[Joandublin]

Hi folks

I got a copy of my latest lab results today from the Hospital. Its interesting because I have never seen them presented in this way.

The Anti dsDNA antibodies are back down again and are in the weak positive range but the interesting thing was a new 'Result Interpretation' comment typed underneath the results on the sheet. It reads:

'Weakly positive anti-dsDNA is not specific for SLE and may be seen in other connective tissue diseases, autoimmune hepatitis and occasionally other inflammatory conditions'

I've never seen this type of comment before on my lab results and I get my anti ds DNA measured at every visit.

I also had an Anti Extractable Nuclear Antigen panel done and it had another comment under the Anti-Ro antibodies. My Anti-Ro antibodies are listed as 'HighHigh' and the comment underneath reads:

'Anti-Ro antibodies are usually associated with Sjorgren's syndrome or Lupus but may also be found in other connective tissue disease. In women of childbearing age, the presence of anti-Ro may be associated with congenital heart block.'

My Anti LA(SS-B) antibodies result reads Equivocal and underneath it reads

'Equivocal by ELISA and weak positive by Immunoblot'

Other antibodies (RNP, SM, Anti Scl 70, JO-1 Antibody) all negative and no comment underneath.

I just thought it was very interesting to see blood results like this. It almost looks like a 'lesson in Rheumatology':hehe:. They were clearly instructive comments to whoever would be interpreting the results, i.e. the Rheumatologist. I wonder has there been some shift in collective thinking in Rheumatology here in Ireland? I must investigate this more:hehe:

I just wondered if anyone else had noticed anything different about the way their blood results were presented?

Cheers
Joan:rose:

 

[Katharine]

Well, if it is a new trend it sounds pretty good! Useful to us patients too.

It certainly hasn't come to Belgium yet. My blood test results still look like a lesson in chinese :lol:

Katharine

 

[Lily]

Hi Joan,

It's very common here to have those comments on the results, a lot of labs do it. A lesson for some docs perhaps :lol: Well any Rheumy worth their qualifications should already know, but at least it educates the uneducated ones and also helpful for GP's.

I'm glad your Anti-DsDNA is now low :thumbs:

love
Lily

 

[Joandublin]

:hehe: Lily

...and there was me thinking we were leading the way in educating the docs!!:lol:

The other thing that was different was that the reference range for the ANA was written as 'Negative' and mine is just listed as 'High'. No titre....


Love
Joan

 

[greenhaggis]

My recent bloods were:

ESR low
CRP high
C3 okay
C4 okay
anti ds-dna neg at 0-20, weak positive at 20-75, positive at over 75!!

These test were done last week I understand all but the anti ds-dna!

Lesley

 

[Lily]

:lol: Hi Joan,

That seems strange not to show the titre of the ANA, did it show the pattern?

Hi Lesley,

It seems your lab reads anything under 20 as negative on the Anti-DsDNA and therefore doesn't bother reporting a number. Mine does the same, although whether they use a different method for testing I don't know, the last time I looked anything under 5 was classed as normal by my lab and I'm never over that i.e. never had a positive reading.

As far as your ESR & CRP they usually report an actual number here then give normal ranges. Same with the C3 & C4 - funny how different labs operate. Is this an exact copy of what your doc gets or does he get a more detailed report?

love
Lily

 

[Raglet]

Lesley - there are LOTS of different tests for anti-ds-dna and they all have different ranges, so the main thing to do is to only use the reference range on your results rather than comparing them with anyone elses results.

Joan

my labs have stuff about sle etc when my anti-ds-dna come up positive, which they always do. I haven't seen the comment about low positives not being specific for sle, but then I don't think I have ever been weakly positive so that is probably why.

Yup, it's paint by numbers for doctors these days .......

cheers

raglet

 

[Joandublin]

Hi Lily

That seems strange not to show the titre of the ANA, did it show the pattern?

Nope - didnt show the pattern either . Maybe they are saving on typing ink :hehe: I think the first ANA I got several years ago did say speckled pattern though.

Love
Joan

 

[rwb200]

We have seen comments of this nature on labs for several years now.
I have asked the doctor about it and at first he just kind of discounted what they had put on the sheet. I pressed the issue and he expalined.

That the labs do this but he puts little value in what they put down. They list a comment based on that one test and the norm for people.
They know nothing of the history of the patient and know nothing of the norm for that patient.
So while there comment may be true for the typical case it can not be counted on in all cases the doctor has to take the information and balance it with past history and past tests.

With Lupus and many other deseases the patients lab tests are not normal to beggin with. So a lab may conduct a test and make a comment that sounds real bad to a patient but when reviewed by the doctor he may see a big improvment over past tests for this patient and it would be good news for that patient.

He would prefer that these comments were not put on the tests that he just got the reading and was able to make a judgement on his own and talk to the patient about it.
This would prevent many of his patients from getting alarmed by some of the comments that they may see on the sheets.
Or prevent a patient from reading the results and taking it as a diagnoses and stopping medications based on what it says and not on his advice.
For this reason he many times prefers not to give a copy to the patient but to talk to the patient about the test when they come in and tell them what he feels it says.

 

[Lily]

Hi RWB,

I agree (and Joan would too) that results without interpretation by a doctor are not a good idea especially reading the numbers. However Joan was just commenting on the automated comments that the computer spits out, it's not a Pathologists personal opinion that he has typed in. Most countries usually have a Manual of Pathology that all Pathologists go by which lists several reasons for various positive tests.

With ANA's now they will often put a comment that a low positive can be due to things other than autoimmune too which is a good thing so people don't just jump onto the fact that Lupus is listed as just one of the possible causes (something most GP's know but not all) , something that most well educated patients know or at least learn in their journey.

love
Lily

 

[BigSis]

I think these automatic comments/warnings are becoming more commonplace.

At my last GP appointment when making out prescriptions for my meds she mentioned a lot of red highlighted warnings coming up on the computer. Like eye checks for the plaq and stuff.

I agree that it's a bit like 'doctoring by numbers' but it does no harm and might do some good.