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Thread: Confused with results and diagnosis

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    Question Confused with results and diagnosis

    If anyone has any links, knowledge, or basic information that might shed some light on my question, it would be greatly appeciated!!

    My PCP is calling it a possible Lupus/Systemic Sclerosis overlap.. But basically, an undifferentiated autoimmune disease. (My symptoms include severe joint pain, difficulty swallowing, photosensitivty, fatigue, chest pain, shortness of breath, I could go on LOL.. But absolutley NO 'skin thickening' as seen as the hallmark for SSc)


    Blood work showed:
    Positive ANA- 1:320 speckled AND homogeneous
    RNP antibody- 172 (100-120 normal)
    SCL-70 antibody- 195 (100-120 normal)


    There is little to no information regarding mixed ANA patterns, high anti-RNP or SCL-70 levels. Please help me, I want to educate myself!
    "Rule number one is, don't sweat the small stuff. Rule number two is, it's all small stuff."
    -Robert Eliot

    Dx: Potential Lupus, Diffuse Systemic Sclerosis, Mixed Connective Tissue Disease

    Rx: Prednisone 5mg 1x daily, Lyrica 75mg 2x daily, Omeprazole 200mg 1x daily, Xanax .5mg prn

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    Quote Originally Posted by tripLexie View Post
    If anyone has any links, knowledge, or basic information that might shed some light on my question, it would be greatly appeciated!!

    My PCP is calling it a possible Lupus/Systemic Sclerosis overlap.. But basically, an undifferentiated autoimmune disease. (My symptoms include severe joint pain, difficulty swallowing, photosensitivty, fatigue, chest pain, shortness of breath, I could go on LOL.. But absolutley NO 'skin thickening' as seen as the hallmark for SSc)


    Blood work showed:
    Positive ANA- 1:320 speckled AND homogeneous
    RNP antibody- 172 (100-120 normal)
    SCL-70 antibody- 195 (100-120 normal)


    There is little to no information regarding mixed ANA patterns, high anti-RNP or SCL-70 levels. Please help me, I want to educate myself!


    I posted about the patterns in your other thread. Did it not answer your question? Maybe this will be more clear

    -Antinuclear Antibody (ANA) positive, speckled pattern.
    -Autoantibody to DNA leads to inflammation in the placenta.
    -Autoimmune disease screening in the woman is negative (No evidence of lupus or rheumatoid arthritis).

    A blood test determines the presence of antibodies to polynucleotides, histones and DNA. This process involves running 27 different tests on a sample of blood.

    The presence of antibodies is also tested for by doing the ANA test. This is a less sensitive test but one that many doctors have already done on their patients before we ever see them.

    The test is reported as a titer and a pattern. Any titer above 1:40 is significant. The titers can get into the thousands such as 1:2,500. This simply means that the test is positive when the blood serum is diluted many times.

    The pattern is reported as homogeneous, nucleolar or speckled:

    -Homogeneous: the antibody is to the ss DNA or ds DNA.
    -Nucleolar: the antibody is directed to the polynucleotides.
    -Speckled: the antibody is directed against the histones.

    Some women demonstrate a mixed pattern of speckled/homogeneous. These same antibodies appear positive in women with lupus, rheumatoid arthritis, Crohn's disease and other autoimmune diseases. They are usually in high titers. Pregnancy losses, infertility and IVF failures cause the titers to be much lower and a low positive titer does not mean that you have or are getting an autoimmune disease; however, this is ruled out during the testing.

    In women with autoimmune diseases these antibodies cause inflammation in joints and organs. In women with no autoimmune diseases but a positive antibody, the antibody causes inflammation around the embryo at the time of implantation or in the placenta after implantation. This inflammation is exactly the same as occurs if you get a splinter under your fingernail. The tissue around the splinter gets hot, red and swollen and it happens quickly.

    RNP is conducive with Mixed Connective Tissue Disease but that doesn't mean you will get them all (overlapping features of primarily three connective tissue diseases — lupus, scleroderma and polymyositis and sometimes rheumatoid arthritis). Please note that even without MCTD many/most Lupus patients end up with overlapping diseases. The SCL test is also one that confirms overlap disease.

    Hopefully this gives you more information and helps you understand the test results!
    Last edited by tgal; 02-23-2012 at 03:51 PM.
    Mari

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    tripLexie (02-23-2012)

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    This definetly helps! Thanks so much for all the insight!
    "Rule number one is, don't sweat the small stuff. Rule number two is, it's all small stuff."
    -Robert Eliot

    Dx: Potential Lupus, Diffuse Systemic Sclerosis, Mixed Connective Tissue Disease

    Rx: Prednisone 5mg 1x daily, Lyrica 75mg 2x daily, Omeprazole 200mg 1x daily, Xanax .5mg prn

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    Hi Lexie,
    Here's a link that I found helpful:
    http://www.merckmanuals.com/home/bon...ease_mctd.html

    MCTD is my diagnosis, too. I don't have any tight skin of scleroderma, so I guess that's why my rheumy didn't list it. She listed my overlap as being Lupus, Sjogren's, RA and Psoriatic Arthritis. From what she said, I assume docs can make the dx of MCTD for any overlap.
    Hope this helps.
    Hugs,
    Marla

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    tripLexie (02-27-2012)

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