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Question? re anti Sm & ds DNA

442 Views 6 Replies 4 Participants Last post by  Postie
I don't know if this is the right section for the question but wasn't sure where to put it.

I was reading information on lupus and I came across this. It says even if your ANA is positive and high and you have a rash and low white count and alot of the other symptoms, it said that if the sm test and Anti-DNA are negative than most likely you don't have Lupus.

Does anyone know about this?

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"that if the sm test and Anti-DNA are negative than most likely you don't have Lupus"

Hi postie

That isn't true. Only about a third of people with lupus have positive anti-Sm and about one half have the anti -dsDNA antibodies

But if those antibodies are present they would confirm a diagnosis if there are enough other typical symptoms and signs. .

Diagnosis is essentially clinical backed up by blood tests.The "other symptoms" part is important. A high ANA an indeterminate rash and a low white blood cell count would not necessarily suffice for a lupus diagnosis. Even an ANA of 640 might not mean lupus.


PS I started a new thread for your question which is preferable to tagging it on to an existing thread. To start a new thread go to the front page of the section and click on New Thread at top or bottom left of the page :)
I also gave it a specific title
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My Anti ds-dna positive in Dec 2007, March 2008 now negative!

Not sure if I've ever been tested for anti-SM so can't pass comment on that one!

Take care,

Hi CindyLou!

Clare has given you excellent information. Anti-Sm and anti-dsDNA results do not rule out lupus if negative, but do usually confirm the diagnosis if positive.

In my case, I was negative both anti-Sm and anti-dsDNA at the beginning of my diagnosis journey nearly 2 years ago. My ANA was 1:1280 and I had other clinical symptoms that pointed towards lupus. My rheumatologist is a bit conservative, and diagnosed me first with Undifferentiated Connective Tissue Disease. In January of this year, I had a positive anti-dsDNA test, and she immediately changed my diagnosis to lupus.

I think many rheumies follow the line of thinking that negative results on these tests does not tell them much.

What Is The Difference?

What would be the difference between lupus and undifferentaiated connective tissue disease?

I think all my symptoms follow both diseases--would that be correct?

I am thinking on making an appt with a dermatologist but wanted some of your ideas on these two diseases.

If you have these symptoms, I'm presuming that it could be either one?

fevers off and on of 100-101.
low white count
positive ANA
white count that dropped from 2.3 to 2.1 in a couple months
ANA went from 160 and 320 up to 640
some kind of rash on face and chest and neck that never changes
sun sensitivity to face and eyes
severe fatigue
muscle pain

I can't think what else

Those could go with either lupus or uctd--right?

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Sort of right yes, although there is a technical difference. I am sure that some doctors diagnose lupus (usually described as 'mild' ) when others are more particular and will only diagnose lupus when there is a lupus specific symptom. When there are no disease specifics at all suggesting a definitive diagnosis of any of the CTD's, that's when strictly speaking a UCTD diagnosis is appropriate
They are treated the same way anyway and it is much better to have a UCTD diagnosis from the insurance point of view. SLE is always viewed as a no- go by the insurance companies even if the person has the minimum of symptoms well controlled or even in remission and has been stable for years.

Try your utmost to get a dermatologist who has some experience of lupus and also to get the specimen examined by a board certified dermatopathologist who needs to be informed what he is looking for.
If the punch is taken from the face it should heal up nicely. It might also be taken from inner forearm from unaffected but exposed skin, and/or from unexposed unaffected skin such as the buttock.

By the way how is your fibro being treated ?

Good luck
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Hi Clare

My fibro isn't severe. I only have 11 tender points. My problem is the muscle pain in the forearms. Once in awhile I have stinging pain in the shoulder blades. I started having painful stabbing pain in the back when I was sitting in the computer chair, so I had to buy a laptop. I had more severe fatigue from sitting in the computer chair.

So I don't take anything for fibro because it doesn't really bother me.

Now yesterday when I was hanging out clothes, I had severe pain in the muscle of my forearm and it had never been that severe before. It hurt alot.

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