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Thread: ANA Nucleolar - should me doc have mentioned this?

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    Question ANA Nucleolar - should me doc have mentioned this?

    Hi everyone,

    So since I started having tests for and was diagnosed with lupus (about 1 and a half years ago) I have always had an ANA that appears on my results as positive homogenous 1:640. To my knowledge it's never shifted, never improved with meds, just stayed there. However, recently I requested a copy of some recent blood results from an old GP i saw once back in Australia. She'd told me everything was ok (apart from some vit deficencies) but I'd requested a copy for the nutritionist I've been seeing and alongside the usual ANA result was:


    ** POSITIVE Nucleolar Pattern (Titre 1:640)

    An antibody to a cytoplasmic antigen has been detected.

    Suggest anti-smooth muscle and anti-mitochondrial antibodies if

    clinically indicated.

    Also suggest anti-ENA antibodies to exclude Jo-1 if not already

    requested. **


    Can anyone help explain this please? Not got a rheumy yet here in NZ...need to get a referral!

    Thankyou.
    I spent 2 years travelling Australia. Check out my travel blog at http://travelpod.com/members/helenlear

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    Basically they were just informing your doctor that there may be some kind of AI issues going on with you. ANA itself is not really a test for AI diseases although it leads one in that directions. Further testing, which looks like was done here, gives more information. This was telling your doctor to be on the lookout for several AI things. Since you already knew that thee really wasn't anything to mention
    Mari

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    The only extra testing I had done was well before these tests..before i'd ever had this new pattern show up. I guess what I'm asking really is does this analysis nucleolar pattern indicate anything other than lupus and what tests should I be having because of it? The last bloods had done by a rheumy were about 8 months ago...just ANA and dsDna really...and nothing with a nucleolar pattern showed up, just homogeneous. This nucleolar pattern has only shown up in the last couple of months and no further tests have been done.
    Not sure if I'm making sense? Heads not been working well the past few days. Thanks for replying tgal xx
    Last edited by Shine; 12-11-2012 at 02:29 AM.
    I spent 2 years travelling Australia. Check out my travel blog at http://travelpod.com/members/helenlear

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    Often, when antibodies to cytoplasmic antigens are detected - this is prior to (or indicative of) a finding of positive ANA. This suggests, to the doctors, that (as Tgal mentioned), there may be some type of AI issue developing. ANA is NOT an indicator of Lupus. It is one, of many, tests run in order to determine if the issue is Lupus (or another AI or connective tissue disease).
    Many people have a positive ANA without having the disease. It is just that many people with Lupus do have a positive ANA. There are a battery of tests that doctors will run in order to determine which (if any) Auto-Immune disease you may have. There really is no test that you should as for, especially given the fact that you have been diagnosed with Lupus. The other statements you provided were suggestions of tests that should be considered if further indicators of AI disease was found.
    ANA titers and patterns can vary between laboratory testing sites because each lab may use a different method. However, are the commonly recognized patterns:
    • Homogeneous - total nuclear fluorescence due to antibody directed against nucleoprotein. Common in SLE (lupus).
    • Peripheral - fluorescence occurs at edges of nucleus in a shaggy appearance. Anti-DNA antibodies cause this pattern. Also common in SLE (lupus).
    • Speckled - results from antibody directed against different nuclear antigens.
    • Nucleolar - results from antibody directed against a specific RNA configuration of the nucleolus or antibody specific for proteins necessary for maturation of nucleolar RNA. Seen in patients with systemic sclerosis.
    As has been mentioned, ANAs are found in patients who have various AI diseases, but not only autoimmune diseases. ANAs can be found also in patients with infections, cancer, lung disease, gastrointestinal diseases, hormonal diseases, blood diseases, skin diseases, and in elderly people or people with a family history of rheumatic disease. ANAs are actually found in about 5% of the normal population.
    Again....the ANA results are just one factor in diagnosing, and must be considered together with your clinical symptoms and other diagnostic tests.

    I hope that this has been helpful...

    Peace and Blessings
    Namaste
    Saysusie

    Look For The Good and Praise It!

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    Thanks. I'm waiting for my Rheumy referral now and will take a copy of these new results as they've never been looked into..plus my current symptoms are getting worse. Had my first referral rejected by the hospital because I'm not an NZ resident and it's not seen as urgent medical care. Sliiiightly peeved off about that but that's another matter entirely. going private now...at $220 an appointment, y'know, because I'm filthy rich.
    I spent 2 years travelling Australia. Check out my travel blog at http://travelpod.com/members/helenlear

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