Blood Test Question

[JosieSue]

Hi! I am relatively new to this site, but have been lurking since my primary care doctor started testing me for possible autoimmune disorders. I find I have many of the same symptoms that many of you are describing. I have a high sed rate and high C-reactive protein. My ANA came back normal. I have virtually every symptom of Sjorgren's and many of Lupus. He is referring me to a rheumaltologist.
My question is about the ANA. Does it always need to be elevated when you have an autoimmune disorder?

[Clare.T]

Welcome !

I don't know about all autoimmune diseases, but ANA is only a screening test and maybe elevated in many conditions.
It almost always is elevated in lupus and further tests are usually done if there is very strong evidence for a connective tissue disease but negative ANA.

GP's often won't do any further tests but anti Ro is a good idea if possible because it is the one most commonly found in ANA negative lupus and is associated with Sjogren's, ( ~80%) subacute cutaneous lupus ( ~50%) and SLE ( ~30%).

That's part of an ENA panel. See if the doc would run one.

CRP is typically not elevated in lupus and might suggest an infectious origin for inflammation.

I hope you get some answers soon

Clare

[raggedyann1]

Josie,

Each of the different connective tissue diseases has a different percentage.
with lupus the number is only 5% have a negative ana. But your pcp might be saying its normal but it is actually low titer. Like 1:40 or 1:80 is often listed as negative or normal on lab sheets. That information can make a difference sometimes. Other diseases like sjogrens have a higher % with a negative ana.

It also depends on what the other blood test results are, in what is sometimes referred to as a "lupus" panel. The website below explains the ana's and some of the other blood tests used in diagnosing lupus and other diseases. IN addition to what is listed here a rheumatologist will also run the complements that apply to lupus and the tests dealing with the lupus anti-coagulant.

http://www.med.usyd.edu.au/rheumato/Reum_P...ng/AUTOANTI.pdf (http://www.med.usyd.edu.au/rheumato/Reum_PDF/Teaching/AUTOANTI.pdf)

Many of the lupus symptoms are also found in sjogrens and other diseases. Lupus is known as the disease of 1000 faces because of all the different things that can be connected to lupus. But it is also known as the disease that mimics. So often many other things must be ruled out, especially if you continue to have a low ana.

Make sure your pcp is referring you to a rheumatologist that specializes in lupus if at all possible. Esp with your low or negative ana, a true lupus specialist will look at the whole picture and not immediately rule out lupus because of your ana result.

Let us know how things go.

Take care,
Karen

[JosieSue]

Thank you so much for your replies. I am very anxious to meet with the rheumatologist. It's nice to know there is a place to come for support!!