04-08-2007, 01:02 PM
I am a 24 year old female and I have not yet been diagnosed with Lupus, however the nephrologist is sending me in for a kideny biopsy this week. I guess I've always had blood in my urine (it's hereditary) but on a few cases there's been protein as well, and i tested positive for the ANA. I've also suffered from chronic fatigue, anemia, and I've been diagnosed with Mono twice (once in college and once in the military). I have really bad acne, so my face is always red.
However, I also got the smallpox and anthrax vaccine two days before I had my blood tested for the ANA. My only concern is that maybe the vaccine could have been what cause me to test positive? Does anyone have any experience about this. I have no idea what a biopsy entails, and my doctor wont be back in for awhile, and the internet doenst really explain how the procedure works (I really cant be out for too long, as Im in the military and we are doing predeployment training). Anyone have any input? Thanks so much!
04-08-2007, 02:39 PM
Hi, Anne - and welcome.
There have been some rare reported cases where certain vaccines have been linked to a positive ANA test, usually the hepatitis vaccine. Unfortunately, since it mostly military personnel who get smallpox and anthrax vaccines, there isn't much research available about their possible side effects. But since you had the vaccines only two days before the test, it's unlikely your body had time to develop a significant autoimmune reaction to them.
There are many possible reasons to have a positive ANA besides lupus - many people in the general population - especially women - will have a positive ANA with no underlying reason. There are also medications which can cause a positive ANA, and a positive ANA test can be associated with almost any of the connective tissue diseases, RA, thyroid disease, diabetes, mono, acute viral illnesses, and bacterial infections. So a positive ANA in and of itself is not always a cause for concern. But when you have a positive ANA in combination with other symptoms that suggest lupus, then further testing is a good idea.
A kidney biopsy sounds very frightening, but it is usually more uncomfortable than painful. It is done in a hospital, usually under sedation or light anesthesia, although some doctors use general anesthesia, You will probably have some blood work and a urinalysis done before the test, to make sure you don't have an infection or other problem that would make a biopsy risky. If your biopsy is scheduled for next week - you should not take any aspirin or over the counter pain medicines (motrin, aleve, etc.) because they can interfere with your blood clotting. So avoid taking these until after your biopsy unless your doctor specifically okays them.
The biopsy is usually done percutaneously - meaning through the skin. You will be lying face down, with something underneath you to support your rib cage. Your skin will be cleaned with an antiseptic wash and may be painted with betadine. You will be given something to numb your skin before the doctor inserts the biopsy needle. The doctor locates your kidney using ultrasound or a fleuroscope, and marks the location for the biopsy on your skin. The rest of the skin is draped off so only the biopsy site shows. As the needle is inserted, you may feel pressure and a pushing sensation, then a popping feeling as the needle enters the kidney. You will have to hold your breath for a few seconds as the needle goes in. It may take two or three "passes" to get enough samples for the biopsy. During this time your blood pressure and heart rate will be monitored. After each biopsy pass, the doctor or a surgical technician may put pressure on the biopsy site to stop any bleeding. Then the puncture site will be bandaged.
You will have to stay in bed for several hours after the biopsy, and many doctors prefer you stay overnight to be monitored in case of bleeding. Your blood pressure will be checked regularly for several hours afterward, and additional blood may be taken. If your blood pressure stays stable and you don't have any problems, you should be able to leave the hospital the mext day. You can expect to feel a little weak and sore after the biopsy. BUT you will not be able to do any heavy lifting or strenuous exercise for at least two weeks after the biopsy, until your doctor clears you, so if you have a civilian doctor, make sure he understands you are military and puts you on restricted duty status for at least two weeks. There is a real risk that heavy exercise could cause your kidney to start bleeding at the puncture site. After the biopsy, if you notice a significant amount of blood in the urine, feel faint, or have worsening pain or fever, you should let the doctor know right away.
It can take a few days to get back all the biopsy results, but hopefully your doctor will be able to give you the results more quickly.
Several of us have been through biopsies, so if you have questions, please feel free to ask.