One of the difficulties in getting a Lupus diagnosis is that many of the symptoms mimic other diseases (particularly auto-immune diseases). All of the symptoms you mention could be due to Lupus. However, a positive ANA may suggest an autoimmune disease, but further specific testing is required to assist in making a final diagnosis of which auto-immune disorder you might have.
About 95% of SLE patients have a positive ANA test result. If you also have symptoms of SLE, such as arthritis, a rash, and autoimmune thrombocytopenia (any disorder in which there are not enough platelets. Platelets are cells in the blood that help blood to clot), then you will probably be diagnosed with SLE. In cases such as these, a positive ANA result can be useful to support your Lupus diagnosis. Two subset tests for specific types of autoantibodies, such as anti-dsDNA and anti-SM, will be ordered to help confirm that your 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.
Other conditions in which a positive ANA test result may be seen include:
Sjögren’s syndrome: Between 40% and 70% of patients with this condition have a positive ANA test result. While this finding supports the diagnosis, a negative result does not rule it out. The doctor may want to test for two subsets of ANA: Anti-SS-A (Ro) and Anti-SS-B (La). The frequency of autoantibodies to SSA in patients with Sjögren’s can be 90% or greater.
Scleroderma: About 60% to 90% of patients with scleroderma have a positive ANA finding. In patients who may have this condition, ANA subset tests can help distinguished two forms of the disease, limited versus diffuse. The diffuse form is more severe. Limited disease is most closely associated with the anticentromere pattern of ANA staining (and the anticentromere test), while the diffuse form is associated with autoantibodies to the anti–Scl-70.
A positive result on the ANA also will also show up in patients with Raynaud’s disease, rheumatoid arthritis, dermatomyositis, mixed connective tissue disease, and other autoimmune conditions. Your doctor must rely on several test results, clinical symptoms, and your history before he can make any diagnosis. Because the symptoms of Lupus may come and go, it may take months or years to show a pattern that might give a doctor enough information to make a diagnosis of SLE or any of the other autoimmune diseases.
So, it is hard to say what your symptoms could indicate. Since so many in your family have auto-immune disorders, it is not unlikely that you would develop one also.
Have your doctors scheduled further testing? If not, perhaps you could talk to them about running some of the specific tests.
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