View Full Version : ANA Titer question ?

07-16-2008, 05:00 AM
Hi there,
Does anyone know if the titer elevation corresponds with how active the disease is or how bad you feel (or is that the same thing)? Anyhow, I hope you know what I mean. Mine was 1:1280 (which seems pretty high...How high can it get?) 2 weeks ago when I last had blood work.

Just wondering. Any answers would be appreciated.

07-16-2008, 05:08 AM
Hi Donna -
Though I am no expert on ANA titers - there is alot of info in the sticky(s) here on this site. THere is also labtestsonline, and a link under our "website" forums. Im sure Saysusie will come along and explain it to you as well.
I have learned, however, that our test results dont necessarily correlate to how we are feeling. Some people blood work will be fine, but they will feel sick as ever, and sometimes people will have NO symptoms, and their blood work is off the charts.
Like I said, however, Saysusie Im sure will give you more accurate info. Incidentally, I have a negative ANA, and still do when Im in the worst of flares...Its just the way my blood is.
Good luck and take care!

07-16-2008, 08:22 AM
ANA (Antinuclear Antibody) Test

To perform the ANA (antinuclear antibody) test, sometimes called FANA (fluorescent antinuclear antibody test), a blood sample is drawn from the patient and sent to the lab for testing.

Serum from the patient's blood specimen is added to microscope slides which have commerically prepared cells on the slide surface. If the patient's serum contains antinuclear antibodies (ANA), they bind to the cells (specifically the nuclei of the cells) on the slide.

A second antibody, commercially tagged with a fluorescent dye, is added to the mix of patient's serum and commercially prepared cells on the slide. The second (fluorescent) antibody attaches to the serum antibodies and cells which have bound together. When viewed under an ultraviolet microscope, antinuclear antibodies appear as fluorescent cells.
# If fluorescent cells are observed, the ANA (antinuclear antibody) test is considered positive.
# If fluorescent cells are not observed, the ANA (antinuclear antibody) test is considered negative.
How is the ANA titer determined?

A titer is determined by repeating the positive test with serial dilutions until the test yields a negative result. The last dilution which yields a positive result (flourescence) is the titer which gets reported. For example, if a titer performed for a positive ANA test is:
1:10 positive
1:20 positive
1:40 positive
1:80 positive
1:160 positive
1:320 negative

The reported titer in our example is 1:160.
Three parts of an ANA report

An ANA report has three parts:
# positive or negative
# if positive, a titer is determined and reported
# the pattern of fluorescence is reported
What is the significance of the ANA pattern?

ANA titers and patterns can vary between laboratory testing sites, perhaps because of variation in methodology used. These are the commonly recognized patterns:
# Homogeneous - total nuclear fluorescence due to antibody directed against nucleoprotein. Common in SLE (lupus).
# Peripheral - fluorescence occurs at edges of nucleus in a shaggy appearance. Anti-DNA antibodies cause this pattern. Also common in SLE (lupus).
# Speckled - results from antibody directed against different nuclear antigens.
# Nucleolar - results from antibody directed against a specific RNA configuration of the nucleolus or antibody specific for proteins necessary for maturation of nucleolar RNA. Seen in patients with systemic sclerosis.
What does a positive ANA result mean?

ANAs are found in patients who have various autoimmune diseases, but not only autoimmune diseases. ANAs can be found also in patients with infections, cancer, lung diseases, gastrointestinal diseases, hormonal diseases, blood diseases, skin diseases, and in elderly people or people with a family history of rheumatic disease. ANAs are actually found in about 5% of the normal population.

The ANA results are just one factor in diagnosing, and must be considered together with the patient's clinical symptoms and other diagnostic tests. Medical history also plays a role because some prescription drugs can cause "drug-induced ANAs".
What is the incidence of ANA in various diseases or conditions?

Statistically speaking the incidence of positive ANA (in percent) per condition is:
Systemic lupus erythematosus (lupus or SLE) - over 95%
Progressive systemic sclerosis (scleroderma) - 60-90%
Rheumatoid Arthritis - 25-30%
Sjogren's syndrome - 40-70%
Felty's syndrome - 100%
Juvenile arthritis - 15-30%

Subsets of the ANA (antinuclear antibody) test are sometimes used to determine the specific autoimmune disease. For this purpose, a doctor may order anti-dsDNA, anti-Sm, Sjogren's syndrome antigens(SSA, SSB), Scl-70 antibodies, anti-centromere, anti-histone, and anti-RN.

The ANA (antinuclear antibody) test is complex, but the results (positive or negative, titer, pattern) and possible subset test results can give physicians valuable diagnostic information.

Titer levels can correlate with the activity of the illness, but you can also be in a flare without a high titer or not be in one with a high titer...

07-16-2008, 04:46 PM
I don't know "how high can it get", but mine was also 1:1280 on the two tests they did. Mine had both "speckled" and "homogenous" patterns. None of my other "things" have been positive (Lupus coagulent, negative; RA factor, negative; others I can't remember the names of, all negative).

I don't particularly feel bad, so I don't think the ANA level is tied to how you feel necessarily. I have had some bad flare ups which left me in the bad for a day or two at a time (wicked fatigue, sick feeling inside and out). But overall, I'd say I feel pretty good (on the whole) and my ANA is 1280 as well.

Hope this helped. Just wanted to let you know I had the same ANA level.

Take care,