Conflicting Labs

[bellenova]

About a month ago I had a positive ANA result and a positve Anti dsDNA of 81.  I get a referral to a rheumatologist and they repeat the ANA, but this time it's negative. The lab was supposed to do several other tests (sed rate,
c-reactive and urinalysis) but they "didn't see those orders" so only the ANA was redone. I'm waiting to go back for more labs (out of town this week). In the mean time I am just trying to understand how this is possible or what it may mean.

So if Anti dsDNA antibodies are a kind of antinuclear antibody.... Is it possible to be so strongly positive for dsDNA and negative for ANA?

Symptoms include left-sided neuropathy (weakness in left hand and left foot drop), extreme fatigue, joint and muscle pain, purpura on arms, feet and abdomen (but only a few like 10-20), black streaks under my fingernails, dark urine, bruising for no reason, random low grade fevers, abdominal pain, and sevear sometimes debilitating vertigo. All symptoms come and go except the neuropathy and fatigue.

The first rheumatologist I saw moved her practice so after waiting a month to get in, I'm now waiting another month to get in somewhere else. I know, be patient. It can take years for a real dx if it's autoimmune.... But is there anything recommended to speed up the dx process? How do you deal with the not knowing and the "is this real" feelings?

Anything to watch out for in the mean time? I travel constantly for work and I'm worried I'm going to get stuck in a hotel room with a bad episode of symptoms with nothing to do for help. Everyone I talk to keeps saying things like, it's nothing until it's somethin,. This does not feel like nothing :-/

[DaveHnt]

My advice is to get a comprehensive blood workup now before you are put on auto-immune meds (even prednisone)...otherwise you will never know your baseline blood results.  Get at least CRP, Sed Rate, ANA with reflexive analyzer (includes ds-DNA as well as C3 and C4), TSH, T4.  ANA must be taken many times (or at least a few) and a trend established as it fluctuates much like blood pressure.  If you really want to be thorough have Exegen send you an Avise SLE+ lupus test kit and take that to your rheumy.  It will not be covered by insurance (~$500) and only a good rheumy will accomodate (fill with blood and send)...but you will have done every blood test possible for lupus and will have that data going forward.

[fntn]

Sometimes the testing thresholds can be the issue in cases like yours. So yes it is possible to get conflicting results. Given your past history of positives, definitely get retested, and insist that your SED and CRP are done as well. There's no point in finding out that your ANA is positive again without assessing the current systemic inflammation level. Good luck this time and hoping you can get an answer.