I get this question very often. People will have a positive ANA on several test, and some be extremely significant (1:2,560), then after treatment is started, it turn negative. What does this mean to the medical field? All of these people have lupus like symtpoms along with at least 4 of the 11 criteria for lupus.
Yes, I agree this question comes up several times. While I don’t have all the answers I would like to share whatever information I have on this topic.
ANA test can at times be positive in a person not having any signs or symptoms of a autoimmune disorder. This ANA titer can be strongly and highly positive without any cause and in absence of any sign or symptom of autoimmune disorder, actually does not need any treatment. This ANA can go back to normal at any time during the course of the person’s life.
Sometimes ANA becomes highly positive due to some drug the person took in recent past, and then becomes negative over a period of time. The person may not need treatment and even if receives treatment, the values go back to normal.
If a person has diagnosed autoimmune disorder, then also the ANA values can increase or return to normal during the treatment. This probably indicates when a person is in remission and when he is having a flare. Sometimes there is no such identifiable link.
Honestly speaking, one cannot rely only on ANA to diagnose lupus or any other disorder. This is why there are 11 criteria to diagnose lupus of which positive ANA is one. So a person can have negative ANA during treatment, but if any four other signs and symptoms are present he is still diagnosed to be having lupus.
Hope this was helpful to some extent. Take care!
You mentioned "high" titer. What do you consider "high". In my researching I've read that the ANA can be elevated, but when it gets to a very significant level like 1:2,560 it is a strong indicator of lupus. Keep in mind 5/11 criteria is going on too.
Does plaquinel and (or) prednisone affect the ANA levels?
In general ANA levels are read like this:
Generally a reading less than 1:80 (1 part plasma with 8 parts diluting solution (fluid)) is read as a negative ANA.
1:80 is considered a "low positive" and is not confirmatory of any disease. More tests are usually required to confirm the diagnosis. Most of people with 1:80 ANA do not have SLE or any other autoimmune disorder. However all results have to be clinically co-related. So if there are symptoms of an autoimmune disorder at 1:80, then this can be taken as confirmatory for disease.
1:320 is a definite positive and mean the disease is active.
1:640 and higher dilutions is considered very high and tissue damage is imminent.
Immunosuppression by steroids or treatment with plaquenil can cause a negative ANA result even in presence of lupus disease. This is an instance where the 11 criteria of lupus diagnosis come into play. Hope this helps. Take care!
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