Posted 10/3/2022 6:41 PM (GMT -8)
A positive ANA just indicates *something* *may* be wrong with the autoimmune response. The rheumatologist is the correct Dr to determine if anything is wrong, and if so, what it is and how to treat it. I am including below the different kinds of ANA patters and what they might indicate, as well as the 11 diagnosing symptoms for Lupus. Let me know if you have more questions!
If ANAs are present, the pathologist will see fluorescent cells making a staining pattern. The fluorescent pattern seen can help identify the type of autoimmune disease present. Staining patterns include:
Homogenous: A homogenous staining pattern means the entire nucleus is stained with ANA. It’s the most common type of staining pattern. A homogenous pattern can mean any autoimmune disease but more specifically, lupus or Sjögren’s syndrome.
Speckled: A speckled staining pattern means fine, coarse speckles of ANA are present throughout the nucleus. A speckled pattern may indicate various diseases, including lupus and Sjögren’s syndrome.
Centromere: A centromere staining pattern means the ANA staining is present along the chromosomes. A centromere pattern may indicate scleroderma.
Nucleolar: A nucleolar staining pattern means ANA staining is present around the nucleoles. The nucleoles is inside the nucleus and produces the cell’s ribosomes. A nucleolar pattern may indicate scleroderma. But it can also indicate Sjögren’s syndrome or mixed connective tissue disease or be a false positive.
Peripheral: A peripheral staining pattern means ANA staining is present around the edges of the nucleus. It has a shaggy appearance. A peripheral pattern may indicate lupus.
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.