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Hello, my name is Connie, this is my first time here, of course I am frustrated. I have a positive ana, my antinuclear/ab test is 1:640, my ana pattern is centromere. I have had symptoms of raynauds, sun poison, joint pain also. I am really confused and scared. I don't know if it is scleroderma, lupus, raynauds. I was told that the positive ana could be from my thyroid disease, but what about the rest, please help????
 

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Hello Connie

I hope your doctors are competent enough to reach a diagnosis decision soon. First, there are a number of conditions that your results so far might reflect apart from straightforward either SLE, or scleroderma. There's other connective tissue diseases, overlaps, atypical variants and cross overs. People might not fit neatly into any of the diagnostic boxes.

Scleroderma must not be assumed either by you or your doctors simply because of the centromere pattern of the ANA. Like all test results, the significance depends on other symptoms and other test results plus expert evaluation.
Centromere pattern can be found in drug induced lupus, SLE, rheumatoid arthritis, Sjogren's syndrome, overlap syndromes and primary biliary cirrhosis, according to one presumably reliable site.

I don't know all that much about scleroderma but it is a general term that covers various expressions of the condition. Further more specific testing needs to be done to get a better idea of what might be going on and it can be quite complicated to assess. for treatment and prognostic purposes.

There is also a diagnosis called Mixed Connective Tissue Disease which has features of scleroderma, polymyositis and lupus with Raynauds being an almost universal feature, plus sausage like fingers and distinguished by anti RNP antibodies
I think there might still be a diagnosis called CREST syndrome which stands for calcinosis, Raynauds, esophagal immotility (or maybe dysmotility), sclerodactyly and telangiectasia.There are variants of this too when not all those features are present. Centromere antibodies are mentioned as frequently associated with this set of symptoms.

I have the impression that ANA titres are low when they are caused by thyroid disease and that anything above 1:160 is more likely to be caused by lupus or connective tissue diseases.
Further testing for more specific antibodies certainly needs to be done

I hope that reassures you a little bit and helps you to make sure you are getting the best from your doctors. I'd say there's almost certainly some autoimmune CTD process going on but of course I am not a doctor.
A skin biopsy might be useful if diagnosis stalls for some reason. It can show SLE even on unaffected non exposed skin. Not being positive doesn't rule out SLE but being definitely positive certainly rules it in.

Please let us know how you get on - we'll help you all we can to get some answers

Bye for now

Clare
 
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