Questions about ANA and ds DNA

[fexaloo]

Hello,



I was wondering if anyone had any insights on some tests results. I tested positive 1:80 for ANA. My titre is 80 and the pattern is nucleolar. I tested negative for dsDNA, my lab report cites 0 - 200 IU/ml as normal and my test came back as 32 IU/ml. I tested negative for a lupus inhibitor by DRVVT and Dilute Porthrombin Time. MY CBC came back within normal ranges. My platelet count is 366 and my luekocyte count is 5.9, sed rate is 10, RBC is 4.6.

I asked for an ANA test after vauge symptoms of joint pain (especially in shoulder at the time, but also in hands, feet, toes), chronic unexplained hives, rash on cheeks and bridge of my nose that seems triggered by heat, alcohol and exercise. My abdomen also feels as though my stomach muscles are pulled. I also had a bout of TMJ and generally feel bagged.

Based on my results my DR. did not order any other tests at this time. Wondering what thoughts any of you might have on this. Is it useful to retest for ANA if it is somewhat borderline? What is the significance of a negative dsDNA. Any thoughts would be appreciated. I am worried sick ....

[Clare.T]

Welcome to the forum Fexaloo

The significance of the anti ds- DNA lies more its presence than its absence because if it is present it will confirm and SLE diagnosis. Since many people with proven lupus do not have detectable anti ds -DNA, its absence does not prove a person does not have lupus.

The ANA could certainly be tested again, but it's only worth doing it after several months, I think. He could do the complement tests, C50, C100 C3 & C4 as appropriate which might be interesting in view of the hives. And the ENA panel. The anti cardiolipins are usually done as well as the lupus inhibitor.

Good luck
I hope you get some answers and help soon

Clare

[fexaloo]

Thanking you for your response.

A couple more questions..

Does a negative dsDNA with the levels I noted mean that it is not present. I guess what I am asking, does a person without lupus have no detectable levels of dsDNA i.e ZERO? My lab notes that 0 - 200 IU/ml is negative and I am 32 IU/ml. Would it be accurate to say that the anti ds DNA is absent in light of my lab test results?

I forgot to mention that I was tested negative for a lupus inhibator and RA factor.

What is an ENA panel?

I'm really feeling worried....

[Clare.T]

The anti ds DNA is well within the normal range for that lab and that test method, so I wouldn't worry about that. Levels can vary from time to time . Once and only once, in 34 years, I had an abnormal reading. I think negative is a concept meaning insignificant, rather than zero.

The number of people with lupus who have a significant ds DNA is given as 50%-80%. Diagnosis is made by a number of signs and symptoms medical history and physician experience.

The 'ENA' panel refers to tests for anti -Ro & anti-La, anti- Sm, anti- RNP
Like I said, testing for complement levels would usually be part of thorough testing. Urine should have been tested too

:)

Clare

[Raglet]

low level anti-ds-dna like you have had are normal. It is just the way that our immune systems work. It doesn't make you more likely to develop lupus, incase you were wondering about that. It is only when the levels go above the range set by the lab that they become significant.

hth

raglet

[fexaloo]

Thanks for your response, that really helps me to understand.

[nicky00]

I am being treated with Planquenil ( an anti-malarial drug for lupus) based on a handful of positive symptoms.


My bloodwork = a high ESR (not everybody with lupus seems to have a high ESR).
A mildy positive ANA homogenous pattern ( I have read not everybody has a positve ANA)

Negative for dsDNA,ENA & anti-cardio and inhibitor.

Some of those results could have changed since my last blood test.

From my simple understanding in general is that the whole road to diagnosis is, along with the science,patience,perseverance and a good Rhumatologist who perhaps is capable of thinking outside as well as in the box.

Good luck

[fexaloo]

Nicky,

If you don't mind me asking a few questions. What is considered a high SED? Also what is classified as a mildy elevated ANA? What were your other symptoms, did you ever get hives? Also, did the DRs diagnose you with lupus or justing treating you like lupus?

[Clare.T]

Hi fexaloo

There are links to the most useful test sites in a sticky post at the top of this section.

For women the normal is 1-20 and for men under 50 it is 1-15, if I remember rightly but you can check it out here

http://www.fpnotebook.com/HEM124.htm

SED rate can be elevated for all sorts of reasons, any cause of inflammation caused by immune system activity of any sort.

It isn't always elevated in lupus even when somebody's quite ill but persistent elevation certainly is a diagnostic criterion, among others.

The ANA titre is usually considered moderate at 1:160 - 1:320. The higher it is the more likely it will be due to autoimmune CTD's. Everything depends on what other signs and symptoms there are, and on the doctor's clinical judgement.

Many doctors will not diagnose without an ANA unless there is some lupus specific like skin

Asking any one person about their own case might not be very helpful. It's almost as if we each had our own version of lupus, sort of mix and match. That's what the classification is about. Hives doesn't figure on it not because it doesn't occur (sometimes as the very first sign) but because it doesn't occur all that often.
The complement test I mentioned can be very significant especially with the hives symptom.

All the same it is the sort of symptom that could well play a role as part of a total picture.

Doctors will usually only treat for lupus or a very similar disease, when they are sure it is, or most probably is, having excluded other disease possibilities.

Some doctors will diagnose more readily than others. In some circumstances they will treat for lupus without making a formal diagnosis because the insurance implications of an SLE diagnosis are serious.

Some doctors will not diagnose 'SLE' without a lupus specific symptom - they might call it 'UCTD' instead, Undifferentiated Connective Tissue Disease, meaning there are no specific signs for any particular disease.

Bye for now

Clare

[nicky00]

Glad Claire/Raglet have answered your questions.

My ESR should be around 18 -20. It was 80.
Now down to 40 .

My ANA was at the low end of positive ( forgive me but I cant remember it now.

I did use to get a lot of allergies. My forehead & lips would swell. I would become very itchy. Generally a swollen face.

If I got stung by something like a bee my whole body would come out in hives. This was of course unusual as I tried to avoid being stung.

Generally I just noticed my body was showing odd signs/symptoms and I fell ill and extremely exhausted all the time.
With allergies one would feel this way.

Up until this point I had felt allergy free but I did have lots of episodes of feeling buggy and run down.
My feet became painful to walk on and felt very swollen along with my hands and fingers. The skin felt tight and puffy although I had to say I did not see any signs particulary of odema.
I now put this down to inflammation...Allergies can be a thyroid prob. mine wasnt. Generally we are all different.You can have some similarities but not have Lupus.


Nicky