This might be a no brainer question but I wanted to ask... in general, does the level of SSA correspond with your worsening of symptoms?
I got my medical records and saw that my SSA was 88 about 10 years ago and now it is 196. SSB is negative.
And, what is ANA?
Hi Charlie,
I don't think I've yet welcomed you to the forum, so let me say "Welcome!" ;)
That said, no question around here is a no-brainer. These test results are hard to decifer. And I'm sorry I really don't have a good answer to your first question. Others will come along with an answer in regard to the SSA levels, I'm sure.
I can tell you what ANA means: It stands for Antinuclear Antibody, and the test is done to determine anti-nuclear antibodies in your blood.
Antibodies are proteins that help fight against infections from bacteria and viruses. With autoimmune diseases, the immune system actually produces antibodies that attack our bodies when there is no infection. ANA can be used to determine different kinds of illness.
May I ask if you're being diagnosed, or have you had illness for a while? Please keep us posted. Feel free to ask anything at all! ;)
Take care,
Melinda
My rheumy actually just explained this to me so I think I can help!
My ANA and SS-A both maxed out on Quest's lab results, but the level of antibodies isn't suggestive of disease activity - to measure disease activity, they use the SED rate or ESR which are actually markers of systemic inflammation.
ANA is positive in a number of rheumatic diseases, while SS-A is found in SjS and Lupus. My rheumatoid factor is also really high, which is apparently common with SjS as well as rheumatoid arthritis, although that's one I have no idea about (what does it mean for those of us with SjS?)...I'm going to have to ask next time what, if anything, that means!
Both my SSA-SSB always maxed out with Quest as well. I wish they wouldnt max it out..maybe it would help determine the amount
of SS activity then?
Gursie
SSA & SSB are markers only, so they don't determine disease level. There is NO test to determine disease level in Sjogren's. There are some tests, (ESR, CRP, etc) that along with clinical symptoms, help doctors determine how active the disease is. But no test alone can measure disease level. Same goes for nerve involvement/activity. Tests can be negative, yet obvious clinical neurological presentation. They just haven't found a "TEST" to measure activity for any part of Sjogren's yet.
Quote from: anita on December 05, 2011, 04:49:19 AM
SSA & SSB are markers only, so they don't determine disease level. There is NO test to determine disease level in Sjogren's. There are some tests, (ESR, CRP, etc) that along with clinical symptoms, help doctors determine how active the disease is. But no test alone can measure disease level. Same goes for nerve involvement/activity. Tests can be negative, yet obvious clinical neurological presentation. They just haven't found a "TEST" to measure activity for any part of Sjogren's yet.
What do you mean by activity with SjS? ESR or SED may not indicate disease severity but they do indicate disease activity per my rheumatologist. They use ESR, CMP and CRP to determine disease activity. That's exactly what he told me about the antibodies - they help make a diagnosis but aren't measures of how
severe our disease is - they rely on systemic inflammation markers to track disease progress, which is why I have blood drawn every 3 months for CBC, CRP, CMP, and ESR.
Quote from: mshistory on December 05, 2011, 05:03:02 AM
Quote from: anita on December 05, 2011, 04:49:19 AM
SSA & SSB are markers only, so they don't determine disease level. There is NO test to determine disease level in Sjogren's. There are some tests, (ESR, CRP, etc) that along with clinical symptoms, help doctors determine how active the disease is. But no test alone can measure disease level. Same goes for nerve involvement/activity. Tests can be negative, yet obvious clinical neurological presentation. They just haven't found a "TEST" to measure activity for any part of Sjogren's yet.
What do you mean by activity with SjS? ESR or SED may not indicate disease severity but they do indicate disease activity per my rheumatologist. They use ESR, CMP and CRP to determine disease activity. That's exactly what he told me about the antibodies - they help make a diagnosis but aren't measures of how severe our disease is - they rely on systemic inflammation markers to track disease progress, which is why I have blood drawn every 3 months for CBC, CRP, CMP, and ESR.
So what if you have elevated ANA plus positive SSA antibodies but NO Sed Rate or CRP??!! Does that mean that you have an AI but there's no inflammation going on in your body? Presently I do have osteoarthritis and a friend of mine had elevated ANA with her osteoarthritis and no AI's.
