Blood work results; do these toss me back firmly in Limboland,

or do they just rule out more mimics so that they need to look more closely at MS?

ANA  1:40 (weakly positive, same as when I had my LP)

SSA  2

SSB  0

ANCA  <1:20          reference <1:20


My catsitter/friend scanned and e-mailed the results to me, and they came across as almost too small to read.  I was able to move them into a photo program that showed them a bit larger and it became clear that these tests gave no evidence of anything.

I'm not sure about Sjogren's, but i'm thinking with the anti-bodies that low, they wouldn't think of doing a biopsy; anyone know if I'm correct?  I'm pretty sure it doesn't rule it out totally, but the numbers are darn low.  Thought I might have a partial answer, at least.

Does anyone know about these results?  I'll do some googling, but the maids are coming in this morning so we're going to Lahaina to meander around, not wanting to watch them clean and vacuum.

Thanks for any help!

Kathy

Kathy

[jensequitur]

Blood testing rules out mimics, so it sounds like you're getting closer to a diagnosis.

[Wobbly]

I'm not sure what the results mean, so can't help much here...you do have inflammation..that we know... and antibodies... when do you go back for the results?

I'm curious to know more about them... my ANA is low positive as well.  and my ANCA is ??  can't remember that one...but I think it we neg...

take care
wobbly
undx

[spastic]

Hiya Kathy!!!  I hope you are having a good time in beautiful Hawaii!!!  I'm still jealous-hehehe!!!  

Did it say if there was a particular pattern with the ANA? Ok, this is what I know about the ANA test, and I hope I remember this right, if there is a pattern seen it is considered a positive result, if they don't see it they consider it negative.  I'm pretty sure its when they do the test by ELISA.  But it sounds like the Dr is narrowing it down, its just too bad it takes so long for them to figure it out!!!  Hang in there and enjoy Hawaii!!!

Love Ya,

Ada

[slightlybroken]

ANA...A weakly positive ANA can occur in healthy individuals. Sometimes, from what I've read, it can point to an inflammatory disease that you will develop down the road. The doctors can get more information from the tilter (dilution added to the sample) and looking at the pattern. The more positive ANA result you have, the more likely you suffer from an autoimmune/inflammatory response.

SSA...According to my results a <40 is considered normal or negative.

Your SSB and ANCA are within range as well.

My mother has Sjogrens and she never tested positive for the ANA or the SSA & SSB. They had to confirm with the lip-biopsy which showed the chronic inflamation (inflammation) and lymphocyte infiltration.

There is other test for Sjogrens besides blood panels. An opthamologist can perform the Schirmer Test, Rose Bengal and Lissamine Green, Slit-Lamp Exam. If I'm not mistaken, if you show positive on 2 out of the 3 test, they will recommend more testing for Sjogrens because it is highly likely that you have it.

If they suspect Sjogrens, and you have the signs and symptoms of Sjogrens, I would maybe confirm with an opthamologist just to have it ruled out completely. Doctors tend to forget that not all people come up positive in the blood work. It took my mother years before finding a DX because her blood work wasn't showing anything. The blood test are only 70% reliable when it comes to DX this disease. That's not very good if you think about it.

Have fun!!!

[Quixotic1]

All the above are correct.

Sjogren's Syndrome can be "sero-negative" meaning the antibodies for it are negative.  As I understand the gold standard is the lip biopsy, I believe.

An ANA of 1:40 is very weak and not really indicative of anything.  The lower your titer, the less likely that it indicates an underlying autoimmune disease.  All + ANA tests show some sort of pattern, like homogeneous, speckled..

I don't think this changes your limbo status at all.

Q

[Quixotic1]

Hey, we haven't been seeing you!  Thanks for adding the info here, but we need more SeeBee time!

Quix

[Fluffysmom]

OK, the ANA pattern was homogenous and speckled, just like when I had my LP.  I remember Quix saying then that it's not normally both, either one or the other.

My neuro-ophthalmologist ordered the blood tests because of my Schirmer test, the appearance of my brain MRI, and my 4 hour eye exam, including my history of dry eyes, mouth, and elsewhere.

I go in for a VEP not long after I get back, and see the neuro-ophtha a week later.  I hope he can suggest someone (rheumetologist?) for me to see and go for a lip biopsy if enough of the non-serological criteria.  I'll ask him about the other tests; I'm not sure how thoroughly he tested for Sjogren's, though he seemed to think that I may have it.

I can handle a lip biopsy; I read that they weren't too bad.

Thanks, slightlybroken, for all the detailed information.  

Quix, does the pattern mean anything specific as Ada suggested?  How can I be homogenous and speckled at the same time?  Limboland comes with so many questions!

Thank you all for your input.  As beautiful and wonderful as it is over here, the heat is starting to get to me; today I carried cold water at all times, and had to find air conditioning often, and we were only out an about for a few hours.  I came back to the condo, ate ice cream while lying on an ice pack, drank cold water, used a whole lot of lubricating eye drops, etc.

