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Cathie
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Hi
I have an ana which is positve at 1:160. My rheumatologist thinks that I do not have Lupus although I have many Lupus like symptoms (fatigue, aches, malar rash, headaches etc). Apparantly I am one of the 'normal' population with a raised ana and everything else is a coincidence!. Can anyone tell me whether an ana of 1:160 is normal?
Thanks
Cathie
 

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Hello Cathie
According to this site about 5% of the healthy population have an ANA of 1:160.
http://www.ii.bham.ac.uk/clinicalimmunology/CISimagelibrary/ANA.htm

(NB This site mentions other readings such as 100 or 1400 which aren't the usual test method which doubles each time from 1:40. Don't be put off by this because it's still clear what is normal )
1:160 isn't all that impressive but it's good enough if there's enough evidence that lupus is the cause of the symptoms and not another disease which also often has low level raised ANA and some similar symptoms such as autoimmune thyroid. Of course there might be other causes of symptoms and the ANA might be coincidental.
Diagnosis is sometimes by exclusion as much as anything.

Clare
 

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Hi Cathie,

Acording to som sources, up to 5% of the population will have a positive ANA and not have lupus. These people will pretty much exclusively have titres less than 1:320, titres over 1:1250 being almost always seen in conjusction with a real connective tissue disease.

So, yes it is perfectly possible to have an ANA of 1:160 and not have lupus. The point is though , that it is far from certain that you do not have lupus. You do have symptoms which might be lupus (or a related condition). You need to remain under specilist care - either by staying with the same rheumy, getting a second opinion, or by seeing a different specialist, eg a dermatologist or immunologist.

Unless you have a positive kidney biopsy, or a positive skin biopsy, or high titres of anti DNA antibodies, diagnosis is a clinical decision based on the weight of evidience for or against lupus. So, changes in your symptoms or blood tests can be the thing that tips the ballance and leads to diagnosis.

Of course the doctor has to know what to look for and be open minded in considering lupus as a possibility. A doctor who does not want to play detective on your behalf is not the right doctor for you.

It may be a good idea for you to start a sort of file on yourself with a journal of symptoms, photos of rashes, copies of blood tests etc, so that you can keep track of what is happening and better present a full 'case' to doctors when you see them.

Please don't feel alone. This difficult pre-diagnosis stage is one almost all of us have been through.

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