Is anyone familiar with the ANA test?

[Only me]

My daughter recently had some blood work done. She tested positive on the ANA test and the result was 1:160. Since the test was ordered through the neurologist she wants my daughter to see a rheumatologist. The neurologist said that the test was positive but a low positive but since my daughter has other symptoms (painful, swollen knees) as well as her ongoing insomnia and other problems she feels that dd should be checked by a rheumatologist.

 

I was just wondering what the 1:160 means.

 

It's a bit interesting. My oldest daughter went through a bunch of testing two years ago for Marfan Syndrome. The genetic test came back negative but they wanted us to followup with an orthpedic surgeon and also with the Marfan clinic in one year. The orthopedic surgeon felt that she still had some kind of connective tissue disorder but wasn't sure which one and to just keep a close eye on her. Last year we went back to Children's Memorial and the geneticist finally gave us the all clear that she didn't feel that dd had any kind of connective tissue disorder.

 

I was looking over my other daughter's lab results and the positive ANA test suggests that she could possible have a connective tissue disorder or something like Lupus. Now I'm wondering if my oldest daughter has a connective tissue disorder (just not Marfan syndrome) since they are genetic.

[Ibbygirl]

I'm sorry I have nothing useful to say to help, but I just wanted to send you lots of :grouphug: :grouphug::grouphug::grouphug::grouphug: I hope that all turns out well.

[TravelingChris]

I have a positive ANA score. THe thing you need to know is not only the ration but the pattern: speckled, etc. THe pattern is what helps determine the condition. THat said, a small percentage of the population has a positive ANA and nothing wrong at all.

 

It doesn't have to be lupus since a number of autoimmune conditions also have it. I have Sjogren's Syndrome and a yet undiagnosed form of inflammatory arthritis. I have had my disease for about 15 years and am doing quite well.

[Perry]

 

I was just wondering what the 1:160 means.

 

Short answer: that is the ANA titer, the last dilution that gives a positive result.

 

Long answer:

 

There are two (three really, but two for our purposes) parts to the ANA test:

1) is the test positive or negative, and

2) if positive, how positive is it?

 

They are looking to see if your dd has an antibody (Ab) that attacks structures in the nuclei of her cells. First, they add your dd's serum to a commercial preparation of cells. If her serum contains anti-nuclear Ab, the Ab will bind to the cells. A commercially prepared antibody that is tagged with a dye is then added. If there are any Ab-cell complexes, the dye will attach to them and you can see them "glow" under UV light. So that tells you you have a positive result. If there is no antibody in the serum, no complexes are formed, and the dye labeled antibodies have nothing to attach to, so there is no reaction and you would see nothing.

 

 

If there is a positive result, they do a "serial dilution". That means they repeat the positive test, diluting it repeatedly until the test turns negative. That way, they have an idea of how much antibody there is. The dilutions are

 

1:40

1:80

1:160

1:640

1:1280

1:2560

 

(They might go higher or lower depending on the lab; those are the ones I'm familiar with.)

 

A 1:40 dilution means there is 1 part serum mixed with 40 parts saline. As the second number goes up, the serum is more dilute. If you have a positive test at 1:40, that means that there was a reaction when you diluted the serum at 1 part serum:40 parts saline, but when you made it more dilute, there was no reaction. So a positive test at 1:2560 is much "more" positive than a positive test at 1:40.

 

Another way of looking at it is if you have lots and lots of antibodies in your blood, you will still have high enough numbers to react even if the blood is very dilute. If you don't have many antibodies, there won't be enough to react as the dilutions get higher.

 

 

The ANA is notorious for having a low PPV (positive predictive value). PPV is the percent of people with a positive test who actually have a disease. For the ANA, the PPV for lupus is about 11-13%. IOW, only 11-13% of people who have a positive ANA will actually have lupus. Many completely healthy people have positive ANAs, so it doesn't necessarily mean a disease is present. It does mean that they should keep looking though.

 

As the titer goes up, the likelihood of there being a disease present goes up. A 1:160 titer is sort of borderline for being positive. That's why your doctor said it's low positive. It may indicate a disease, or it may be perfectly normal.

 

Hope that wasn't too confusing.

 

This page might be helpful.

[Perry]

Long answer:

 

There are two (three really, but two for our purposes) parts to the ANA test:

1) is the test positive or negative, and

2) if positive, how positive is it?

transientChris reminded me of the third part of the ANA test, which is the pattern.

