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Hi everyone. I do not have any diagnosis as I've only been having symptoms since March of this year but know that something isn't right. It started out with numbness in right arm, hand and foot. Then the fatigue and joint pain started. I went to my GP and she ordered blood tests. Everything was normal except ANA was positive with titer of 1:640. She wanted me to see a Rheumy (took 2 months to get in!) and she couldn't find any evidence of Lupus or any other autoimmune disease. This was in June. Since then I've developed other odd symptoms such as burning sensations in different parts of body, twinges of pain under fingernails, dry eyes, signifigant hair loss, and occasional sharp chest pain. My fingers are very stiff in morning but loosen up fairly quickly upon waking. I still have joint pain but it comes and goes and is pretty mild. I just don't know what to make of all these oddities. I should mention that my sister has Lupus, R.A., and Myastinia Gravis, and I have 3 female cousins on same side of family with Lupus, R.A. etc.
Any advice/information would be great! Thanks for listening.
09-16-2007, 11:19 AM
One of the difficulties in getting a Lupus diagnosis is that many of the symptoms mimic other diseases (particularly auto-immune diseases). All of the symptoms you mention could be due to Lupus. However, a positive ANA may suggest an autoimmune disease, but further specific testing is required to assist in making a final diagnosis of which auto-immune disorder you might have.
About 95% of SLE patients have a positive ANA test result. If you also have symptoms of SLE, such as arthritis, a rash, and autoimmune thrombocytopenia (any disorder in which there are not enough platelets. Platelets are cells in the blood that help blood to clot), then you will probably be diagnosed with SLE. In cases such as these, a positive ANA result can be useful to support your Lupus diagnosis. Two subset tests for specific types of autoantibodies, such as anti-dsDNA and anti-SM, will be ordered to help confirm that your condition is SLE.
A positive ANA can also mean that the patient has drug-induced lupus. This condition is associated with the development of autoantibodies to histones, which are water soluable proteins rich in the amino acids lysine and arginine. An anti-histone test may be ordered to support the diagnosis of drug-induced lupus.
Other conditions in which a positive ANA test result may be seen include:
Sjögren’s syndrome: Between 40% and 70% of patients with this condition have a positive ANA test result. While this finding supports the diagnosis, a negative result does not rule it out. The doctor may want to test for two subsets of ANA: Anti-SS-A (Ro) and Anti-SS-B (La). The frequency of autoantibodies to SSA in patients with Sjögren’s can be 90% or greater.
Scleroderma: About 60% to 90% of patients with scleroderma have a positive ANA finding. In patients who may have this condition, ANA subset tests can help distinguished two forms of the disease, limited versus diffuse. The diffuse form is more severe. Limited disease is most closely associated with the anticentromere pattern of ANA staining (and the anticentromere test), while the diffuse form is associated with autoantibodies to the anti–Scl-70.
A positive result on the ANA also will also show up in patients with Raynaud’s disease, rheumatoid arthritis, dermatomyositis, mixed connective tissue disease, and other autoimmune conditions. Your doctor must rely on several test results, clinical symptoms, and your history before he can make any diagnosis. Because the symptoms of Lupus may come and go, it may take months or years to show a pattern that might give a doctor enough information to make a diagnosis of SLE or any of the other autoimmune diseases.
So, it is hard to say what your symptoms could indicate. Since so many in your family have auto-immune disorders, it is not unlikely that you would develop one also.
Have your doctors scheduled further testing? If not, perhaps you could talk to them about running some of the specific tests.
I wish you the very best
Peace and Blessings
Thank you for your reply Saysusie. Your information was great! I believe the Rheumatologist did all the tests specific for Lupus and R.A. only. She did not find anything other than the positive ANA. Those tests were done only 3 months after symptoms began. Is it possible to have Lupus but all tests except ANA come back negative/normal?
She couldn't see anything physical (I know this is common) to indicate Lupus or R.A. as I don't have any visibal swelling or redness in joints (just pain and stiffness) and no rash. The symptoms I do have are very odd and sporadic. I feel like I'm on the verge of something but have no idea what.
Again, thank you for the info.
09-17-2007, 06:15 PM
It is not likely that you would have lupus if all other tests came back negative. Aside from the physical conditions that you need to get a lupus diagnosis, you also have to have lab tests that indicate Lupus. You may be suffering from another auto-immune disorder and until tests are run for those disorders, it is hard to say what you may have.
Doctors usually test to eliminate possibilities, so the testing process can be lengthy and may sometimes feel repetitive. It is arduous, I know. :?
Waiting around while not knowing what is wrong can also be hard on you. But, there is no other way to know for sure without going through the process!
I wish you the very best and remember, we are here to help you no matter what your diagnosis may be!
Peace and Blessings