Positive ANA test and some symptoms - looking for feedback

Hi folks,

I was hoping to get some feedback from knowledgable patients about whether I should pursue a positive ANA result with a rheumatologist.

I went to my GP because I've been feeling just terrible lately, mostly with fatigue and terrible brain fog/cognitive difficulties, occasional low grade fever (like 99 degrees). I'm a research scientist by profession, so the brain fog is especially troubling to me. I need to be able to articulate complex thoughts and ideas to do my job, and I've really been struggling with it recently.

I've had a lurking suspicion for a while that I might have an autoimmune disease such as lupus. My father had autoimmune glomerulonephritis that contributed to his passing away. I've had lots of skin troubles over the years - many rashes, including a hot, red face rash that comes and goes, and pressure urticaria (hives that form when I apply pressure to my skin, like from crossed legs). I also have a ton of antibiotic/medication allergies, which I've been told by doctors could be a sign of autoimmunity.

Anyway, GP ordered blood tests and I had a positive ANA with dual pattern (homogeneous pattern with 1:160 titer and few nuclear dots pattern with 1:320 titer). However, all of the specific antibody tests were negative. These tests were for: DS, SM, RNP, SM/RNP, Chromatic (nucleosomal), SSA, SSB, SCL-70, Jo-1, Centromere B, and Ribosomal P.

I followed up with my GP, and he was very dismissive of the possibility that I could have an autoimmune disorder. His words were that there was "no evidence" of that, despite the positive ANA, family history, and symptoms. He suggested my fatigue was due to stress, and I left feeling pretty stupid.

Is it worth trying to get in touch with a rheumatologist, or is this probably nothing? I'm kind of tired of feeling crappy all the time, and of course fear that I could be ignoring something serious, after watching my father's health decline from autoimmunity.

Other tidbits: I am 30 years old and female. No other health problems aside from some autonomic oddities (orthostatic hypotension, IBS, functional dyspepsia).

Thanks so much.

Thanks a lot for your reply, I really appreciate it. I think I will make an appointment with a rheumatologist. Sometimes it's really tough to go to the doctor with vague symptoms like "fatigue" because they tend to just dismiss you as a hypochondriac or malingerer (and I think they do it even moreso to women). It's embarrassing. I was actually kind of hopeful about the positive ANA test because I felt like with something abnormal in my bloodwork, the doctor would actually believe that I felt bad and wasn't just "stressed" or whatever. But my GP seemed to think the positive ANA was meaningless since the other antibodies were negative. I think I probably don't meet the diagnostic criteria for lupus right now, but I felt like my doctor was kind of waving it away too quickly, especially given family history.

It sounds like it's prudent to get a second opinion from a specialist.

Thanks again!

Pepe Silvia said...
Hi folks,

I was hoping to get some feedback from knowledgable patients about whether I should pursue a positive ANA result with a rheumatologist.

I went to my GP because I've been feeling just terrible lately, mostly with fatigue and terrible brain fog/cognitive difficulties, occasional low grade fever (like 99 degrees). I'm a research scientist by profession, so the brain fog is especially troubling to me. I need to be able to articulate complex thoughts and ideas to do my job, and I've really been struggling with it recently.

I've had a lurking suspicion for a while that I might have an autoimmune disease such as lupus. My father had autoimmune glomerulonephritis that contributed to his passing away. I've had lots of skin troubles over the years - many rashes, including a hot, red face rash that comes and goes, and pressure urticaria (hives that form when I apply pressure to my skin, like from crossed legs). I also have a ton of antibiotic/medication allergies, which I've been told by doctors could be a sign of autoimmunity.

Anyway, GP ordered blood tests and I had a positive ANA with dual pattern (homogeneous pattern with 1:160 titer and few nuclear dots pattern with 1:320 titer). However, all of the specific antibody tests were negative. These tests were for: DS, SM, RNP, SM/RNP, Chromatic (nucleosomal), SSA, SSB, SCL-70, Jo-1, Centromere B, and Ribosomal P.

I followed up with my GP, and he was very dismissive of the possibility that I could have an autoimmune disorder. His words were that there was "no evidence" of that, despite the positive ANA, family history, and symptoms. He suggested my fatigue was due to stress, and I left feeling pretty stupid.

Is it worth trying to get in touch with a rheumatologist, or is this probably nothing? I'm kind of tired of feeling crappy all the time, and of course fear that I could be ignoring something serious, after watching my father's health decline from autoimmunity.

Other tidbits: I am 30 years old and female. No other health problems aside from some autonomic oddities (orthostatic hypotension, IBS, functional dyspepsia).

Thanks so much.

Hi Pepe Silvia,

I have to quote people because of memory loss

Like other members have stated you need to see a Rheumo as alot of GP don't deal in what rheumo's do and mine alone won't mess unless a letter is stated from my rheumo.

If you have a positive ANA then further tests need running plus theses you mentioned besides (orthostatic hypotension, IBS, functional dyspepsia) are also autoimmune diseases.

I got that worried with my brain fog that i mentioned to my neuro about Alzhimers but was told having nerve damage can cause these combined issues.

Thanks for your feedback, everyone. You've convinced me that I should see a rheumatologist and I'm not being silly to do so. I'll make an appointment ASAP.