Author Topic: Borderline Positive ANA 1:240  (Read 4175 times)

sissyjane

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Borderline Positive ANA 1:240
« on: November 08, 2010, 02:50:49 PM »
My Rheumatologist just called and said my ANA test is borderline positive. She thinks I have Sjogren's. She's sending me a lab slip for another blood test, but she didn't say which one. My calcium was a teensy bit high...so I'm to stop taking it and my Vit. D., until I see her again in January. I think she's testing my Vitamin D level as well. Last Winter I was on prescription (40,000)units of Vit D, until we got it back up.

So, is a ANA of 1:240 positive in your opinion for Sjogren's? It's too low to be Lupus , right?

Yikes- I'm still nervous...

Carebear

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Re: Borderline Positive ANA 1:240
« Reply #1 on: November 08, 2010, 03:30:27 PM »
Hi Sissyjane,

Don't be nervous.  It's far better to know what you are dealing with, than not knowing.

A positive ANA may mean you have an autoimmune disease, which can include Lupus, Sjogren's, scleroderma, Rheumatoid arthritis or Raynaud's.  Or it may even be a false positive.

Hopefully the next set of blood tests will be more definitive for you and your doctor.

For myself, ANA tests negative.  Yet I still meet the criteria for Sjogren's.  It's all so complicated, isn't it?  So try to relax.  For most of us, diagnosis was a long, bumpy road.  I hope you reach your destination quickly and safely!
Sjogren's syndrome, RA,  Raynaud's phenomenon, Celiac Disease, Hashimoto's Thyroiditis, Grave's Disease, Fibromyalgia, Osteoarthritis, Osteopenia, Cervical Stenosis

Daisy1234

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Re: Borderline Positive ANA 1:240
« Reply #2 on: November 08, 2010, 03:50:30 PM »
Hi SissyJane:

Having a positive ANA may mean that you have some type of AI condition.  I have severe primary Sjs and my ANA is much higher than yours.  Just to let you know that the amount of ANA doesn't determine which type of AI disease that you have. ANA test may be followed by additional tests that are considered subsets of the general ANA test and that are used in conjunction with the person's clinical history to help rule out a diagnosis of other autoimmune disorders. More tests will be necessary to determine which one along with a symptom analysis. 

Try not to let yourself get upset and wait to see what happens.  Not everyone who has Sjs or another type of AI disease has it severely and some people can live relatively normal lives with an AI disease while in others it is much more difficult to live with.  Once you find out what is going on you'll be in a better position to deal with whatever comes you way.

Hugs,
Daisy

inga

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Re: Borderline Positive ANA 1:240
« Reply #3 on: November 08, 2010, 04:22:47 PM »
That is an odd number.  Could she have said 'borderline' at 'one to forty'?  (>1:40)?

ANA is usually stated >1:40, 1:80, 1:160 and it doubles each dilution.

If she said, 'borderline', then 240 would be beyond borderline, but, I have never seen it with a ratio of 240.  >1:40 is not considered positive.  1:80 is slightly positive or borderline, and usually they don't even consider it an issue unless it is >1:160.  I am sure they will do an ENA to see if you have specific antibodies anyway.

There is an ANA Elisa which is stated as a decimal, that could be 2.40, in which case it would be over the normal limit, of 0.9.

sissyjane

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Re: Borderline Positive ANA 1:240
« Reply #4 on: November 08, 2010, 04:27:07 PM »
I bet she did say 1:40. She has a very strong accent, and it was on the phone.

Disregard this post please...

inga

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Re: Borderline Positive ANA 1:240
« Reply #5 on: November 08, 2010, 04:38:07 PM »
Nothing like an accent to cause a panic attack....has happened to me too!

It is worth a repeat.  It is that gray area between normal and positive....a lot of this disease is in that area.

sissyjane

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Re: Borderline Positive ANA 1:240
« Reply #6 on: November 08, 2010, 05:18:33 PM »
My Schirrmer's test was positive, and I have all of the symptoms. With this blood test being borderline, I guess that's why she is ordering additional tests. ;)

inga

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Re: Borderline Positive ANA 1:240
« Reply #7 on: November 08, 2010, 05:47:03 PM »
Likely they will want the darn lip biopsy.  It isn't all that bad....a week of discomfort, a month of numby feeling.  Just make sure it goes somewhere credible to be read.

