Positive ANA test (1:640) but negative for all Autoimmune Diseases. Why?

Hi directrpep!! Welcome to the forum. Yes, the ANA is pretty fickle. It can go positive and then negative again and the other anti-body-specific tests can all be negative. This does not mean you do not have an autoimmune disease but it is likely that you don't have systemic disease (organ and blood involvement). There ARE those with lupus who have negative ANA . . . but your recent test is just a "slice" of your life, it is just a glimpse and just one indicator. There is a link at the end of my signature regarding "4 of 11 criteria" for diagnosing lupus. The doctor will look at lots of indicators to decide what is going on. Lots of us have taken many years and several doctors to figure things out. He'll watch you over a course of time. He should be treating your symptoms though. How are you feeling?? Has he got you on a treatment plan for your symptoms?? Blessings!

Hi AlwaysRosie,

Thank you. So, are you saying that because my tests came out positive both times (1:640), but negative for other AI diseases, then i still most likely have an autoimmune disease? Is this most likely Lupus? Or is it possible that I don't have anything at all and just a positive ANA test?

Sorry, trying to understand if it is possible to have positive ANA tests at a 1:640 level yet still not have an AI disease.

I do not have any signs. I mean, I am always cold, i know that. I get sick quite easily (like the cold, flu) if I am in the cold too long. I have tonsiliths which I was thinkng about getting my tonsils removed because of that. Other than that, I am OK. I don't have any other problems.

Thank you.

Hi Directrpep, Actually . . . you received non-information from me. I'm sorry this is so frustrating. If you don't have any symptoms . . . I would enjoy your life and not worry about the ANA. Many people have + ANA and it just doesn't amount to anything. Your numbers are very low too. When an ANA is + there is also a pattern. The pattern can give the doctor some information as well. But DO hang on to your copy of each blood work that you get and keep a file. It may help later when a pattern starts to emerge. But really, you could have a high positive ANA and have no symptoms, in which case there would be no need for treatment. Check out that link I suggested and you'll see that even if you had a high positive ANA and symptoms, you would need 4 criteria to be dx'd with lupus. Watch what happens when you are exposed to sunlight. Most of us (people with Lupus) either get a rash from the sun, or we have an increase in symptoms (a flare). Some are so sensative that florescent lights affect them. REALLY . . . enjoy yourself and don't think about that ANA again unless you develop pain, fatigue or other symptoms to go along with it. Sending you some hot tea and a big hug!! Blessings!

Hello

It's the symptoms that define the disease  with the bloodwork backing them up. ANA is not specific to lupus or  autoimmune disease of any sort.

An ANA of 1:640 is high enough to indicate lupus or a similar autoimmune connective tissue disease, rather than the other autoimmune diseases such as thryoid  which may also happen to have an elevated ANA assuming  there are any of the relevant typical symptoms.  Other diseases tend to have lower levels.

ANA is not diagnostic of other sorts of diseases but it is diagnostic of lupus, meaning that it is one of the many diagnostic criteria.

There are very few specific signs of lupus; two antibodies: anti ds- DNA which is found in  maybe 50% of those who have a lupus diagnosis and is regarded as specific but can occasionally be found in a few other diseases, and anti -Sm ( Smith) which is regarded as 100% specific but only 30% of those with lupus have them. These antibodies can be present without disease although a person with them is at higher risk of developing SLE down the line.

High ANA can be found in the healthy close blood relatives of people with lupus.

The other specific lupus symptoms are skin and kidney biopsy findings. Lupus skin is found in about 30% of those presenting and a kidney biopsy isn't done unless there are signs of kidney disease in urine and blood. Lupus bloodwork can be present without any disease and lupus can be present without any relevant blood work at all, but that is very unusual indeed especially for none to appear within a couple of years of diagnosis unless the patient has been receiving effective treatment.

Always being cold could be a sign of thyroid problems. The ANA could result from chronic infections. A good indication of immune system problems could be complement testing which could reveal complement deficiencies that might account for chronic infections or be low because of them - chicken or egg scenario.

Bee

It took two years of being positive before my Anti dsDNA was positive. Give it awhile, monitoring your ANA and you'll probably start to see a difference in the other lupus tests.

