ANA test questions, new to this

A positive ANA can mean one of many things -- or it can mean nothing, in some people nothing at all is wrong! All it really indicates is that you probably want to see a rheumatologist for a complete workup.

In the absence of any information about your symptoms, it is impossible to suggest what, if any, auto-immune disease might be present.

Check out the thread, Lupus 101, it lists the 11 diagnostics symptoms for Lupus as well as definitions for what the different ANA patterns may indicate.

1) A titer of 1:80 is a low positive, not a high positive. High would be something like 1:640, or 1:1280.

2) IFA = immunofluorescence assay, a method for lighting up the antibodies and viewing them

3) There are three or four different patterns that are common with ANAs. Each pattern can be loosely associated with different conditions (but I stress loosely).

4) No, it's not so positive that it can't be anything else. It's a low positive, for one thing. And for another, even a high positive doesn't mean it must be lupus; a high positive just means it's more likely you have one of the many autoimmune diseases associated with ANAs.

I agree with what GreenBeans wrote - low positive ANAs can mean many things or nothing at all. Best to meet with a rheumatologist, get more blood tests done for subtypes of ANAs, go over all symptoms and history, and go from there.

astroman said...

1) A titer above 1:80 is usually considered positive.

2) The homogeneous, or smooth pattern is found in a variety of connective tissue diseases, as well as in people taking particular drugs, such as certain antiarrhythmics, anticonvulsants or antihypertensives.

3) This homogenous pattern is also the one most commonly seen in healthy individuals who have positive ANA tests."

These are NOT contradictory. Let me try & explain.

1) So, you have a positive ANA. Even 1:40 is positive. The amount of the titer DOES NOT relate to the severity of disease, or really much of anything else. You could have 1:1280 and still not have any disease symptoms, and nothing would be diagnosed, ie. no disease.

2) People can, and often do, have positive ANA's for a variety of reasons. These are the diseases/reasons likely if you have a positive ANA and it's homogenous. This still does NOT indicate a diagnosis. (Lupus is not really considered a connective tissue disease, so chances are even if you have something, it's not Lupus - but still falls to a rheumatologist to diagnose.)

3) Some people, like in 1 & 2 above, have a postive ANA and no disease. And it might be the homogenous pattern and no disease. If you have a positive ANA and homogenous, you are more like to be HEALTHY than if it was anther pattern

I think the thing you are missing here is this:

Lupus and auto-immune diseases are NOT diagnosed by bloodwork. You can have all the ANA or other blood tests you want, but you need a complete workup by a rheumatologist to evaluate you with respect to the 11 diagnosing symptoms to see if anything is going on or not.

Typically, four or more of the following eleven criteria must be present to make a diagnosis of Systemic Lupus.

1. Malar rash: butterfly-shaped rash across cheeks and nose
2. Discoid (skin) rash: raised red patches
3. Photosensitivity: skin rash as result of unusual reaction to sunlight
4. Mouth or nose ulcers: usually painless
5. Arthritis (non-erosive) in two or more joints, along with tenderness, swelling, or effusion. With non-erosive arthritis, the bones around joints don’t get destroyed.
6. Cardio-pulmonary involvement: inflammation of the lining around the heart (pericarditis) and/or lungs (pleuritis)
7. Neurological disorder: seizures and/or psychosis
8. Renal (kidney) disorder: excessive protein in the urine, or cellular casts in the urine
9. Hematologic (blood) disorder: hemolytic anemia, low white blood cell count, or low platelet count
10. Immunologic disorder: antibodies to double stranded DNA, antibodies to Sm, or antibodies to cardiolipin
11. Antinuclear antibodies (ANA): a positive test in the absence of drugs known to induce it.

Hope that helps.

(If it makes any difference to you, I am the "Lynnwood" who recently stepped down from moderating this forum for 13 years.)

Post Edited (GreenBeans) : 7/22/2018 10:35:51 AM (GMT-6)

astroman said...
beave -thanks , however bear with me here. Now I'm even more confused. You can see why-

" A titer of 1:80 is a low positive, not a high positive. High would be something like 1:640, or 1:1280."

Your example (1:640, or 1:1280) would fall into low antibody range as stated below.

The range on my Quest test report says exactly this:

<1:40 negative
1:40 - 1:80 low antibody level
>1:80 elevated antibody level

and I'm at 180
...

I don't see how 1:640 or 1:1280 falls into the low antibody range of 1:40 to 1:80.

Here's a list in increasing order:
1:40
1:80
1:160
1:320
1:640
1:1280