Diagnosis VS ruling out

[nanadebby04]

My PCP did some more lab work today-what are we lokking for?  I fthese tests are positive or negative what does it all mean??

ANA
Rheumatoid factor
sedrate
B12 and folate level

Thanks for any insight....
Debbie

[Quixotic1]

The ANA is very non-specific and low-titer positive ANA are very common even in healthy people.  If the ANA really indicates an underlying disease, it is typically quite high, like 1:640 or higher.

Some infections and some drugs can make the ANA falsely positive.  that's why they do the back up reflex test.

Yes, the ANA is one of the screening tests for the most common of the autoimmune diseases.

Q

[nanadebby04]

The ANA refex came back negative-so what does that all mean?  I am guessing this is r/o the lupus, sjogrens, etc?

Thanks
Debbie

[nanadebby04]

Thanks Quix for the info.  I got the results today.

ANA is positive.  This has been sent for furhter testing.
Sedrate, Rheumatoid factor, B12, folate all normal.

Does the ANA prove or diprove anything?  Is it aother piece to a very largfe puzzle?

Thanks for all your info yoou don't know how much it is appreciated!!!

Debbie

[Quixotic1]

He is doing the testing to rule out mimics of MS.  

ANA is a screening test for many of the autoimmune diseases, like Lupus, Sjogren's.  These can cause a vasculitis in the brain which really can look like MS.,

RF is looking for the main marker of Rheumatoid Arthritis not really an MS mimic.  A few other autoimmune diseases can have an elevated RF.

Sed Rate (ESR) - is a marker of inflammation.  If it is elevated one would look more toward autoimmune diseases

B12 - Looking for a deficiency which can really mimic MS.  Deficiency is less than about 230, but some people between 230 and 500 will have neurological symptoms

Folate - works with B12 to maintain healthy red blood cell levels.  Folate deficiency is not related to neurololgical disease in general.

Things that would prompt sending these tests only would be an extra suspicion about having an autimmune disease.  Things that would prompt this would be joint swelling and pain, rashes, fevers, hair loss, anemia.

they should be included with any work up for MS.  The list of appropriate blood tests for someone with neurological symptoms and CNS lesions would include:

ANA
ESR
B12
VDRL
Lyme Disease
HIV
Anti-Phospholipid Antibody
ACE
Copper Ceruloplasm
HTLV-I
HTLV-II

and then anything else that specifically comes up with the history and physical.

Quix