Hi gold,
I know - this is all so confusing, isn't it? Sometimes I feel like absolute crap but my blood work only shows mild inflammation (like my blood proteins will be barely high). When I was first diagnosed with SjS, my SED rate was higher than it is now but I feel worse now than I did then! I totally agree that we shouldn't rely on blood tests alone but symptoms as well to determine how we are doing because those tests could probably change from day to day, even if our symptoms continue to worsen. If your CRP and SED rates are normal, I don't think it necessarily means you aren't flaring, it just means that one blood test at that one point in time didn't detect inflammation. I think maybe these tests are more useful for uncovering new problems (e.g., kidney and liver function) than they are for telling us how severe our disease.
I'm worried about my osteo as I read in an article by Elaine Morris (?) that she's seen erosive osteo in hands and feet of people who have had SJS for awhile. My rheumies just think it's general osteo which the radiologists have termed it to be. I haven't received the results of my hand xrays...maybe they'll say something more. My osteo right now is only in my hands and feet. >:(
Quote from: mshistory on December 05, 2011, 05:03:02 AM
Quote from: anita on December 05, 2011, 04:49:19 AM
SSA & SSB are markers only, so they don't determine disease level. There is NO test to determine disease level in Sjogren's. There are some tests, (ESR, CRP, etc) that along with clinical symptoms, help doctors determine how active the disease is. But no test alone can measure disease level. Same goes for nerve involvement/activity. Tests can be negative, yet obvious clinical neurological presentation. They just haven't found a "TEST" to measure activity for any part of Sjogren's yet.
What do you mean by activity with SjS? ESR or SED may not indicate disease severity but they do indicate disease activity per my rheumatologist. They use ESR, CMP and CRP to determine disease activity. That's exactly what he told me about the antibodies - they help make a diagnosis but aren't measures of how severe our disease is - they rely on systemic inflammation markers to track disease progress, which is why I have blood drawn every 3 months for CBC, CRP, CMP, and ESR.
The ESR test is used to help determine inflammation, but it cannot tell where it is. Here's a quote from Lab tests online: "Since ESR is a nonspecific marker of inflammation and is affected by other factors, the results must be used along with the doctor's other clinical findings, the patient's health history, and results from other appropriate laboratory tests. If the ESR and clinical findings match, the doctor may be able to confirm or rule out a suspected diagnosis. A single elevated ESR, without any symptoms of a specific disease, will usually not give the physician enough information to make a medical decision. Furthermore, a normal result does not rule out inflammation or disease."
So an ESR "can" be helpful, but it doesn't necessarily judge how active Sjogren's is or where Sjogren's is attacking the body. And by no means does a low or negative ESR mean that your Sjogren's is inactive. Most doctors use more then just an ESR to gauge 'active' or level of disease.
One other point. I don't want anyone to think I dismiss the ESR (or other tests). It is a good tool. It just cannot gauge severity or level of activity alone. As we know, everyone is different and Sjogren's can effect so many different parts of the body/organs. So a clinical assessment is just (if not more) important. One can very easily have a negative ESR & CRP, yet have raging neuropathy or other manifestation from Sjogren's...it's just how this disease is.
The SSA & SSB are in fact just markers (not indicators of activity) and as we all know, they can be negative also in people with documented Sjogren's (+lip biopsy or other tests).
My rheumy said that the ESR and SED rate are sometimes not elevvated either? gosh, we we had something!!! sometimes, I cant tell If Im flaring or have some type of virus/infection?
gursie
I was very late getting any positive blood work and even with all the symptoms I have had over the years I have never had an elevated sed rate. That test usually ran 1-4 and up to 20 is normal. I just had a sed rate of 18 and my immunologist is concerned that my inflammation is increasing as this test moved upward. In someone else this number would mean nothing!
Blood work helps but it sure doesn't tell the whole story, does it. Irish ;D
So annoying with bloodtests and understanding them. >:(
I have positive SS-A and ANA, but almost never elevated ESR, even when my rheum can feel the inflammation just by touching my joints.
What does SSA and SSB "maxed out" mean?
I know on Quest labs, the reference range is up to 8.00...it doesnt go higher...maxed out. Mine is always at 8.00 and I wish it would go higher so maybe I could tell when Im flaring, etc.
gursie
Charlie,
If yours are "maxed", then I would guess they are both positive. You should ask for copies of the labs.