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lovemysalr
02-22-2009, 09:22 AM
Hello, I was Diagnosed with SLE and Sjogrens in Sept of '08. At that time I was put on 400mg of Plaquenil per day, Voltaren 150mg per day, Restasis eye drops twice a day and Vitamin D 50,000IU once a week.

My most recent blood work has me a bit confused. I love my Dr (Rheumatologist)but he's not so great about explaining things over the phone. I do have an appointment with him again on March 3rd. I am followed every 6 weeks at this point.

I will list this by dates only listing the labs that are out of range or that he circled:
9/08 (I was DXed at this point)
ANA 1:1280 Homogeneous
PT 11.9 (L)
APTT 37.2 (H)
NEUT #12.5 (H)
NEUT% 85.4 (H)
VIT D3 22
DNA DS AB (H) 14

12/08
ANA 1:640 Homogeneous
SSA AB Positive
SSB AB Neg
DNA DS AB (H) 14

(NEW LAB)
02/09
ANA 1:80 Homogenous
DNA AntiDS (H) 14
CRP <0.4 (this is circled by Dr and has "verified by repeat analysis" in bold under it)
Sed Rate 3 (this has a check mark next to it by Dr)
VIT D3 21
DNA ASB ELISA Neg


The new labs have me confused! Can anyone help explain what they mean? I am assuming that if the meds I put on in Sept are working, that would be why the ANA is dropping? What is the CRP and Sed Rate looking for? How can one DS DNA be positive and the other, taken the same day be neg? Thank you very much for any help.

Allison

mountaindreamer
02-22-2009, 10:09 AM
hi allison,

i am not the expert on blook tests, but I want to welcome you to the group, and assure you that someone will be along who can offer you a ton of information. I believe you are right.....the bloodwork can fluctuate according to whether you are in a flare, and when the meds are working. Hand tight, someone smarter than me will be along.

welcome, and hope we can help

phyllis

ssingh
02-22-2009, 11:57 AM
I don not see your DNA DS ever negetive in ur post. your DNA DS is very consistent at 14(H), mine was 12 last time. When I am arround 12 then my LUPUS is not in great control. everyone is different. What I found in last 12 years that as my DS DNA goes up and worse I would feel.

lovemysalr
02-22-2009, 12:26 PM
Thank you for both of your replies. I am still trying to learn all I can. The lab I was referring to is:

DNA ASB ELISA Neg

Was I mistaken thinking that this was a DNA anti-DS test as well? What test is it? Thank you for all your help.

Allison

sick n tired
02-22-2009, 01:21 PM
I just got the results for ds dna as 137(H)...I am not sure what that means and what the scale is...is it really 137 or really 1:37?

I agree...your ds dna looks high in both...

ssingh
02-22-2009, 03:03 PM
hi Allison
DNA ASB ELISA Neg is different than Anti Double standard DNa

Faith
02-22-2009, 08:23 PM
Hi Allison,

CRP, Sed Rate, and Anti-DNA by Farr, are looking for inflammation as well as complements C3 and C4. They review all and see if your inflammation is high or normal within your body. After being placed on Plaquenil, you may see a difference in your numbers as far as Anti-DNA by Farr, CRP, Sed Rate, C3 and C4. The lower the C3 & C4 indicates more inflammation. Usually CRP and Sed rates are high if you are going thru a flare.

I hope this helps. Check out Daniel J. Wallace's book "Lupus for patients and families" through your local library. It goes through all the labs, and explains it.

Take care,

Faith

lovemysalr
02-25-2009, 11:07 AM
Thank you so much for your help. I really thought that the 2 labs were the same thing! Silly me! I have done a Google search and I can not seem to find what the test DNA ASB ELISA is for. I have several books on SLE and none of the mention this test either. They, of course. all mention the anti-dsDNA, but no reference to the other one.

Anyone know?

I will try and find the book you mentioned Faith, my library does not carry it. :-(

Thanks again, Allison

Saysusie
02-25-2009, 01:21 PM
ANA Test

ANA is short for anti-nuclear antibody, and this test is used to diagnose SLE. However, it can come up positive for cases of Sjogrenís syndrome, Raynaudís disease, juvenile chronic arthritis, scleroderma, rheumatoid arthritis, antiphospholipid syndrome, and many other autoimmune disorders. This is why the ANA test is used within the ACR criteria, but it is not necessarily the definitive test for lupus.

The ANA test is usually ordered when common lupus symptoms are observed in a patient. With mild symptoms, it can take doctors years to recognize a pattern that warrants a lupus test (in the meantime, we can be told that we have other diseases or that it is all in our heads!). The positive test only tells the doctor that there is an autoimmune disease present, not what that disease may be. So further testing will be needed. Also, there is sometimes a false positive ANA test, which happens more often as people get older, so doctors are not usually prone to see this as a marker for an auto-immune disorder.

Approximately 95 percent of SLE patients have a positive ANA test. If the ACR (American College of Rheumatology) criteria are not met, other tests like the anti-dsDNA and anti-SM tests can help doctors determine if the patient has Lupus (SLE).

Anti-DNA Test
The long name for the Anti-DNA test is the Antibody to Double Stranded Deoxyribonucleic Acid test. DNA is an important part of the cell nucleus and it is what makes up our genes. The anti-DNA antibody is the reason people have a positive ANA test. If a person has a positive ANA test, but not anti-DNA, have antibodies that are attacking other parts of the cell nucleus.

A positive result on the anti-DNA test almost always confirms a lupus diagnosis. The higher the amount of anti-DNA, the more active the lupus is. There are some other rare diseases that can also produce a positive anti-DNA test.

NOTE: While a positive anti-DNA test offers a definitive lupus diagnosis, a negative test DOES NOT necessarily mean that lupus is not present. Sometimes, it just means that the lupus is in remission (the disease is not very active). Other tests can still be positive in lupus patients who have a negative anti-DNA tests.

Antinuclear antibodies (ANA) are frequently present in people with Lupus and, less commonly, in other autoimmune diseases, such as Rheumatoid arthritis, Collagen vascular diseases, chronic liver diseases and systemic sclerosis (scleroderma). ANA bind to several nuclear antigens including DsDNA, SSDNA, RNP, Sm, SSA and SSB.
ANA ELISA is widely used as a screening procedure for different autoimmune diseases.
ELISA = enzyme-linked immunosorbent assay. It is a screening test for total rheumatoid factor (RF). ANA tests can be very confusing for patients and doctors. Trying to compare levels of antinuclear antibodies done with different methods is very difficult. The ELISA is usually used as a screen and if positive, then doctors will usually do the fluorescent test to obtain a titer. Your doctor has obtained other tests at this point to see if he/she can pinpoint the type of antinuclear antibodies that you are making which will be more helpful in deciding if the ANA test is a sign of a specific condition. Sorry I can't be more specific but these tests can vary a lot from lab to lab.

I hope that I've answered your question :-)
Peace and Blessings
Saysusie

lovemysalr
02-28-2009, 11:31 AM
Thank you very much. You all have answered my question.

SLE is just so confusing! :-) Just when I get a handle on one set of symptoms, along comes something new to throw me a curve ball.

I just found the book that was mentioned and I am enjoying it. It is very detailed and does not talk "down" to the reader.

Thank you all once again for your help!

Allison