ANA Test-1:80, RNP-1.5, U1RNP-negative

[maja330]

Hello,
2 years ago, because of a hand rash, I made an ANA test which was 1:80 positive (FANA methode), and the anti-rnp was bordering 1:0, but the  U1-rnp was negative. The other results of a complete ANA test were also negative.(CCP, IgG-abs, ds-DNA-ab, chromatine abs, SS-A/Ro(60kD), La/SS-B, Sm (B'B/D), U1-RNP/SM, Scl-70, Jo-1/Histidyl-tRNA-Synthet., Ribosomal P-protein abs, c-ANCA, p-ANCA, Cardiolipin-Ig-(G/M/A), B2-glycoprot.-1-ab, Lupus-anticoagulant, MAK/TPO-abs - all negative).I made a check up 1 year ago and the results for ANA  remain the same (1:80), and ENA the same, but the anti-rnp is little over border line 1.1 (border line is 1.0) and U1-rnp is again negative. The last test (ANA and ENA) I made was in febuary this year ANA the same again 1:80, ENA all negative as upper writen, but RNP now elevated to 1.5 (anti U1-RNP -negative).
I do not know what could this mean? I have never taken drugs that induce positive ANA. The doctor still tells me the results are overlapping results. I am not sure if it's not dangerous for me to be pregnant. Can hiperthyroidsm be a reason? I am on treatment now, although test for Hashimoto is negative. I want to begin pregnancy. Could first pregnancy mean progress to the eventual ANA test result or danger for the baby, I’m 41?
Thanks very much in advance
With respect

[eagles46]

I would like to know more about my lab results.  I recently went to the ER for pain in which I thought was from arthritis or a broken arm. However, after being given pain meds and discharged home, I was still in a lot of pain and the pain was getting worse and now in both arms and legs. Since 2010 I have high blood pressure, hypothyroidism and ptosis along with other symptoms. This last ER visit I was told that a ANA was done in 2010 that I was unaware of and it was positive. My primary care physician ordered the test again last week along with other test to rule out Lupus. I am not sure about the results of the test.

ANA= Positive

ENA PANEL
ENA JO-1 AB <1.0 (Negative) Units  MY RESULTS ARE  <0.2
ENA RNP AB <1.0 (Negative) Units                                    <0.2
ENA SCL-70 AB <1.0 (Negative) Units                                <0.2
ENA SMITH (SM) AB <1.0 (Negative) Units                        <0.2
ENA SSA (RO) AB <1.0 (Negative) Units                            <0.2
ENA SSB (LA) AB <1.0 (Negative) Units                             <0.2


URINALYSIS AUTOMATED LC, MICRO

RBC UA   Standard Range 0 - 3 /HPF       Your Value   4
WBC, UA                             0 - 4 /HPF                           4
BACTERIA UA                                                              Occasional
SQUAM EPITHEL,UA         0 - 4 /HPF                           6
HYALINE CASTS, UA          0 - 1 /LPF                          1

DSDNA ANTIBODY

DSDNA AB =Negative

[Dr. Kokil Mathur]

Difficult to say for sure but possible.

[maja330]

Dr.Kokil you say it may be MCTD, even if SS-A(Ro) >0.2, SS-B(La) >0.2 (negative) and without clinical  symptoms? Do you want to tell me that the MCTD is onset and that I will probably begin, in the near future, having clinic symptoms and do you suspect it because of the raising RNP in the past 2.5years?
Thankyou in advance
P.S. I had broken capillaries on one cheek for 2.5 years, now (after vacation) I have them as well on the other cheek, maybe symptomatic for butterfly rash?

[maja330]

Dr.Kokil you say it may be MCTD, even if SS-A(Ro) >0.2, SS-B(La) >0.2 (negative) and without clinical  symptoms? Do you want to tell me that the MCTD is onset and that I will probably begin, in the near future, having clinic symptoms and do you suspect it because of the raising RNP in the past 2.5years?
Thankyou in advance
P.S. I had broken capillaries on one cheek for 2.5 years, now (after vacation) I have them as well on the other cheek, maybe symptomatic for butterfly rash?

[maja330]

Dr.Kokil you say it may be MCTD, even if SS-A(Ro) >0.2, SS-B(La) >0.2 (negative) and without clinical  symptoms? Do you want to tell me that the MCTD is onset and that I will probably begin, in the near future, having clinic symptoms and do you suspect it because of the raising RNP in the past 2.5years?
Thankyou in advance
P.S. I had broken capillaries on one cheek for 2.5 years, now (after vacation) I have them as well on the other cheek, maybe symptomatic for butterfly rash?

