Re: C3, C4, DsDNA Tests
A positive ANA does not necessarily mean that you have Lupus. There are several other diseases that also have a positive ANA. However, most persons with active Lupus do have a positive ANA. There are 11 criteria used to determine if Lupus is present, a person must meet at least four (4) of those eleven criteria. The "Lupus Foundation" website has a new interactive link "Could I Have Lupus" which is really helpful to those who feel that their symptoms may be due to Lupus. It is informative and easy to understand.
With reference to your questions: "Does the high C3 negate the high level of DS DNA antibodies? & "do I have to have a low level of C3 in order to be diagnosed with lupus?"
First, let me give you a bit of explanation so that you'll understand the tests. The complement system is one of the natural defense mechanisms that protects our bodies from infections and perhaps tumors. Measurement of complement components aids in the diagnosis of immunologic disorders, especially those associated with deficiencies of complement components (such as multisystem rheumatic diseases, such as systemic lupus).
Decreased levels of C3 are associated with autoimmune disease, neonatal respiratory distress syndrome, bacteremia, tissue injury and chronic hepatitis. Decreased levels of C4 may indicate disseminated intravascular coagulation (DIC); acute glomerular nephritis, chronic hepatitis and SLE.
Increased levels of both C3 and C4, in addition to increased concentrations of C-Reactive Protein, are linked to acute inflammatory disease and tissue inflammation (As happens in Lupus).
So doctors are looking for indications of inflammation (increased C3 & C4) &/or indications of auto-immunity and/or kidney involvement (decreased C3 & C4).
If Lupus nephritis (kidney involvement) is indicated in the C3 & C4 compliments, the DS DNA test ( along with antinuclear antibodies and levels of Ig & IgM ratio) help to support the diagnosis of Lupus nephritis and helps to determine the extent of damage caused by the nephritis. The IgG/IgM ratio of anti-dsDNA antibodies represents a significant parameter used by doctors, to distinguish patients with lupus nephritis from those without renal involvement. So, one test does not negate the other. Evaluation of anti-dsDNAisotypes is simply a diagnostic tool to define subsets within Lupus (SLE) patients who have different clinical manifestations. In particular, the IgG/IgM ratio of anti-dsDNA antibodies are used as a diagnositc marker for lupus nephritis during the course of the disease.
All of the tests are used as aids in determining if a condition exists and the extent of that condition.
Also, please know that, for diagnosis, Anti-dsDNA antibodies are frequently detected in active SLE, but they are not specific for SLE as they are also present in up to 30% of other disease groups. Therefore, doctors will use the aggregate results of all tests, personal history, and presenting symptoms to make a diagnosis. All tests are merely parts of a combination of things used to make a determination.
I hope that this has been helpful to you. Please let me know if it confused you further and/or if you need further information!
Peace and Blessings
This was a really good sticky !! Thank you.
Recently I had this scenario: "Increased levels of both C3 and C4, in addition to increased concentrations of C-Reactive Protein, are linked to acute inflammatory disease and tissue inflammation." along with a positive RA factor (though the RA factor was right at the cut off after months of increases from way below normal.
I was kind of confused about wtf was going on with my complements until I read this. You are such a cool lady
Hi Saysusie - thanks for posting this -
I'm especially interested in the dsDNA since this came positive for me - do you know or have a link to those other diseases that have this positive as a marker? Many thinks for your insight -
You rock!! Thanks for putting this into words that even I can understand.... You are a blessing!
You are all very, very welcome :laugh:
If you look up DS-DNA positive then it will let you know that it is very rare to have a positive without having Lupus it is the one dna test that my rhuemy said was differtly Lupus
I like that criteria survey. It includes important issues like severe fatigue. I think if fatigue is so bad that it disrupts your life, it ought to be included in the diagnostic criteria, especially if an overactive immune system causes that symptom. I didn't even know painful fingers was a symptom. Mine hurt and feel week, but I have no obvious signs of swelling. I think it's missing things though that ought to be added. Like ongoing muscle pain, or bone pain. It included nothing about the nervous system, and if an autoimmune disease can attack that, it should have. I'm curious of the type of problems it can cause with your nervous system. Great site though. I had plenty to check off. Taking that to my doctor when I go. Thank you for posting this.
I have the same thing my dsdna is extremely high according to my doc. In the 60's if that makes any semse
hi, I was diagnosed 9/12/13, my ANA direct was positive and my Anti-DNA (DS) AB QN was positive, then there is a whole page with names and scary stuff and percentages, the dr who diagnosed informed me by leaving me a voicemail on my bday (jerk) I called him back and he said follow up with rheumatology? I have no idea what this all means or if he diagnosed correctly. I have had unspecified edema bilaterally for the last 10 months, joint pain in hips, knees, and feet, calf and thigh pain recently, a really itchy rash on my knees and left arm, headaches, tummy pain and no one will tell what the hell to do to fix it or relieve symptoms. im scared. today I went to memorial er as told to by triage rn and urgent care rn, for left sided edema, face swollen and edematous hands which my edema has always been bilateral never one sided, they treated me like crap at the er, said it was not an emergency that none of my lab tests were important, (I showed her the ANA results) told me to follow up with primary and said she would only run electrolyte panel, then put me in the waiting room for 2 hrs. I am scared I cant find a dr in Colorado springs that's worth a darn, and need advice please
Hi Devil Ducky, I'm sorry about the hell you're being put through by the medical system, we've all been there. You likely need a course of prednisone to calm down what sounds like flare symptoms. I'm disappointed but not surprised the ER basically brushed you off the way they did. If your doctor can't get you in quickly, I would call all the rheumatologists in your town, explain that you're likely in a flare and see who can get you in to be seen in the next week. Good luck!