ANA and ds-DNA results & symptoms

[fexaloo]

I am a 36 year old female and tested positive for ANA and negative for dsDNA.  My ANA level was 1:80 with a nucleolar pattern.  The dsDNA lab tests notes that 0 - 200 IU/ml is considered negative.  My dsDNA level was 32 UI/ml.  My other blood tests were Leukocyte count 5.9, RBC 4.63, Hemoglobin 140, platelet count 366, sed rate 10. and uric acid 232.  I tested negative for a lupus inhibitor by DRVVT and Dilute Prothrombin Time. I also tested negative for RA factor.  
What lead me to all this tests were some ongoing symptoms:   explained recurrent hives, redness on cheeks and bridge of my nose triggered (feels warm and gets red) by heat(hot baths), exercise, or a glass of wine. I was treated for perioral dermatitis 8 months prior.  There is always a slight redness over my cheeks and bridge of nose and it is also slightly bumpy in appearance (no pustuales).  
other symptoms that made me concerned about lupus was joint pain, especially in my shoulders, but also my knees, hands, fingers,feet & toes.  My abdomen feels sore and tender, like pulled muscles.
I am worried SICK about the possibility of lupus and wondered if in your opinion, my symptoms and test results were indicative of that.  Also would there be any merit in repeating the ANA test?  Would you look into doing any other tests?  I would really like to do any further testing that might help rule in or rule out why my ANA is positive.  

[Kevin Pho, MD]

An ANA of 1:80 is only mildly elevated, and the dsDNA is within the negative range.

Note that people without disease can present with a mildly positive ANA level.  You can also test anti-sm antibodies.  

Clinical criteria remains the mainstay of diagnosis.  Normally four of the following criteria is needed to make the diagnosis of lupus:
http://www.uklupus.co.uk/dxlupus.html

A tissue biopsy of an affected organ can also be suggestive of the diagnosis.

I would discuss this option with a rheumatologist, or second opinion.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[fexaloo]

Thanks for the prompt reply.  I am quite anxious about this test result.  
Do you think it would be useful to repeat the ANA test?  Also, what should I be looking for in a urine test?  Thanks,

[Annie62]

Lupus isn't the only condition that is linked to a positive ANA (mildly positive in your case).  If your DsDNA was negative then, from my understanding, it would be unlikely (but not impossible?) that you would have lupus.  But the ANA can be mildly positive in other connective tissue diseases (rheumatoid arthritis, Sjogren's, scleroderma, etc.) as well as non-connective tissue autoimmune diseases (MS, etc.), and sometimes it is just positive due to other factors-certain meds, chronic infections, etc.  I had an ANA of 1:80 and 1:160 and it doesn't look like I have any connective tissue disease, though I do have an autoimmune disease causing autonomic dysfunction-which one I don't know for sure yet.  

ANA levels fluctuate, so if you are having diffuse joint pain and any other symptoms, I would follow up and have your ANA repeated as well as the other autoantibodies that are tested for the various connective tissue diseases.  The best person to do this would be a rhematologist if you haven't already gone to one.  So don't freak out thinking you have lupus just because your ANA was 1:80 (not saying you can't have it, just that that titer doesn't mean you do, especially with the negative double-stranded DNA).  I made the same mistake 13 years ago when I first got sick.  I read somewhere a positive ANA was linked to lupus and immediately thought I had lupus.  It's not that black and white/clear-cut.  Usually much higher titers are seen with lupus 1:640, etc., but of course they can fluctuate up and down.  My ANA has fluctuated between 1:40-1:160.  

[calicotv]

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[mmv1965]

its nice to be able to have a place to voice our test results . me  positve ana high numbers homogeneous and specled. underactive thyroid with antibodies, elevated coproporphyrins in my serum porphyrins test and major blisters on my skin testedpositive skin biopsy for porphyria cutanea tarda, all other millions of blood test wee normal. hang in there everyone im trying to.

[Jessie26]

Hi how, are you feeling nowadays??? Just thought I would share my story with ya since yours sounds a lil like mine. First let me start off by sayin I have lupus. Had it for the last 6 years now. So anyway let me tell you about how this all came to be.
At 21 I began to pain all over my body, not knowing what it was I tried my best to continue with my daily activities. Friends and family would always ask me how was I feeling and the only way I could describe it was I'm 21 stuck in and 90year old body. I would laugh they would laugh and on with my day I would go. As the days past I was takin more days off work, trying to relax by the pool get my energy up, not knowing that the sun was only making matters worse. All that sun bathing caused the buterfly looking rash on my face, which I shrugged off as a real bad sun burn. One day I decided I had to get some help so off I went to th Hospital, only to wait 15 hours and be sent home. Few more days past, now for some strange reason I was menstrating dangerously heavy, along with all my other symptoms off again to the same hospital, this time waited 11 hours the gave me a pill sent to for some blood work and off home I went still with no answers to why I was feeling like sh**.  Again some days past and still getting worse, now I was barely able to dress myself, it was a struggle to get out of bed to walk to pretty much do anything. This time my mom insisted I go to the hospital and this time we went to another one. As soon as I walked in to triage, the nurse told me that it looks like I have lupus.
So long story short that what it was.  My symptoms consisted of fatigue, joint pain, rash, loss of appetite( a few other I can't remember) and shortly after a positive ANA.  
Anyhow today I have a few more added symptoms, and you know what I'm still living. I have my days, but its not so bad really, I think of all those other ppl out there in more serious situations with life threatening diseases. Well my dear not sure if my story helped. If you do have lupus, don't worry it will be ok.  Hang in there and your in my prayers
God Bless

[chrissy21776]

You may also want to look into the disease porphyria, which I have, and it is almost interchangeable symptom-wise with Lupus, MS, and can cause the butterfly rash -which I have. Elevated coproporphyrins are indicative to the disease Hereditary Coproporphyria.  Many people are misdiagnosed, ***@****

[Nicksmom1990]

A related discussion, ana titer nucleolar of 1:1280 was started.

[floridagirl11]

A related discussion, I have reversed my Nucleolar ANA was started.