[maja330]

Dr.Kokil you say it may be MCTD, even if SS-A(Ro) >0.2, SS-B(La) >0.2 (negative) and without clinical  symptoms? Do you want to tell me that the MCTD is onset and that I will probably begin, in the near future, having clinic symptoms and do you suspect it because of the raising RNP in the past 2.5?
Thankyou in advance
P.S. I had broken capillaries on one cheek for 2.5 years, now (after vacation) I have them as well on the other cheek, maybe symptomatic for butterfly rash?

[Dr. Kokil Mathur]

Hi!
The anti-RNP can rise in mixed connective tissue disorders, lupus, scleroderma, and rheumatoid arthritis. You are testing negative for anti-U1 RNP antibodies, the presence of which is conclusive for mixed connective tissue disease (MCTD). However in a few percent of patients with MCTD, the anti-U1 RNP antibodies remain negative. Since you have been tested negative for lupus and other autoimmune disorders, MCTD is a likely diagnosis. Also, it can be rheumatoid arthritis.  Usually Anti-sm antibodies rise in EBV infection and not anti-RNP.
If you are interested in conceiving then I am sorry but at your age and with thyroid problems and likely MCTD, carrying a pregnancy forward is going to be an up-hill task with flares of MCTD and thyroid irregularities which needs to be closely monitored. Also, the risk of miscarriage and low birth weight babies is high. Take care!

[maja330]

Respecte Doctors,
As a result to my raising RNP  for the past 2.5 years from 1.0 to 1.6 and normal is >1.0, the U1-RNP>0.2 and all ENA panel results are >0.2.
I tested for Epstein-Barr virus. The results are as follows:
Epstein Barr nuclear antigen (EBNA) >0.8 (normal is >1.0)
Viral capsid antigen (VCA)-IgM >0.2 (normal is >1.0)
D early antigen (EA-D): 1.0)
VCA-IgG: 5.8 (normal is >1.0)
What does this EBV result mean?
Is the elevated RNP is a result to VCA IgG 5.8

[maja330]

Respecte Dr.Kokil,
I hope you are doing well. As a result to my raising RNP  for the past 2.5 years from 1.0 to 1.6 (U1-RNP>0.2) I tested for Epstein-Barr virus. The results are as follows:
Epstein Barr nuclear antigen (EBNA) >0.8
Viral capsid antigen (VCA)-IgM >0.2
D early antigen (EA-D): <0
VCA-IgG: 5.8
I know this means a past infection witk EBNA.
I would kindly like to ask you is the elevated RNP is a result to the above mentioned, since I was searching the possible causes?
Am I predisposed to cancer or MS or at any other risk?
What can I do about it?
I thank you very much in advance
With all my respect I greet you and thank you in advance

[maja330]

Respected and dear Dr.Mathur,
I have been writing you for quite a while. Your answers mean a lot to me. All that you suggested as blood tests is done and the results are SS-A(Ro) >0.2, SS-B(La) >0.2. I regulated as well the hyperthyroidism to TSH 2.29 mU/L and FT4 pmol/L. I have no symptoms although I am still concerned about the anti-RNP which in the past 2,5 years has been raising (in a total of 4 blood tests) from 1.0 to 1.1 to 1.5 and 1.7 in the last test. The U1-RNP has been >0.2 an still remains with that value. Do you have any idea why the anti-RNP is constantly raising and would it mean a futur possible elevation of the U1-RNP?
I will be waiting for your appreciated and valuable answer respected Dr.Mathur.
I thank you very much in advance.
I send you all my respect

[Dr. Kokil Mathur]

Hi!
ANA test can be positive without any cause, and sometimes remains positive as people age. Also, yes, hyperthyroidism can cause a high ANA. Anti-RNP antibodies are raised in mixed connective tissue disease, and lupus erythematosus. However, since anti-U1 RNP antibodies is negative these two disorders are more or less ruled out. A sub-study of anti-RNP antibodies, SS-A (Ro) and SS-B (La), can be carried out to rule out Sjögren's syndrome. Do discuss this with your doctor.
If you have hyperthyroidism, then this needs to be corrected before you become pregnant. At 41 years of age, there can be other hormonal problems too which can affect pregnancy. So, you need to be under an expert who can carefully monitor you during pregnancy. Usually there is no harm to baby, but chances of miscarriage will be high. Please discuss with your gynecologist before planning a baby. Take care!


The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.