We did find a great place to snorkel where you can just walk into the water and see the fish.  It's not far away, by a big fancy hotel in Kaanapali in a public beach park. I hope to try it out; I haven't been snorkeling since 2001.

Kathy

[Lulu54]

Hi Kathy,
I'm glad these wonderful folks have given you answers because I haven't a clue... :-)

Now my question for you is why are you not relaxing and enjoying your time in paradise instead of dissecting lab reports?  These crazy things will wait until you get home - limbo is going nowhere.  Now go snorkel, and swim and party at sunset for all of us who are stuck here in the continental 48 with cra ppy winter weather.  

soak in a sunset for me,
Lulu

[Fluffysmom]

The sunset is gorgeous this evening, but my arms don't want to hold up the camera.  I just went out with my cell phone to get you a picture, but it's not quite as spectacular.

I'm just thinking about test results because even with Provigil I'm running out of go-power and am frustrated by all this waiting and wondering. Y'know, limbo su ck s.

I'll go see if i can upload a new picture or two.

Kathy

[spastic]

Hey Sweetie, just wanted to get you some info on the patterns, I do have to stress this though, an ANA is just a tool and not exactly specific diagnostic test, some people have negative ANA's but have the condition and some people who are positve are healthy.  I am so wary of the ELISA testing because it can be unreliable, especially with lyme disease and RA.  I can't remember have they done an ESR or CRP or the double-strand DNA?  

Okay, here is the info I found on the patterns, it is from labtestsonline , they have a lot of info there,

Homogenous (diffuse) - associated with SLE and mixed connective tissue disease
Speckled - associated with SLE, Sjogren’s syndrome, scleroderma, polymyositis, rheumatoid arthritis, and mixed connective tissue disease
Nucleolar - associated with scleroderma and polymyositis
Outline pattern (peripheral) -associated with SLE

But, I do have to agree with Lulu, have fun, relax and take in all that beauty!!! It is gorgeous there!!!  It is snowing here right now.

Love Ya,

Ada  

[doni54]

Hi Kathy,

I can't add anything to the great answers you've already been given, but I agree with Ada, you need to be having fun and not letting these tests intrude on your vacation.  You can deal with all that when you get home.

Did you ever talk to Donna (Want to Feel Well), she can also give you first hand info on this.  That's how she got her dx, through the lip biopsy.

Have fun and enjoy the beautiful weather, raining and flooding here!!!

Hugs,
doni

[Fluffysmom]

I will have fun!  Today we're going to the swap meet and stock up on tomatoes, papayas, avocados, and some other stuff (we made a list last week).  I'm going to ship home some jams and jellies that taste like the islands

We're not sure what we're going to do after that; probably drive up to the north side of the island and check out some beaches that are supposed to be the best for snorkeling.  If we have energy, we may stop and rent some snorkel gear.

doni, thanks for reminding me to write to Donna; I really am mostly immersed in the whales and tastes, scents and views of the island.  I'm sure she would have some good first-hand information about Sjogren's.  Stay safe and dry!

Ada, my dear, thanks for the pattern information.  That was so nice of you to look it up!
My ESR was somewhat elevated, I think about 33, don't really remember.  My CRP has been somewhat elevated in the past; haven't had it measured recently.  No double-strand DNA.

I'll not worry about any of this, as I'll talk with my docs when I get back, with a little time to research before  I see them so I can ask the right questions.

Well, snow can be beautiful, too. Take good care of your sweet self and enjoy your in-house band; or are they tired of the guitar and drum thing already?  

Love and Hugs,

Kathy

[shoshin]

Keep enjoying that warm weather and great food! Our street is a sheet of ice today so I'm just a wee bit jealous.

I think several people have already pointed out that you could still have seronegative Sjogren's where it doesn't show up in the blood. I was told (like Quix said) that the lip biopsy is the gold standard and they made me have one before I was dx'd with MS.

It really wasn't bad and I didn't have much pain afterward. They did give me some mouthwash to prevent infection and that turned my teeth a nasty color. So if they give you that stuff, try to schedule a dental cleaning for shortly after you'll be done with it. And I still have a little bump on the inside of my mouth where the biopsy was.

sho

[shoshin]

PS On the SSA, is that supposed to be a 0.2? At least on my results, it says >1.0 is positive and 0.8-1.0 is borderline. Could be a different lab, too, I suppose.

sho

[Fluffysmom]

Thanks for the info; I won't worry about the biopsy if I have one, and I'll schedule a teeth cleaning after I'm done with the mouthwash, if that's what i get.  With my dry mouth, my teeth can always use a cleaning, anyway, no matter how much I floss and brush.

The scanned version of my lab results that my friend sent me was so small, that i'm not totally sure what was what.  I guess I'll find out for sure when I see one of my docs when I get back.

Kathy