View Full Version : what is going on?
12-08-2008, 05:41 PM
Can someone please help me? I went to the doctor in Sept. He did an ANA test that came back positive. (sorry no titer reported). The lab then sent off to another lab for the dsDNA which came back at 18. According to paperwork, 10 is high. Doc then sent me to rheumy. Went to new doc, he was angry that no titer was reported and sent me back to lab for new ana and dsdna. Both of these came back as negative. He now says first test was in error, second test was right. No follow-up to explain. How can two different labs say positive and third lab say negative? Any insight out there?
12-08-2008, 05:59 PM
I feel sad for you. I don't know what to think. They did not even want to repeat the tests? Maybe the lab that reported the negative results made the mistake. I think that it is terrible the way the doctors treat people when they are sick with this rotten illness. Maybe Saysusie will have an answer for you.
12-08-2008, 10:29 PM
Well, I do know that you can not compare ANA tests from two different labs, but I have run into the same problem as you. My primary doctor ran an ANA which came back positive, sent me to a rhuemie and he ran his own test and that came back negative. So, all is apparently well for the time being. I don't have any answers, but I wanted to tell you that the same thing happened to me.
I am sure that someone here will know more. ((hugs))
12-09-2008, 10:01 AM
One of the things that we are warned about is the fact that each lab has its own measurement to determine positive or negative ANA. 95%-98% of patients with SLE will have a positive ANA test, but the majority of people with a positive ANA test do not have SLE. A positive ANA test can be found in many conditions, including Sjogren's Syndrome, scleroderma, rheumatoid arthritis, & mixed connective tissue disease. Many normal healthy people will also have a positive ANA test. Therefore a positive ANA test, on it's own, does not mean that person does or does not have lupus. Also, there is a condition known has ANA-Negative Lupus. These patients usually have other clinical markers for Lupus.
The reliability of the ANA test depends upon the laboratory. Many variables can interfere with the test & give false numbers. The accuracy of the test can also vary, depending on many factors, such as the strength of the fluorescent antibody, or even the quality of the microscope used. It is advisable, if ana is positive or negative & if you are presenting symptoms, for your doctor to run further lab tests to see if you have the other clinical symptoms of Lupus.
Peace and Blessings
Because a positive ANA can indicate many other diseases, doctors have to look very carefully at the titer (number) & pattern of the ANA test. That is why your doctor was upset when no titer or pattern was given on your first test.
The titer shows how many times the lab technician had to mix fluid from your blood to get a sample free of ANAs. Thus a titer of 1:640 shows a greater concentration of ANA than 1:320 or 1:160, since it took 640 dilutions of the plasma before ANA was no longer detected.
The great difference between various titers can be misleading. Since each dilution involves doubling the amount of test fluid, it is not surprising that titers increase rapidly. In fact, the difference between titers of 1:160 & 1:320 is only a single dilution. And it doesn't necessarily represent a major difference in disease activity.
ANA titers go up & down during the course of the disease, & may or may not reflect disease activity. Therefore it is not always possible to tell from the titer how severe a person's lupus is.
A titer of 1:80 or lower is usually considered negative. Did your doctor give you the titer of the test that he ran?
The pattern of the ANA is studied by microscope. The technician examines a specially prepared slide that shows where antibodies attack the nucleus. Certain antibodies attack certain areas of the nucleus, producing four specific patterns.
The rim (peripheral) pattern is the most specific pattern for lupus, while the homogeneous (diffuse) pattern is the most common pattern seen. The remaining patterns are the speckled and nucleolar patterns. In some cases, the pattern helps the doctor decide which of the autoimmune diseases is causing the problem and which treatment program is appropriate.
12-09-2008, 11:31 AM
Thanks for all of your help!
The new test did not list a titer either.
After stewing on it for a while, I decided I am going to make an appt. with another doctor and have him go over all that I have and give me his opinion. I am currently without a GP, so I am going to get one and go from there. I knew that the ana could vary, but I couldn't seam to locate the information I needed. I knew you guys would be able to help me.
12-11-2008, 03:55 AM
Good for you. Let us know how it goes and what you find out.
Peace and Blessings
12-11-2008, 06:54 AM
The process of putting together a good "health care" team is so difficult. There are time constraints, money issues, and just plain exhausting. Keep up the good work....after all, you are your best advocate.
Share a smile today,