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high ANA and centromere antiboy
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high ANA and centromere antiboy

Hello Doctor,

I am a 58 years woman who recently experiece finger join pain and stiffness and ankle stiffness in the early morning.  I went to see my pcp and have blood test done. The results showed negative RF, CRP and low ESR 13 but high ANA 1:1280 titer.  He later referred me to see an rheumatologist.  More test was done.  The results were

negative results for
RF 7  (< 14)
CRP <0.2 (0.0-0.9)
antiCCP < 16  (<20)
DNA double stranded < 1  (< 4)
sjogren's ab  <1.0  ( 8.0       (<1.0)  

but with positive results with
ANA titer   1: 1280    (1:40)  with centromere A pattern
TSH      5.3  with TPOab  683  (<35)  

The doctor said the  high ANA titer caused by thyroid problem,  ask me to do follow up after 3 months.  However, I am still have this minor joint pain on my middle finger of right hand since taking advil 4x/day.    I am afraid that I am in an early stage of auto-immune disorder disease and miss the early diagnosis and treatment.
My sister has RA for 13 years.   I research thru internet and found high anti-centromere antiboy is associated with Crest symdrome or Primary biliary cirrhosis.      What should I do next ?  should I go to get second opinion or simply wait ?    Please advise,  Thanks !!
Tags: high ANA
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1761045_tn?1318005261

Dear yes139,

Thanks for providing the details of your tests. Your results do look like it’s an autoimmune disease of late onset.  But frankly I still believe in the appearances of physical symptoms. As you have mentioned you have a painful finger and ankle joint of recent onset with stiffness. To term it Rheumatoid it needs to fulfill the following criteria-

1. Bilateral presentation, that is pain should be present in the same joints in both hands or legs.
2. More than 3 joints should be affected.
3. Small joints of hand and leg should be involved.
4. Morning stiffness as you have should be present for an hour in morning, and
5. There should be changes seen on x-ray

If you don't have most of the above symptoms, I’d regard your symptoms to be because of a minor osteoarthritic episode which might subside completely in a few days.

Rheumatoid factor even if negative does not exclude rheumatoid arthritis. In more than 70% rheumatoid arthritis patients RA factor is negative. But ANA(Anti-nuclear antibodies) titre is quite specific. You also have a family member who's suffering from rheumatoid.

In my opinion you should wait for some time for either the symptoms to progress or regress, before you take a second opinion or more tests. We will need to watch for some time to decide whether you need anti rheumatoid or anti thyroid medicines. Meanwhile you need to allow the inflammation to subside by taking antiinflammatory medicines, rest, hot fomentation and some exercises under a physiotherapist supervision. You can also consider local ultrasonics to relieve pain. Follow up with the rheumatologist after 3 months.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards.
Dr. Atul Wankhede
4 Comments
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Avatar_n_tn
sorry that I forgot to put more lab results for the second test

ESR   27   (0-20)
Centromere antibody   > 8.0   (< 1.0)

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Avatar_n_tn
Hello Dr.   Thank you for your advice.   I do have stiffness on both hands and ankels, but didn't last long(just few minutes) right after i exercise them before I get out of bed.

But joint pain only happened to the middle finger of right hand.   I will take your advice to wait a while then go to have more test done.

Thanks again !!
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1761045_tn?1318005261

Dear yes139,

Thanks for your  reply. I would like to add that at least one joint in hand needs to be swollen and the morning stiffness should be present for at least an hour before maximal improvement to term it rheumatoid. I believe in our decision to wait for some time.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards.
Dr. Atul Wankhede
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