ANA test accuracy

Hi...I was just wondering if the ANA test has good accuracy for diagnosing lupus.  I had this test and a SED test.  My SED was 7 and my ANA just came back negative.  The doctor will not provide me with any numbers on that.  I'm on a search for what's wrong with me so just looking for any insight on this. Thanks!

[Red_Star]

Your doctor cannot legally withhold your medical information. Request all lab work.  Read through the pathology recommendations which can be very helpful (many doctors ignore these recommendations but they are always of value and may put you on the right path to a correct diagnosis) not to mention the doctors may be too busy and skim read through the labs and miss something.

I know from experience so check your labs personally! It is also where the numbers are in the range that can give a clue as well. Eg: vitamin B12 needs to be in the upper end of the range to be free of symptoms.

ANA can be positive due to many conditions and in some people with no sign of disease. About 95% diagnosed with Lupus will have a positive ANA.

[rjb950]

Okay thank you.  I go back next week so I will request those results. What do you mean by pathology recommendations?

[Red_Star]

On your blood work there should be pathology notes. They may just say all labs within normal range or go into more detail if a lab is out of range, may recommended further testing based on the current labwork, and list possible conditions seen with certain results.

[rjb950]

Okay thank you!

[karajo]

what kind of symptoms are you having?

[rjb950]

A lot!  Currently I have tingling and burning in my legs and feet with occassional numbness which seems to be brought on when I stand for long periods of time.  My left ankle is weak which makes it hard to get moving especially in the morning.  My eyes have been extra sensitive to light lately and on some days I experience this blurry vision in my left eye.  I also have periodic feelings of numbness in my hands and burning as well.  I have muscle twitches (not constant) all over my body from the feet to my head.  I get itchy sometimes and my skin is very dry.  Also most days I have diarrhea and sometimes get dizzy or faint feeling.  I have searched and searched and been to the doctors and the only thing they have determined so far is that I have peripheral neuropathy which explains the tingling and burning but not really the other symptoms.  I was tested for thyroid but only TSH and for lupus for which my sed rate was 7 and my ANA results just came back "negative".  A friend of my mom's has lupus and she said she has a lot of the same stuff going on that I do so I thought that was possibility.  Oh I also have acid reflux and loss of balance.

[Red_Star]

The peripheral nerves are divided into sensory nerves, motor nerves and autonomic nerves.

If sensory nerves are damaged, symptoms include tingling and numbness, loss of ability to feel pain, loss of ability to detect changes in temperature, itchy skin, loss of coordination, burning or shooting pains.

If motor nerves are damaged, symptoms include muscle weakness, muscle atrophy, muscle twitching and cramps, muscle paralysis.

If autonomic nerves are damaged, symptoms include dizziness and fainting due to lack of blood pressure control, reduced ability to sweat, inability to tolerate heat, difficulty in swallowing, loss of control bladder control, bloating, constipation or diarrhea, heartburn/reflux, gastroparesis (delayed gastric emptying), impotence.

Causes of peripheral neuropathy includes:

Genetic diseases: Friedreich's ataxia, Charcot-Marie-Tooth disease, Hereditary neuropathy

Metabolic/endocrine: diabetes mellitus, chronic renal failure, porphyria, amyloidosis, liver failure, hypothyroidism

Toxic causes: drugs (vincristine, metronidazole, phenytoin, nitrofurantoin, isoniazid, ethyl alcohol, statins), organic metals, heavy metals, excess intake of vitamin B6, fluoroquinolone toxicity

Inflammatory diseases: Guillain-Barré syndrome, systemic lupus erythematosis, leprosy, Multiple Sclerosis, Sjögren's syndrome, Lyme Disease, sarcoidosis

Vitamin deficiency states: Vitamin B12, vitamin A, vitamin E, vitamin B1 (thiamine)

Physical trauma: compression, pinching, cutting, projectile injuries such as a gunshot wound, strokes, electric discharge including lightning strikes

Others: shingles, malignant disease, HIV, radiation, chemotherapy

[rjb950]

Thank you!  I have been trying to rule these out one by one.  Right now I would say I have symptoms in all three of those categories.  It's frustrating because I just keep getting worse. So would a negative ANA rule out lupus for me?  You said 95% accuracy so I'll probably move on to the next thing.  I know it's not a vitamin deficiency however I have read that taking supplements can improve your nerve health for whatever you have.  I don't think it's genetic because nobody in my family has had these problems.  My mother has hypothyroidism diagnosed at age 51.  And my grandmother has diabetes type 2 diagnosed around age 50 as well.  Highly unlikely I have Lyme disease so that will be my last resort I think.  As far as the toxic stuff I have no idea where to start with that.  I have thought about MS as that was first thing my neurologist brought up but when he tested he couldn't find anything leading him in that direction.  Nerve compression I know I have in my elbows from working at a computer on a daily basis.  The sed rate? Doesn't that test your inflammation?  I was only at 7 with the high of his normal range being 20.  Any thoughts?

