
Veteran Member


Date Joined Apr 2006
Total Posts : 1299
   Posted 7/27/2009 12:32 PM (GMT -7)   
EMG is normally an unnecessary test and functional strength can be tested in seconds in an office visit.  Doctors should never ignore what patients tell them.  If they say muscles are weak and sore that is a very good indication that some type of inflammatory process is active.
 
Get a second opinion and try to find a rheumatologist.
 
Bill
MCTD (lupus, scleroderma, polymyositis).  Diagnosed 2005.  Kidney, liver, GI tract, dysphagia, raynauds, Barretts esophagus, quadriplegic in 2005.  Recovered and now active in skiing, tai, chi, hiking, golf.  Meds: prednisone 2.5mg, imuran 25mg, amlodipine, benazapril, omeprazole, potassium, folic acid, vitamins, maxide and various supplements and vitamins.
 
Remain optimistic and you can overcome the odds.


crazykitty
Veteran Member


Date Joined Jul 2009
Total Posts : 4796
   Posted 7/27/2009 1:23 PM (GMT -7)   
Thanks again,

I will be seeing my rheumy on September 8th. I have alot of questions for him.

I'll be at his office next week for more blood work, my liver enzymes are up.

Robin

Selinascotia
New Member


Date Joined Jul 2009
Total Posts : 4
   Posted 7/30/2009 11:17 AM (GMT -7)   
Have you been tested for syeudogout, my mom almost died from this.Her level of inflamation was through the roof.Her bllod work was confusing as well.She was diagnosed first with lupus then got worse from the lupus meds.She was sent to a really good rhuem doc.He diaganosed her with the syeudogout took her off the meds for lupus and started her on the wright meds.She is doing well now.Stress and lack of sleep play a huge role in all these auto immune diseases.My aunt has lupus 2 others have vitilago,1 cousin with lupus,sister with arthritis,and I have fibro! All related and these diseases too!

Bsime
Veteran Member


Date Joined Apr 2006
Total Posts : 1299
   Posted 7/30/2009 11:44 AM (GMT -7)   
The condition is called pseudogout.  It is similar to gout which deposit purine crystals in the joints, usually the big toe.  PG deposits another type of crystal in the joints typically the knees.
 
 
Any of us with lupus can experience joint inflammation.  I had it in every joint in my body until meds brought my immune system under control.  the pain was awful.
 
Bill
MCTD (lupus, scleroderma, polymyositis).  Diagnosed 2005.  Kidney, liver, GI tract, dysphagia, raynauds, Barretts esophagus, quadriplegic in 2005.  Recovered and now active in skiing, tai, chi, hiking, golf.  Meds: prednisone 2.5mg, imuran 25mg, amlodipine, benazapril, omeprazole, potassium, folic acid, vitamins, maxide and various supplements and vitamins.
 
Remain optimistic and you can overcome the odds.

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