ANA stands for Antinuclear Antibody. This literally means 'substance against the cell nucleus'. The nucleus is the 'headquarters' of the living cell, therefore the ANA can damage or destroy cells & tissues.
95%-98% of patients with SLE will have a positive ANA test, but the majority of people with a positive ANA test do not have SLE. A positive ANA test can be found in many conditions, including Sjogren's Syndrome, scleroderma, rheumatoid arthritis, & mixed connective tissue disease. Many normal healthy people will also have a positive ANA test. Therefore a positive ANA test, on it's own, does not mean that person has lupus.
Because of this, the physician has to look very carefully at the titer (number) & pattern of the ANA test. The titer shows how many times the technician had to mix fluid from the patient's blood to get a sample free of ANAs. Thus a titer of 1:640 shows a greater concentration of ANA than 1:320 or 1:160, since it took 640 dilutions of the plasma before ANA was no longer detected. The apparent great difference between various titers can be misleading. Since each dilution involves doubling the amount of test fluid, it is not surprising that titers increase rapidly. In fact, the difference between titers of 1:160 & 1:320 is only a single dilution. And it doesn't necessarily represent a major difference in disease activity.
ANA titers go up & down during the course of the disease, & may or may not reflect disease activity. Therefore it is not always possible to tell from the titer how severe a person's lupus is.
A titer of 1:80 or lower is usually considered negative.
The pattern of the ANA is studied by microscope. The technician examines a specially prepared slide that shows where antibodies attack the nucleus. Certain antibodies attack certain areas of the nucleus, producing four specific patterns.
The rim (peripheral) pattern is the most specific pattern for lupus, while the homogeneous (diffuse) pattern is the most common pattern seen. The remaining patterns are the speckled and nucleolar patterns. In some cases the pattern helps the doctor decide which of the autoimmune diseases is causing the problem and which treatment program is appropriate.
Because a positive ANA test can be found in other diseases as well as SLE, the physician will use a positive ANA test as only one factor in determining whether or not a patient has lupus. A positive ANA test does not mean that a person has lupus. The physician needs to find other clinical features such as butterfly rashes, arthritis, pleurisy, blood abnormalities, kidney disease, etc., in addition to a positive ANA test before making a diagnosis of SLE.
The reliability of the ANA test depends upon the laboratory. Many variables can interfere with the test & give false numbers. The accuracy of the test can also vary, depending on many factors, such as the strength of the fluorescent antibody, or even the quality of the microscope used.
Once a patient is found to be ANA positive, the physician may want to further investigate which antigen in the nucleus is responsible for the positive ANA test. The knowledge of which antigen is responsible for the positive ANA test can sometimes be helpful in determining which disease is present. For instance, antibodies to DNA (the protein that makes up the body's genetic code) are found primarily in SLE. Levels of these antibodies in the blood can be useful to the physician in following the course of lupus, especially in patients with kidney disease. Anti-DNA levels, however, do not always perfectly match the clinical course of lupus kidney disease. Antibodies to histones (DNA packaging proteins) may be very helpful in determining whether a patient has drug-induced lupus. These antibodies may be found in SLE as well. Antibodies to Sm antigen are found almost exclusively in lupus, & when present, help to clinch the diagnosis of SLE. Antibodies to RNP (ribonucleoprotein) are found in a variety of connective tissue diseases. When present in very high levels, they are indicative of mixed connective tissue disease, a condition with features of SLE, polymyositis, and scleroderma. Antibodies to SS-A are found in both lupus and Sjogren's syndrome and are sometimes associated with babies who are born with neonatal lupus.
I like to thank you so much for your information about ANA test I never understood it. Now I print all your information and I give them to my daughter because she is the one the doc suspects she has SLE. Is that the same thing as Lupus? She does not know her test results but I think she said something about ANA was 1:9 that makes sense? and other test for Lupus was positive in the low side. The doctor said she is not sick enough yet to have symptoms beside sometimes joint pain and fatigue. She is not taking any medication at all and she had 2 test done Fatigue can be due to her being in college full time and having a full time job. For 2 years she works and go to school non stop, including every other weekend double shift. So yea, she is exhausted mentally and physically In May 15 she will graduate from College thanks God and I hope her health will improve after that. She is 2 month pregnant now and she complains of pain in her abdomen, back pain, tail bone, wrist but the doctor said that is because she is pregnant and her muscle stretch. I don't want to be in denied but I have hard time to believe she has SLE or... I wish for her to don't have this disease. If she does how this will affect her pregnancy. Can you give us any suggestions how to copy with this and how to prevent any flare I told her at next appoitment to ask for all the copy from her tests and then I can send you another comment with her tests results.How you copy with the disease and how you feel? What happens if you don't take any medications for this? I heard the medications is bad as the disease is. What is the difference if you take them or not? Thanks a lot!
Actually, I can't take credit for writing that info. I found it on the net, copied and pasted it. I can't remember where I got it from.
Yes, SLE is Lupus....SYSTEMIC LUPUS ERYTHEMATOSUS. That means it is throughout the body. Can affect many parts of the body.
Definitely listen to your doctor. Pain is constant for me. If I do too much (of course, I'm 46), then I am in more pain--And if I have too much stress on my mind, I have tons of pain. The sunshine will cause me to hurt the next day or two---depending on how much time I spend in the sun. I spent 2 hours in the sun washing my window screens and couldn't wake up the next day. And I was fully clothed, only had my head and lower arms getting sun. I slept the next 30 hours or so, very deeply. Felt like I had taken millions of sleeping pills. The doc has me on Methocarbomal for the muscle spasms that trail through my entire body, including my heart. I kept thinking I had heart trouble, but it was just spasms. I also take Darvocette for the pain, and it doesn't make it all go away, but enough. And I take Celebrex for the joints/arthritis. I seem to do well on the meds, but off them, I can barely move. I doubt there are many meds your daughter can take while she's pregnant!!!
I know every person that has SLE will have different symptoms than I have. Many of the same symptoms, but then millions of different ones. Crazy, huh?
As for being pregnant with Lupus, I can't say. I had two babies, and think I may have had lupus my entire life without knowing it, therefore, was pg with lupus. I did fine, very very fine, except my blood pressure was way too high. Other than that, I had no problems. Typically, Lupus and pregnancy don't mix at all. But it depends on what part of your body the lupus is affecting, from what I've read.
The only thing that helps me cope with the pain is soothing music when I have to hold still from the pain....but if I have no choice but to keep going, I just keep my mind busy with other things. Have your daughter start learning meditation. There may be classes for it, and she will learn to tune out the pain and it will help her in many, many ways.
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