You should definitely be seen by a rheumatologist, and especially one who specializes in lupus. I can't believe that your family doctor hasn't already referred you. Why did they take the ANA test anyway? You must have been having symptoms or they wouldn't have ordered that tests. When my completment levels scored low my rheumyt finally gave me my definitive diagnosis. I suggest that you find a rheumy who will take the time to answer all your questions because you really shouldn't be in the dark. There's a great book but the name eludes me. If someone else out there remembers it, would you please let direcrpep know the name? Is it Wallace? It's on the Healing Well list of books.

Good luck getting to the bottom of things.

Pat

There are a few things we do avoid. The sun (increases immune response), immune boosting meds, immune boosting foods (alfalpha sprouts) and estrogen containing meds. I'm sure others here can add to that short list, but that's it in a nutshell. Yes, a rheumatologist is the lupus specialist unless your have organ disease, and then he may refer you to specialists when necessary. Make sure (because you are cold) that you have your thyroid checked. That was likely part of your initial "well checkup" but do make sure. Drug induced . . . . shows in other bloodwork, so your doc should have picked up on that if she thought of it. More info at Lupus.org . . . link in my signature. If you aren't having symptoms, though, I'm not sure I'd do any more than read up on things so you know what seemingly innocent symptoms go with this mess. Links at the bottom of my signature will help you get a crash course. Blessings!

Hmmmmm . . . The antioxidents in the fruit are great. Eating healthy is one of the best things you can do for yourself. You can Google "lupus nutrition" and find some good stuff . . . but don't buy into any commercials and people selling stuff. The rheumatologist will do the overall assessment and treatment unless something is way wacky and then they refer you to a specialist for each such issue. But, again, if you are symptom free . . . I would enjoy your ride. . . They just don't start any treatment unless you have wacky high blood work or symptoms. So, easy for me to say, I would learn a bit more about things to watch for . . . and then enjoy your health. Its hard to post everything here . . . Lupus is a study of medicine in its entirety because it can involve any part of the body *phewwww*. But if you check out the links I've given you in my signature and then do some searching on interesting aspects (like nutrition), you will have educated yourself. I just want you to be aware of some odd symptoms like: suns sensitivity, mouth sores, rashes, extreme and prolonged fatigue, joint pain, limbs going numb, hair loss, brain-fog, depression, feeling frequently flu-like w/o actually getting the flu (I have all of these but NEVER realized they were related until I felt too awful and started looking for help). Lupans tend to live with a lot of symptoms that they brush off as "normal" because we don't realize that everyone else doesn't deal with all of this. Look at the Lupus Criteria . . . that will give you the gold standard for diagnoses, even w/o a +ANA. Link is in my signature. I hope this helps. I know it is a bummer to be in limbo like you are . . . but you'll look back later and want to have enjoyed that healthy time if you ever do get really sick. Don't let all of this scare you. It unravels bit by bit and MOST people with a +ANA are absolutely healthy. Actually . . . your liver numbers is what I would be checking out. If your doctor hasn't scheduled you for a follow-up, make sure to do so w/i a few months to make sure those numbers are holding or going down. Blessings!

I don't have the time to read through all the responses, so if I repeat something that was said, I am sorry. An ANA test itself is meaningless if you have no symptoms. Very unlikely anything is wrong. Doesn't mean it can't happen later on. Antibodies won't necessarily show up when you first get sick, sometimes it takes awhile. But your not sick, I would not fret unless I became that way. Have it rechecked at a different lab to make sure it's not a false positive.

I'd agree with your doctor on this one. Your symptoms could be related to connective tissue disease. Did your doctor just run the ANA titer or did he try checking for autoantibodies too? Sometimes doctors skip that part of the test, I don't know why. If it's positive, they should go on and check the rest of it. I know 2 months seem like a long time when your feeling bad. I've had to wait almost a year to get in, and finally am this month. I'm counting the days. 9 more days, yay! Problem is I missed my first appt, where my mind was so screwed up on Chantix. So I had to find a new doctor. Getting a little anxious at this point. Just take it easy until you get in to see your rhematologist. Maybe they'll be able to help you feel better. Like having Lyme isn't enough, you have to deal with this.

It could be indicating crest syndrome.

Do you mean 1:80 titers?
That's a very low level almost borderline. I wouldn't worry unless she's having problems.