ANA test questions, new to this

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astroman
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Date Joined Mar 2014
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   Posted 7/21/2018 8:13 PM (GMT -6)   
Hello all, glad to see this is somewhat active here. I'm from the lyme forum and had Hashimoto antibodies for 20 years, so I have other autoimmune.

1)Tested pos for ANA in the past (4 yrs ago), but I received no test details or %'s. So I wonder if it was low titer??? Do they not test further then?

2)A couple more times after I was negative, with no details or percentages, just the word negative.

3)Just tested positive. * This time it has details:*

3A) Its high, says ANA titer 1:80
3B) ANA screen IFA Positive. What is IFA?
3C) ANA pattern is Homogeneous. What's this "pattern" mean? Homogeneous sounds like gene speak.

4) Is this so positive that it cant be anything else?

I'm hoping this is just from Hashimoto or lyme immune body damage, as I dont seem to have lupus symptoms, but they are not to specific. No butterfly mark on face, no fever. Had aches and pain from lyme and Hashi even when ANA was negative. I think lyme is gone as I feel the best in a long time.

thanks

GreenBeans
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Date Joined Dec 2016
Total Posts : 46
   Posted 7/21/2018 9:38 PM (GMT -6)   
A positive ANA can mean one of many things -- or it can mean nothing, in some people nothing at all is wrong! All it really indicates is that you probably want to see a rheumatologist for a complete workup.

In the absence of any information about your symptoms, it is impossible to suggest what, if any, auto-immune disease might be present.

Check out the thread, Lupus 101, it lists the 11 diagnostics symptoms for Lupus as well as definitions for what the different ANA patterns may indicate.

astroman
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Date Joined Mar 2014
Total Posts : 5198
   Posted 7/22/2018 1:29 AM (GMT -6)   
from lupus 101:

"- A titer above 1:80 is usually considered positive.

- The homogeneous, or smooth pattern is found in a variety of connective tissue diseases, as well as in people taking particular drugs, such as certain antiarrhythmics, anticonvulsants or antihypertensives.

- This homogenous pattern is also the one most commonly seen in healthy individuals who have positive ANA tests."

Hmm. I have both, 1:80 and homogenous pattern - they contradict each other.
Had initial lyme symptoms late 80's, then again and with bullseye early 90's. Ended ABX for Lyme in Jan 2016. Flares ended after. Rebuilding / fine tuning / fixing muscles since then; member "10 Percenters Lyme Club". What an adventure this has been. Twenty years of Hashimoto adds to the enjoyment.

beave
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Date Joined Mar 2007
Total Posts : 1827
   Posted 7/22/2018 1:33 AM (GMT -6)   
1) A titer of 1:80 is a low positive, not a high positive. High would be something like 1:640, or 1:1280.

2) IFA = immunofluorescence assay, a method for lighting up the antibodies and viewing them

3) There are three or four different patterns that are common with ANAs. Each pattern can be loosely associated with different conditions (but I stress loosely).

4) No, it's not so positive that it can't be anything else. It's a low positive, for one thing. And for another, even a high positive doesn't mean it must be lupus; a high positive just means it's more likely you have one of the many autoimmune diseases associated with ANAs.

I agree with what GreenBeans wrote - low positive ANAs can mean many things or nothing at all. Best to meet with a rheumatologist, get more blood tests done for subtypes of ANAs, go over all symptoms and history, and go from there.

astroman
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Date Joined Mar 2014
Total Posts : 5198
   Posted 7/22/2018 9:51 AM (GMT -6)   
beave -thanks , however bear with me here. Now I'm even more confused. You can see why-

" A titer of 1:80 is a low positive, not a high positive. High would be something like 1:640, or 1:1280."

Your example (1:640, or 1:1280) would fall into low antibody range as stated below.

The range on my Quest test report says exactly this:

<1:40 negative
1:40 - 1:80 low antibody level
>1:80 elevated antibody level

and I'm at 180

thanks

(I will see another Dr, but my poor experiences with Drs makes me try to understand everything before I see them. If I only believed what Drs said in my lyme past- I might be dead by now.)

yes, - more blood tests done for subtypes of ANAs is what I need.

GreenBeans
Regular Member


Date Joined Dec 2016
Total Posts : 46
   Posted 7/22/2018 11:15 AM (GMT -6)   
astroman said...

1) A titer above 1:80 is usually considered positive.

2) The homogeneous, or smooth pattern is found in a variety of connective tissue diseases, as well as in people taking particular drugs, such as certain antiarrhythmics, anticonvulsants or antihypertensives.

3) This homogenous pattern is also the one most commonly seen in healthy individuals who have positive ANA tests."


These are NOT contradictory. Let me try & explain.