[Red_Star]

I had to diagnose my autoimmune pernicious anaemia (malabsorption of vitamin B12) and Hashimoto's thyroiditis (autoimmune hypothyroidism). My ANA was negative and my inflammation tests ESR and CRP were in range just to add. I had far more symptoms than affected sensory nerves, motor nerves and autonomic nerves however. I'm not sure of all your symptoms but there may be a specific symptom that can help to narrow down the diagnosis.

A negative ANA doesn't rule out lupus but the odds are low. But karajo (who commented above) mentioned having a negative ANA but then going out into the sun just prior to a blood lab and showing a very high positive ANA.

[rjb950]

Hey thanks for the follow up.  I'm pretty sure I'm going to have to diagnose myself also.  As sad as that is.  That's what I'm working on.  Vitamin b12 although present in the blood in sufficient amounts can still be the problem if you have malabsorption correct? In that case how would someone know?  I am also anemic but was told this doesn't cause my symptoms or at least that it's not bad enough to cause my symptoms.

[karajo]

Your symptoms sound more neurological.  Yes, those type symptoms can be seen in lupus, but usually there is is also joint pain and a whole list of other things too.  

I'm assuming they have checked for MS or have referred you to a neurologist.  

I know you said you take supplements.  But just to make sure no stone goes uncovered, do you take 1,200 mg calcium and at least 600 mg of magnesium?  

Your family dr might agree to let you take some B12 shots to see if it helps.  Wouldn't hurt kinda thing.  

[willaway]

Dear Red Star,
thank-you for your post. So can lupus cause all of these things?
You said "The peripheral nerves are divided into sensory nerves, motor nerves and autonomic nerves.
If sensory nerves are damaged, symptoms include tingling and numbness, loss of ability to feel pain, loss of ability to detect changes in temperature, itchy skin, loss of coordination, burning or shooting pains.
If motor nerves are damaged, symptoms include muscle weakness, muscle atrophy, muscle twitching and cramps, muscle paralysis."
My lab tests confirm I have most of these issues-
I also have scleritis and retinal vasculitis in my left eye.Facial rash ,etc Among other issues.
If ANA is negative, how do drs diagnose Lupus?
Im having a brain scan next week for MS, but neurologist says he thinks he is sending me back to the rheumatologist- who says I dont have lupus because I dont have positive ANA... Prednisone 60mg or more helps knock my symptoms down.
Any other ideas what my problem is, progressive breakdown of physical and mental state,since I was 20yrs, most symptoms stay but nerve and mental issues are growing in leaps and bounds.
If autonomic nerves are damaged, symptoms include dizziness and fainting due to lack of blood pressure control, reduced ability to sweat, inability to tolerate heat, difficulty in swallowing, loss of control bladder control, bloating, constipation or diarrhea, heartburn/reflux, gastroparesis (delayed gastric

[rjb950]

Hi!  Thanks for your response. I do agree it seems neurological.  I am only recently getting joint pain and by neck cracks when I move it.  Who knows what's going on here.  They are actually now suspecting MS despite 2 normal MRI's.  I have to go back next week for MRI and LP.  It's weird though because I do have other symptoms I just don't seem to notice them over all the weird sensations and such. Well good luck to you!

[rjb950]

Hi there!  I hear ya!  I also have another MRI next week.  Good luck to you!

[karajo]

When I was being worked up in the diagnostic process, my ANA was all over the place.  And even though my ANA was significant and I had 5 of the 11 criteria for a lupus dx, they still were not convinced.  After spending time in the sun right b4 my appointment my ANA jumped from 640 to 2,560.  I am now on plaquinel and my ANA has been negative.  Still no dx, but am feeling so much better on plauinel.  

I know the ANA can not be dependable in dxing lupus and other autoimmune diseases.  

I pray that you find some answers soon.  Keep us posted.