Hi,
I was a frequent visitor and participated for many years then had lots of life events, was on helpful medication, and seemed to be better. My rheumy left the practice about three years ago (I balled) and the new one is terrible.
Hoping this group can help because the doc is not, I was looking at the chart about AI tests on this site and wondered can one have Sjorens or maybe Lupus with just an abnormal SSA and not a positive ANA? Everything I'm reading seems to suggest ANA has to be positive.
Also wondering, anyone had elevated/high MPV? Any diagnosis made?
Thanks for thoughts anyone might provide.
SjoGril
Second question first, because it's the most straight forward. Having a high or low MPV (mean platelet volume) doesn't mean anything on its own. It should be interpreted within the context of other CBC results, such as platelet count. In most cases, your doctor will simply use your MPV test results to decide whether or not to do additional testing. If there are no other abnormalities in your CBC (especially the total platelet count), it's probably an innocent reading.
As to the ANA, that is a more complex question. Although it's unusual to have any factor of the ANA or ENA positive if the total count is normal, the SSA is a "qualitative test" meaning it shows positive or negative, not the degree of that finding, while the ANA is "quantitative" meaning there is an actual cellular count, As a result, the SSA could be just barely positive, which could happen as the result of things like elevated protein, proteinuria from a kidney or bladder infection, or ketonuria from a high protein diet, because it can show positive from any protein, not just albumin.
All of the Autoantibodies have to be evaluated as an overall picture, not an individual reading (like most blood tests). Usually if the ANA isn't contributing, the next step is an ENA.
Also, SSA on it's own is very vague and often not used to base any diagnosis on without some other supporting results, like SSB, tissue biopsy, or other more specific autoantibodies.
And, if that's not confusing enough, it's possible to have sero-negative autoimmune disease. The diagnostic criteria is quite strict to provide some form of consistent data, and for use in international scientific studies, but at times, understanding doctors will diagnose in order to provide treatment, based on symptoms.
I'm sorry, I've probably confused you more than answering your questions, but I encourage you to try to find a doctor you trust who can make more sense of it.
Hi Linda,
This is extremely helpful, thank you! Everything else was normal though I did note in looking at past history that MPV has been on the rise over the time it's been measured, which is quite a number of years. Not sure if that means anything but will discuss it with my docs.
I have in the past had docs willing to diagnose and treat me as sero-negative, this one is not. She was going to look over my historical records, we'll see what she says when I have a virtual visit with her in February.
Thanks again,
s