For diagnosis they require EITHER: positive blood, as in the SSA or SSB OR minally a + ANA
OR
A positive minor labial gland biopsy.

Then you meet the other criteria.  Schirmers on its own, won't be enough for most Rheums.  Neuros have increasingly stepped in when the serology is negative.

It can take a LONG time for you to seroconvert to a + serum.  Dry eyes can show up way before, but they balk at it until you produce the ANA.  ANA is hit and miss, it can be negative and go positive, then negative.


sissyjane

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Re: Borderline Positive ANA 1:240
« Reply #8 on: November 08, 2010, 06:08:51 PM »
I'll bet the additional tests are the SSA and SSB. Another two weeks of pacing...maybe I'll lose a bit of weight before Thanksgiving. :P

eyeamdry

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Re: Borderline Positive ANA 1:240
« Reply #9 on: November 08, 2010, 06:20:48 PM »
Sissyjane, I amno medical person, but I'll bet you could be right about the SS-A and SS-B being the tests.

If you have no reason for a lip biopsy, such as proof from your bloodtest, skip it.  Lucy

inga

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Re: Borderline Positive ANA 1:240
« Reply #10 on: November 08, 2010, 06:26:33 PM »
Usually the ANA is substantially +.  The SSA and SSB are components of the ANA.

The ANA is the antinuclear antibody titer.  It measure ALL antibodies....if that are +, then they try to find exactly which one is +, that is where the SSA and SSB come in for SjS.  

So if your ANA is negative, usually the SSA and SSB are, or they tell you it's a lab error.

The ANA is the composite of all the extractable nuclear antigens, or ENA.  The ENA consists of SSA, SSB, anti-sm, antidna, (Lupus) antirnps (MCTD), scl 70 (Sclero), anti Jo and a few more I can't remember.

Then to make it all more complex, any of these can appear in any disease.

Then the usual dance of rheumatology is to repeat it, and it undiagnose things, the rediagnose, then undiagnose....it's a circus unless things come back so definitive it hits them over the head.  

Yes, we all want answers and some get them, some are a bit more mired.  I have all the criteria for SjS, except the SSA and SSB.  (I have almost all the complications too)  I am still on the fence as to what I have, other than an autoimmune disease.

This stuff is a journey, think the Oddessy and the Illiad....you will be bored way before the end.  Relax, enjoy the pre-Holiday hype...find the biggest turkey!  I have a few walking around in the field back here.....

inga

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Re: Borderline Positive ANA 1:240
« Reply #11 on: November 08, 2010, 06:30:27 PM »
The Lip Biopsy sinched my diagnosis AND my treatment.  Without it, I would not be getting it.

Here is the catch:

Rheumatologists WANT positive blood work.  They want a +ANA and even better a +ENA (SSA, SSB).

A neuro may accept the rest with the lip biopsy.  Mine was read at the Mayo Path Lab....and STILL was not enough for most local rheums.  Hopkins accepted it and reinforced my current neuro's treatment plan.

It depends on what specialist you see and what kind of treatment you seek.

DragonflyC

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Re: Borderline Positive ANA 1:240
« Reply #12 on: November 08, 2010, 08:55:48 PM »
Hi, Sissyjane!

Your positive Shirmer's test and low positive ANA do seem to point to Sjogren's, but they could also point in other directions.  Did your doctor test your thyroid?  I know that when mine is low, my sicca symptoms get really bad. 

In fact, I had an ANA of 1:40 the first time I had the test done, and I had a positive SS-A of 5.43 (normal is < 1).  My doctor attributed my positive ANA to Hashimoto's (my diagnosis at the time); he said that I might never develop Sjogren's despite testing positive for the antibodies. Treatment for my low thyroid definitely helped my dry eyes at that point.

Four years later, I finally got sick enough to need treatment for SJS.  My SS-A was >8 and my ANA was 1:640.  From what my doctor told me, however, it could have gone either way.

You sound very well informed and that's a good thing.  I hope that your doctors are able to figure this out and help you feel better soon!

--C.

SJS, Hashimoto's, Raynaud's
Plaquenil, Evoxac, Restasis, Levoxyl, fish oil supplements, Vitamin D, NSAIDs, prednisone when flaring
Tested positive for SS-A ( > 8 ) and ANA (>1:640)

Visit me at http://sjogrensstyle.com for ideas about living well despite autoimmune disease.