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Negative ANA Positive DNA
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Negative ANA Positive DNA

Hey all,

I have a testing question that I was hoping someone might be kind enough to help me with.

My wife is experiencing Lupus-type symptoms and as a result her PCP had blood work done which tested positive for the ANA test titer 1:640.  C reactive protein and another inflammation test that was given at the time returned with normal results.

She has since seen a rhuematolgist who conducted further studies.  Her ANA test returned as negative, but her DNA (DS) Antibodies returned with a value of 9.  The rhuematologist said she tested positive although the range indicated 5-9 was intermediate.  Obviously I'm not comfortable with a reading as high as 9, but I'm more confused with a new negative ANA.

How is it possible that during this analysis the ANA returned with negative results and the DNA test returned borderline positive??  I suppose the DNA test may be a false positive, but that would mean that the original ANA test was a false positive as well.  My gut tells me that one mistake, a false negative ANA the second time around, is more likely to be wrong since one false test is most likely more likely than two false tests.

Has anyone ever seen this??  I know some people have mentioned that their ANA test fluctuates and I am beginning to understand this concept, but a positive DNA and a negative ANA in the same round of bloodwork is intuitively a contradictory result for me.

Any help or advice would be greatly appreciated !!!
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471161_tn?1317194550
Hi Justin, I see how you could be confused.  Honestly I don't think doctors know enough about autoimmune to really understand it themselves.  I will tell you that I have had an ANA of 1:1280 for almost three years now but one time it came back 1:320 and another time within that time period it came back negative.  It was in the beginning that it came back negative (about six months into this lupus), the doctor I was going to tied to tell me it was all in my head.  Yes, not being able to stay awake, feeling like passing out when I stand and all the pains that came with it was all in my head???  I used to never get sick and was a workaholic, I loved my job and had no problems to make me depressed.  I went back to my neurologist and he retested and it was 1:1280.  Something was wrong with the other test.  I have never been positive in my DSDNA but I am positive for antichromatin antibodies which is something new they have started watching.  It is a 75% diagnosis for lupus and a 100% in people with drug induced lupus.  Has your wife changed any medications since the last test?  Most people who have a positive ACA do not have a positive DSDNA and visa versa.

When it all comes down to it.....  I would get another test done.  They make mistakes all the time and that sounds kind of messed up.

God Bless...
Joni
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1136439_tn?1290181652
Justin,

Most antibodies will go up and down with a "flare". My last ANA was negative on my last test as well but I was not in a "flare". Anti-DNA is seen in 90% of people with Systemic Lupus according to "The Lupus Bood" by Daniel Wallace.
What are some of your wife's symptoms? Were are you at with the Rheumy as far as furthur testing or a diagnosis?

It is very frustrating to NOT have answers. You will find alot of support from others on this website.
Praying for answers for you!!!
Andrea
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Avatar_m_tn
Joni & Andrea,

My wife is a 31 year old white female and has good health care options.  No history of Lupus in the family.  She is not currently taking any prescribed medications, but takes a 600mg ibuprofen occasionally when her hands hurt.  She experiences joint pain in her knees and her hands, has fleeting chest pain once or twice a month, migraine headaches, and had the initial positive ANA at 1:640 so this is why we went to see a rheumatologist.

We have seen two rheumatologists thus far; I insisted on a second opinion as she is someone reluctant to see doctors.  Both rheumatologists didn't seem concerned.  The first rheumatologist recommended yearly screening for antibodies to see if anything progresses.  The blood work conducted by this doctor is what I described in the previous post.

The second rheumatologist also wasn't concerned after the initial physical exam, and we are waiting to hear about the results of the bloodwork taken from her.  We should hear something within the next seven days.

It is also worthy to note that her C3 and C4 levels were both normal, but were close to the bottom of the normal range; also something that doesn't make me feel completely comfortable.

How high do the DNA antibodies reach with people that have Lupus?  My wife's level was a 9 which the first rheumatologist considered positive.  I'm just curious if this number typically stays between 10-20 for those that have SLE or does it elevate to 50, 100 or higher?

Thanks for all of the help; hopefully we will reach some kind of consistency with the medical testing.


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434278_tn?1324709825
Hi Justin,

I agree w/ Andrea in that anti-double standed DNA antibodies are rarely seen in patients who do not have SLE.  Occasionally, healthy patients have low-level positive test.  Its values reflect clinicl disease acivity.  The values are higher w/ flares and decrease w/ improvement.  

My advice to you is to either ask the rhematologist to repeat the test at a later date or have your PC repeat the test.  Either way, she needs to be followed up. Thre is enough smoke to keep probing.

Praying for your wife, she is blessed to have such a loving and concerned husband.
~Kara
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471161_tn?1317194550
Justin,

I agree with Andrea dn Karajo and I want to point out to you that I have read several items regarding the use of ibuprophen and lupus.  I am going to try to post an article from lupus.org if Medhelp will allow it.  Sometimes they scramble it so if you aren't able to read this try googling lupus+ibuprofen or dsdna+ibuprofen.  I would talk to the doctor about getting your wife an NSAID to take rather than the ibu.  Hopefully this article will get to you.  Oh and I did read that taking ibuprofen for lupus pain can cause migraines.  I try to read only article by the AMA or Mayo Clinic not just someones comments.

God Bless.  We are here.  You and your wife will get good support here.  Karajo is the community leader and she is wonderful.  Please let us know when you wife gets her second doctors blood work back.

Joni


http://www.lupus.org/webmodules/webarticlesnet/templates/new_aboutaffects.aspx?articleid=85&zoneid=17
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Avatar_m_tn
Justin:
I had the same diagnosis. Negative ANA and a positive anti-dna antibodies. The bottom line is doctors still don't have a clue. I felt like an enigma for years wondering whether I had it or not, while all along struggling with pain and fatigue. I would go to the rheumatologist and he didn't know what to do. As long as your internal organs are functioning they don't do much for you. He offered steroids and I politely declined understanding the longterm impact of steroids outweighed the benefits. My course took me to alternative medicine and it was there I began to find relief. Find a naturopath or doctor who will test for Epstein Barr
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