10-18-2005, 06:20 PM
I posted in another area on this site, but have had no responses.....I have NOT been diagnosed with Lupus, but recently had a positive ANA-I just need to know what a positive result means? I see my doctor on Thursday to discuss the blood results, but in the mean time, I've just been sitting here stressing about what all this is??!?! no one can seem to give me any sort of info, so...can you?? thanks in advance!
10-19-2005, 01:38 AM
I'm glad you're going to discuss this with your dr. Having a positve ANA is one of many tests that can be used to determine if you have lupus. Below are the 11 criteria used to determine the factors necessary to diagnose lupus. Unfortunately it sometimes takes months or years to give this diagnosis. I just recently got the diagnosis although I've been going to a rheumatologist for 4 yrs. Developed lupus of the central nervous system but before that, I had some signs but not enough to determine if it was truly lupus. See below and hope this helps!
Diagnostic criteria for lupus
The following criteria are used to distinguish lupus (systemic lupus erythematosus, or SLE) from other autoimmune and rheumatic diseases.
A person with 4 of these 11 conditions can be diagnosed with lupus; 3 symptoms suggest that lupus is probably present, and 2 raise the possibility of lupus. Symptoms may be present all at once or appear in succession over a period of time.1
Butterfly (malar) rash on cheeks
Rash on face, arms, neck, torso (discoid rash)
Skin rashes that result from exposure to sunlight or ultraviolet light (photosensitivity)
Mouth or nasal ulcers, usually painless
Joint swelling, stiffness, pain involving two or more joints (arthritis)
Inflammation of the membranes surrounding the lungs (pleuritis) or heart (pericarditis). This inflammation is called serositis.
Abnormalities in urine, such as increased protein or clumps of red blood cells or kidney cells, called cell casts, in the urine
Nervous system problems, such as seizures or psychosis, without known cause
Problems with the blood, such as reduced numbers of red blood cells (anemia), platelets, or white blood cells
Positive antinuclear antibody (ANA) test
Signs of increased autoimmunity (antibodies against normal tissue), as shown by laboratory tests
10-19-2005, 07:34 AM
This is just an addendum to the great information that Catlady provided. Like she said, there is no single diagnostic test for lupus. There is a screening test called the ANA (anti-nuclear antibody) test which is often checked when a doctor suspects lupus. If the ANA test comes back negative it is considered a normal result, and it is very good evidence against lupus as an explanation for your symptoms. If the ANA test result comes back above the normal range, the test is said to be positive. A positive ANA test by itself is not proof of lupus.
A positive ANA can mean many things. There are many illnesses and conditions associated with a positive ANA, including rheumatoid arthritis, Sjogren's syndrome, scleroderma, and lupus, as well as infectious diseases such as mononucleosis, subacute bacterial endocarditis, and autoimmune thyroid and liver disease.
Certain medications can cause a positive ANA, and many healthy people with no associated illness or condition have a positive ANA. In fact, about 5% of the general population will have a positive ANA, yet fewer than 1 in 1,000 have lupus.
Thus, at least 95% of the people who have a positive ANA do not have lupus! A positive ANA test can sometimes run in families, even if family members have no evidence of lupus.
The ANA is only a test and, like a high cholesterol value, a positive ANA doesn't necessarily equate to having a disease. A positive ANA is only an indicator which points in several possible directions, and indicates that further investigation and analysis may be needed.
The doctor will view your ANA and other lab results, in light of your history and physical exam, to determine if there is sufficient evidence to diagnose a specific illness.
None of the connective tissue (joints, tendons, cartilage, collagen, muscles and skin) diseases has specific diagnostic tests. Diagnosis is therefore based on meeting certain criteria for the disease which are based on the symptoms you may have, your physical examination, and your blood tests. In systemic lupus, the eleven criteria listed by Catlady were developed for research purposes, but they are also frequently used to diagnose lupus.
Usually, physicians do not make a diagnosis of lupus unless they determine that you have at least four of the eleven criteria. If you only have two or three of the eleven criteria, then there may not be enough evidence to support a diagnosis of lupus. Since not all of the criterion are black and white, your doctor may sometimes be uncertain whether you meet a particular criterion or not. This adds to the difficulty in diagnosing Lupus and is part of the reason why diagnosis takes so long and requires so many tests.
Also, if another disease or condition can explain the presence of the criterion in a patient, then it may not indicate lupus. What that means is that it is also possible to meet four of the eleven criteria and still not have lupus, but have another connective tissue disease.
If your ANA is positive and you have many symptoms, your doctor may suspect some kind of connective tissue disease. If, at that time, there aren't enough symptoms and lab work to satisfy the criteria for any one particular disease, then it is impossible to specify a particular disease or to confirm a diagnosis.
Lupus tends to develop slowly and to evolve gradually over time. Many (or even most) people who have just a few of the criterion for lupus never develop this or any other connective tissue disease, and either improve or continue as they are.
Almost all of us here know that waiting for a final diagnosis can be frustrating. If only one or two criteria are satisfied, it's similar to a picture that's only partially developed. No one looking at that picture can accurately identify it. Nor can they predict if it will develop into anything that can be identified, how long it will take before it is developed enough to identify, or if it will develop further at all! That's the frustrating part of diagnosing Lupus, unfortunately!
There is no way to hurry the diagnosis of lupus. The length of time it takes is different for each person, just as the disease itself affects each of us differently. Like Catlady said, it may take weeks, months or years. In some cases, it can take as long as 10 years before enough evidence accumulates indicating that it is, in fact lupus!
I always suggest that you learn the signs and symptoms of lupus so that, if you develop something new, you can tell your doctor right away so that he/she can determine if you have satisfied enough criteria for a diagnosis.
Educate yourself as much as you can, listen to your body but only you know what is and is not normal for your body! Do not let ANYONE tell you that your symptoms are all in your head and insist that your doctor's take you seriously!
I wish you the best!
Peace and Blessings