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Help - ANA/ENA - what do these results mean?

5968 Views 9 Replies 7 Participants Last post by  Pink Pearl

I had these blood results:

ANA weakly positive (speckled ? pattern)

ENA - negative (anti Ro, Ca, RNP, Sm, Jo-1, Scl-70) Sorry if this doesn't make sense but my doc's handwriting is kind of illegible.:lol:

6 months before I had an ANA 1:80

What exactly does this ANA/ENA stuff show?

I've been referred to a top lupus unit but from everything I've read on the internet to have lupus you have to have 'high' positive results for bloods?

Not really sure why I'm being sent there.


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Blood tests only tell part of the story... and while 95-98% of lupus patients will have high positive ANA titres (1:320 or higher), there are some lupus patients with low positive or even negative titres but have lupus confirmed in other ways (biopsy of skin or kidney, other blood test results, and symptoms consistent with lupus).

So, if you have symptoms very consistent with lupus or some other autoimmune disease, it's a good thing you've been referred to a rheumy who is familiar with autoimmune diseases. Good luck at your upcoming appointment, I hope you get some answers and more importantly, some treatment that helps!
Hi there,
I am not really an expert on these test and the result. I know that the tests are for antibodies in the blood stream that attach themselves to specific proteins. The positive ANA is the test that is used to determin the presnce of diseases of the connective tissues although there are a couple that it is not used for.
A positive ANA does not definately mean that there is a disease present and is usually not seen as significat in the absence of other symptoms as apprx 5-10% of the population can have it without the presence of one of these diseases.

The speckled pattern is consistant with Systemic lupus. Mixed Connective tissue disease, and sjogrens syndrome. But not all doctors will diagnose one of these diseases just with a positive ANA and would also require the presents of positive extractable nuclear antigens or the ENA this identifies the specific antigens who are responsible for causng the ANA to be positive. i.e helps to identify the specific or potential disease.

Having a low ANA has no significance as this does not measure disease activity. I had a low positive ANA at first with no ENA and then when I had the second set of set had a positive ENA.

The fact that you are going to see a lupus specialist really is brilliant for you and they will assess you on your bloods, sign and symtoms before making a decision about how to proceed. They will alnost certainly repeat the bloods in a few months or weeks to monitor any changes. They may also run further blood test to identif other potential dieases which cannot be accurately diagnosed using the ANA/ENA screening.

I know this is alot of info, but these tests ad their interpretation s very complicated. I am sure someone else will be along who might put it all better than me!!

I really hope your appt goes well for you. Have you developed many symptoms? Try to be aware of them and what might trigger them and make a list for your appt so you don't forget anything.

Good Luck

Take Care

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Hi there

The ENA (Extractable Nuclear Antigens) are a subset of antibodies which will usually be tested for if the Anti Nuclear Antibody (ANA) is positive. The ENA panel can help the Rheumatologist to more finely pin down exactly what sort of disease process might be going on.

For example people with Anti Ro antibodies are more likely to have increased photosensitivity and also run a risk of having babies with neo natal Lupus. The percentage of people with Sjorgrens that have Anti Ro antibodies is about 75% and 40% for SLE, from what I can make out.

Another example would be that if the Scl-70 antibodies are positive this would be fairly indicative of Scleroderma although can also be present in Lupus.

The RNP antibodies would be more consistent with Mixed Connective Tissue Disease.

Of course, as with all of these antibodies, there arent many very hard and fast rules and clinical presentations play an important part in diagnosis as well.

Its a complicated process and its great that you have a referral to a specialist to try and figure out what is going on.

Let us know how you get on

Take care
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Hi everyone

Thanks for your help with interepreting the tests. I saw the consultant at the specialist Lupus centre. She was nice but very quick. She has just sent off for more tests. The only different tests I am having done are:

.ds DNA antibodies
Complement C3 and C4
Creatinine Kinase
Rheumatoid factor

Do these tests show up anything different to the ANA and ENA? I thought maybe she would check my dry eyes but didn't.

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Hi Jammy,

I am realitively new to Lupus myself so please do not quote me here but I will take a stab at answering your question and someone with more knowledge will be along to correct me and enlighten you if necessary.

*dsDNA is pretty specific for Lupus

*Complement Levels will show if your body is in a flare of sorts. (disease process)

*Creatinine is looking at kidney function.

*Rheumatoid Factor is specific for Rheumatoid Arthritis.

NOW, again, do not quote me but from what I have learned from the wonderful people here on this forum I think the information I have provided here is somewhat accurate. I am stil learning myself, everyday.

Good luck and let us know how you get along. For your dry eyes maybe a Opthamologist is better suited to help you.:wink2:
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Hi Jammy

Just to say that the Rheumatoid Factor can be positive in a number of other autoimmune conditions. For example I have a high positive rheumatoid factor but dont have Rheumatoid Arthritis. I do have SLE though. See this link:

Aside from blood tests, to be diagnosed with Rheumatoid Arthritis you would have to have evidence of joint erosion shown through xrays.

Its good that your consultant is being very diligent. How are you feeling now? I presume you have a number of symptoms which warranted investigation?

Take care and best of luck with this set of blood tests
Hello Jammy

ds DNA antibodies : pretty well specific to SLE; a very important diagnostic tool, but not present in everybody with SLE. One of only four lupus specific criteria.

Complement C3 and C4 : important signs of disease activity when low. Useful criterion

Creatine Kinase: is for muscles either the heart or musculo skeletal muscles.
(It is creatinine that indicates kidney problems)

Rheumatoid factor: Used to diagnose RA ( only 80%) but may be found in infections, such chronic viral infections, infectious mononucleosis and in disease like leukaemia, chronic hepatitis and in numerous connective tissue diseases : Sjogren's ( almost 100%), SLE ( about 30% ), dermatomysositis, SSc. There's another newer test, CCP, that is useful for diagnosing early RA especially if the RF is negative.

Cheers :)
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Thanks for clarification Clare.

I learn new things every day here.
Hi Jammy,
We are all aware of the standard idea of creating immunity with vaccinations.
With autoimmune diseases we find that the body goes into overtime in producing these antibodies. They fall into pretty usual catagories, which are consisitent with others who have similar antibodies. auto=latin for self anti=against body=self explains
ANA= anti nuclear antibody your body produces antibodies against the nucleus of the cell often seen in inflammatory diseases, not specific to lupus, but most people with autoimmune diseases will form these.
anti ds dna= antibodies against double stranded dna this is more often seen in lupus than other autoimmune diseases.
This gives you a basic idea of what the lab tests are searching for.

Ask your rheumatologist what you are being tested for if you have any questions. You can search these online and under the lupus organization websites.

I hope this helps a bit.
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