1) So, you have a positive ANA. Even 1:40 is positive. The amount of the titer DOES NOT relate to the severity of disease, or really much of anything else. You could have 1:1280 and still not have any disease symptoms, and nothing would be diagnosed, ie. no disease.

2) People can, and often do, have positive ANA's for a variety of reasons. These are the diseases/reasons likely if you have a positive ANA and it's homogenous. This still does NOT indicate a diagnosis. (Lupus is not really considered a connective tissue disease, so chances are even if you have something, it's not Lupus - but still falls to a rheumatologist to diagnose.)

3) Some people, like in 1 & 2 above, have a postive ANA and no disease. And it might be the homogenous pattern and no disease. If you have a positive ANA and homogenous, you are more like to be HEALTHY than if it was anther pattern

I think the thing you are missing here is this:

Lupus and auto-immune diseases are NOT diagnosed by bloodwork. You can have all the ANA or other blood tests you want, but you need a complete workup by a rheumatologist to evaluate you with respect to the 11 diagnosing symptoms to see if anything is going on or not.

Typically, four or more of the following eleven criteria must be present to make a diagnosis of Systemic Lupus.

1. Malar rash: butterfly-shaped rash across cheeks and nose
2. Discoid (skin) rash: raised red patches
3. Photosensitivity: skin rash as result of unusual reaction to sunlight
4. Mouth or nose ulcers: usually painless
5. Arthritis (non-erosive) in two or more joints, along with tenderness, swelling, or effusion. With non-erosive arthritis, the bones around joints don’t get destroyed.
6. Cardio-pulmonary involvement: inflammation of the lining around the heart (pericarditis) and/or lungs (pleuritis)
7. Neurological disorder: seizures and/or psychosis
8. Renal (kidney) disorder: excessive protein in the urine, or cellular casts in the urine
9. Hematologic (blood) disorder: hemolytic anemia, low white blood cell count, or low platelet count
10. Immunologic disorder: antibodies to double stranded DNA, antibodies to Sm, or antibodies to cardiolipin
11. Antinuclear antibodies (ANA): a positive test in the absence of drugs known to induce it.

Hope that helps.

(If it makes any difference to you, I am the "Lynnwood" who recently stepped down from moderating this forum for 13 years.)

Post Edited (GreenBeans) : 7/22/2018 10:35:51 AM (GMT-6)


astroman
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Date Joined Mar 2014
Total Posts : 5198
   Posted 7/22/2018 2:54 PM (GMT -6)   
Thanks. Im used to thyroid autoimmune which is diagnosed by three very specific thyroid antibodies, unlike the other harder to define autoimmune diseases.

My original ANA positive report from the distant past had none of these details (Dr did not provide other than "positive") that my current ANA pos test has, - so it looks worse at first.

I will do the sub-ANA test to make sure.

I only have four off that criteria sometimes just three. never five that i know of.

This is prob generated from my hashimoto inflammation- I read that can "tic off" ANA too (sometimes).
Had initial lyme symptoms late 80's, then again and with bullseye early 90's. Ended ABX for Lyme in Jan 2016. Flares ended after. Rebuilding / fine tuning / fixing muscles since then; member "10 Percenters Lyme Club". What an adventure this has been. Twenty years of Hashimoto adds to the enjoyment.

beave
Veteran Member


Date Joined Mar 2007
Total Posts : 1827
   Posted 7/22/2018 3:18 PM (GMT -6)   
astroman said...
beave -thanks , however bear with me here. Now I'm even more confused. You can see why-

" A titer of 1:80 is a low positive, not a high positive. High would be something like 1:640, or 1:1280."

Your example (1:640, or 1:1280) would fall into low antibody range as stated below.

The range on my Quest test report says exactly this:

<1:40 negative
1:40 - 1:80 low antibody level
>1:80 elevated antibody level

and I'm at 180
...


I don't see how 1:640 or 1:1280 falls into the low antibody range of 1:40 to 1:80.

Here's a list in increasing order:
1:40
1:80
1:160
1:320
1:640
1:1280

astroman
Veteran Member


Date Joined Mar 2014
Total Posts : 5198
   Posted 7/22/2018 4:12 PM (GMT -6)   
oops, with 1:640, I was thinking in decimal measurements like reading a caliper; .640 is the same as .64, .80 is the same as .800, not in (smile ratios though. brains out to lunch.
Had initial lyme symptoms late 80's, then again and with bullseye early 90's. Ended ABX for Lyme in Jan 2016. Flares ended after. Rebuilding / fine tuning / fixing muscles since then; member "10 Percenters Lyme Club". What an adventure this has been. Twenty years of Hashimoto adds to the enjoyment.
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