Anti-Nuclear Antibody Test: What Does it Mean?

[Guest guest]

Anti-Nuclear Antibody Test: What Does it Mean?

Getting a diagnosis

can take weeks, or even years. It's like a Polaroid photograph that takes time

to develop. The clinical history is most important. That's why it's so

important that your doctor is a rheumatologist familiar with treating lupus.

And it's important that you keep track of your symptoms, so you can tell the

doctor what has been going on.

Unlike some other

conditions that are easily diagnosed with a single lab test, with lupus, it's

not so easy. This is no surprise, because many things are not easy with lupus!

One lab test will not be enough because of the systemic nature of lupus.

Systemic Lupus Erythematosus (SLE) can affect so many

systems, or parts of the body. If you ever feel like all of your parts have

been under the microscope, that's why! The auto-antibody blood tests are the

most helpful for diagnosing lupus. That's because, as an autoimmune disease, lupus causes the body

to attack itself.

The test that

causes the most concern and from my mail, the most frustration, is the Antinuclear antibody (ANA) test. The ANA test is

important because it shows the body is acting against the nucleus of the cell,

where the commands are sent out. The majority of persons with lupus will have a

positive ANA test. However, lupus is not the only condition that will result in

a positive ANA. Some medications, infections, and other diseases also can come

out positive. A positive ANA is just one piece of the diagnosis puzzle.

Other autoantibody

tests are more specific to lupus. However, not all persons with lupus test

positive for them. Some examples are: anti-DNA, anti-Sm,

anti-RNP, anti-Ro (SSA), and anti-La (SSB). Your doctor may order these

additional tests to try to make a diagnosis.

Now, let's get to

the nitty gritty. What's all this talk about titers?

Here's a Q & A session between doctor and patient on this topic.

Q1. My question is

" What is considered a high ANA titer for lupus? My blood work will say

'Titers of 1:160 and greater should be considered highly suggestive of

connective tissue disease'. But my ANA's sometimes

are l:l60 and l:40 and then last time it was less than

l:40.

A1. ANA reports

include a titer (number) and a pattern. The titer tells us how many times the

technician had to dilute plasma from the patient's blood to get a sample free

of the anti-nuclear antibodies. Thus, a titer of 1:640 shows a greater

concentration of anti-nuclear antibodies than a titer of 1:320 or 1:160.

ANA titers go up

and down during the course of the disease, and a high

or low titer does not necessarily mean the disease is more or less active. A

titer above 1:80 is usually considered positive. However, some laboratories may

interpret different titer levels as positive, so one cannot compare titers from

different laboratories.

Q2. My

rheumatologist doesn't help much because he goes a lot by whether my sed or sedimentation, rate is elevated and other factors. I

always have ANA titers in speckled pattern - do not know what that is either?

A2. The pattern of

the ANA test can sometimes be helpful in determining which autoimmune disease

is present and which treatment program is appropriate. The speckled pattern is

found in SLE and other connective tissue diseases, while the peripheral or rim

pattern is found almost exclusively in SLE.

Because the ANA is positive in so many conditions, the results of the ANA test

have to be interpreted in light of the patient's medical history, as well as

his or her clinical symptoms. Thus a positive ANA alone is NEVER enough to

diagnose lupus. On the other hand, a negative ANA argues against lupus, but

does not rule the disease out completely.

From- Laboratory

Tests Used in the Diagnosis of Lupus

Reichlin, M.D., Professor of Medicine and

Chief, Immunology Section, University of Oklahoma Health Sciences Center,

Oklahoma City, OK

Published by the Lupus Foundation of America.

Remember the big

picture of the process of diagnosing Lupus. Diagnostic tools include:

·

Medical history

·

Complete physical

examination

·

Laboratory tests:

·

Complete blood

count

·

Erythrocyte

sedimentation rate (ESR) - an elevated ESR indicates inflammation in the body

·

Urinalysis

·

Blood chemistries

·

Complement levels -

often low in people with lupus, especially during a flare

·

Antinuclear

antibody test (ANA) - positive in most lupus patients, but a positive ANA test

can have other causes

·

Other autoantibody

tests (anti-DNA, anti-Sm, anti-RNP, anti-Ro [sSA],

anti- La [sSB]): One or more of these tests may be positive in some people with

lupus

·

Syphilis test - may

be falsely positive in people with lupus

·

Skin or kidney

biopsy

Getting a diagnosis

of lupus can be a pain-staking process. However, sometimes isn't it just better

to know? Symptoms are managed for many with anti-inflammatory medications, and

drugs to dampen down the immune system, like Plaquenil.

Your doctor may want a definite diagnosis before proceeding with the treatment.

Lupus is no longer a death sentence. Most people with lupus will live a normal

lifespan. Shop around this site for more information on living better with

lupus.

Hugs,

Deanna