Interpreting Blood Tests
I am a 40 something mother of 3 (and two bonus daughters). As part of a gastroparesis research study, I had labs drawn which showed positive ANA at 1:160 homogenous pattern, elevated ESR, IgA and IgM. I was subsequently referred to a rheumy. the rheumy ordered labs, referred me to the Sjogren's Clinic at UCSF (11/18)and to a neuro-opthamologist (11/12).
After donating 27 vials of precious blood for diagnostic tests, I have the results back and am looking for assistance in interpreting the results:
Histone AB: Positive 7.3 (>2.5 positive)
SS-B: 3.9 Positive
Lyme Positive 1.37 (>1.10 positive)
As part of my labs, the rheumy ordered a HLA27 and HLA51 (Behcet's). The results were:
A 3, 29
B 7, 44
The other (usual AI diagnostic) labs came back within range.
It doesn't appear that I tested positive for the gene that has been linked to AI disorders :D
It seems that I tested positive for Sjogren's and I'm wondering if the results indicate Lupus also. I won't return to the rheumy until 12/18 and would like to see what others think about the lab results. Thanks in advance for your input!
Having been diagnosed with SLE back in 2004 I'd like to think I know a bit about autoimmune disorders. But your very specific test results are way above my paygrade I'm sorry to say. We've got some pretty smart folks here who may have some answers for you though. Anyway, welcome, and make yourself at home!
I just looked at the results and it does show that you could have Lupus by the Homogenous pattern ANA. The positive SSA and SSB antibodies are seen in Sjogrens Syndrome. You could have Lupus with Sjogrens as secondary. I have the Sjogrens as secondary. If it turns out that you only have he Sjogrens then that will be a primary illness. They treat Lupus and Sjogrens pretty much the same way with Plaquenil. I have to wonder about the HLA as I am not sure about what Behcets is. Saysusie would probably know more about that. I hope that I have helped in some way.
My research for you yielded...
Histone A B's aid in the diagnosis of SLE, drug-induced SLE and related Connective Tissue Diseases, such as Rheumatoid Arthritis, Dermatomyositis and Sjogren’s Syndrome. Determination of the patient's histone antibody status may be useful in the differential diagnosis between SLE and drug induced SLE.
Wondering if your doctor was ruling in or out Bechet’s Disease and why not use in a sterile needle into your skin…examine the area two days later. If a small red bump forms under your skin where the needle was inserted, this is positive . This indicates your immune system is overacting…
From my reads HLA- A and B antigen is for diagnosing Ankylosing Spondylitis (AS) as well as several other disorders, such as Reiter’s Syndrome, Psoriatic Arthritis, and arthropathies associated with Inflammatory Bowel Disease. I haven’t found a lab on the internet that carries any information on this test, range. Who is the lab that done the test and search their site online if they have one.
Lyme positive…Patients with autoimmune diseases such as lupus and other spirochetal diseases neurologic conditions, and infectious diseases yield false positive results often. Do you know which Lyme test was conducted? If he was trying to rule in or out Lyme Disease had he performed any other tests, like the Western Blot, ELISA or even better the newest Lyme test, the CP6 LPE....
Know not all labs use the same test, nor the same range for confirming a diagnose...example ANA 1:160 maybe positive in one lab but not in another...
ANA tests are performed using different assays (indirect immunofluorescence microscopy or by enzyme-linked immunoabsorbant assay - ELISA) and results are reported as a titer with a particular type of immunofluroscence pattern (when positive). Low-level titers are considered negative, while increased titers, such as 1:320, are positive and indicate an elevated concentration of antinuclear antibodies.
ANA shows up on indirect immunofluorescence as fluorescent patterns in cells that are fixed to a slide that is evaluated under a microscope. Different patterns are associated with a variety of autoimmune disorders. Some of the more common patterns include:
* Homogenous (diffuse) - associated with SLE and mixed connective tissue disease
* Speckled - associated with SLE, Sjogren’s syndrome, scleroderma, polymyositis, rheumatoid arthritis, and mixed connective tissue disease
* Nucleolar - associated with scleroderma and polymyositis
* Outline pattern (peripheral) -associated with SLE
An example of a positive result might be: “Positive at 1:320 dilution with a homogenous pattern.”
A positive ANA test result may suggest an autoimmune disease, but further specific testing is required to assist in making a final diagnosis. ANA test results can be positive in people without any known autoimmune disease. While this is not common, the frequency of a false positive ANA result increases as people get older.
Also, ANA may become positive before signs and symptoms of an autoimmune disease develop, so it may take time to tell the meaning of a positive ANA in a person who does not have symptoms. Most positive ANA results don't have significance, so physicians should reassure their patients but should also still be vigilant for development of signs and symptoms that might suggest an autoimmune disease.
About 95% of SLE patients have a positive ANA test result. If a patient also has symptoms of SLE, such as arthritis, a rash, and autoimmune thrombocytopenia, then he probably has SLE. In cases such as these, a positive ANA result can be useful to support SLE diagnosis. Two subset tests for specific types of autoantibodies, such as anti-dsDNA and anti-SM, may be ordered to help confirm that the 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.
Hope this helps...
Thank you for posting such an informative response! You've answered so many of the questions that I had. The most difficult aspect of AI issues at this point has been understanding the labs/tests that have been done, the results and the purpose of the tests. Thank you again...
You are very welcome BonusMom...
Hugs...Keep well, be well.