Did they tell you what that was?

[Only me]

The pattern is speckled. What does that mean?

[Perry]

The pattern is speckled. What does that mean?

It's the most common, and least specific. It can occur with a number of autoimmune disorders, and is the most common pattern in people with positive ANA who have no disease.

[jannake]

Hello,

 

I just wanted to let you know that my ANA has been positive for over 15 years. They told me at that time it was likely going to be MS for me. I didn't exhibit signs for rheumatoid arthritis or lupus. The doctor at the time told me his wife had a positive ANA and she hasn't had anything come up. I have been to several different Dr. and still no answer. I have been for several MRI's on my neck and spine and I do not show plaque other than that from migraines. Recently I started losing hair and went to my general practitioner. She said that she wanted to test my vitamin D level because they were finding that people with symptoms that indicated things like lupus, MS and others were being found to have low D levels. My level was extremely low and we started the D at a large dose. So you might want to have them check the vitamin D level. I asked the pharmacist who filled my D and he said he was seeing more of this because we aren't in the sun as much and when we are we put on sunscreen.

Hope that helps.

[Only me]

Actually her vitamin D was tested low about 3 months ago and she has been on vitamin D therapy since. It's good to know that it's highly possible that the positive ANA test doesn't mean anything. I'm also wondering if it's probable that it is just due to her being gluten intolerant since that is an autoimmune disorder. I'm just concerned about her knees swelling but hopefully we'll find out more next week.

[jannake]

I just found out in November that I have a severe intolerance to gliadin which is like gluten. I have been off of gluten since that time since you follow a gluten-free diet with the gliadin intolerance. I will go in April to see if I have the genetic marker for Celiacs. However, it doesn't really matter to me because I feel better w/out the gluten. I am concerned about one of my children and the Dr. suggested that I get tested to see if I carry it and then I will know with more assurance whether to put my child through it. I pray that you find answers. I know that it is scary. My prayers are for your family.

 

Janna

[HappyGrace]

Wow, I'm so sorry your dc is ill. Thank you for starting this thread-it is a Godsend for me to read parts of it-dh just tested positive for Lyme, and at the same time, the doc tested ANA and he was positive for arthritis and lupus! We were freaking out (still are, a little.) We only got the results from a nurse, haven't talked to a doc yet. So glad, Perry, that the rate of actually being positive is so low!

 

We did see an article online that is not typically known by doctors, but that the Lyme can cause the ANA to be high for arthritis and/or lupus. And when they treat the Lyme with long-term antibx, the ANA for arth/lupus does not show up pos anymore, which would NOT happen if it actually was arth/lupus. I cannot imagine that he has lupus-no symptoms, and the only arthritis symptom is joint pain, which is prob'ly from the Lyme.

 

Anyway, did you have your dc cked for Lyme? Maybe there is a correlation there somehow?

Edited February 2, 2010 by HappyGrace

[Only me]

My daughter tested negative for lyme. I hope that your husband is ok and that it turns out that he is negative for lupus. I'll just be glad when we know for sure. Of course I want my daughter's test to be negative but it will mean another dead end. We've gone to so many specialists and no one knows what to do with her. We are trying to figure things out locally before trying Mayo Clinic since I'm sure it would be months before we could get in there. I'm still hoping that it is all just due to her gluten intolerance and that the insomnia and knee swelling, etc. will disappear after she has been gluten free for enough time. I've heard that it can take 6-8 months and it has only been 3 1/2 months.

[HappyGrace]

I should have figured they would have ruled that out. There can be a lot of false negatives though; if you do get her to Mayo or somewhere, they can recheck. I pray for a good outcome for her! And peace for you-it is so unsettling when your dc isn't well and you can't find answers.

[eight_gregorys]

So sorry you and your DD are going through this. Connective tissue diseases can take a long time to diagnose. Like others have stated the ANA is not really disease specific and is used to diagnose numerous conditions. While you could have Lupus with a titer 1:160 it is highly unlikely. I have lupus and my ana was speckled and 1:2560. Is there a chance your daughter has a thyroid issue? That's actually how all this started for me. I have autoimmune thyroid disease which was diagnosed before the lupus. For many years, doctors blamed my positive ANA on my thyroid because that can happen. It wasn't until my kidneys quit working that they finally looked for something else. Have they done an double stranded DNA antibody test? If they suspect SLE that should be the next test done.

 

You are doing such a good job. Just keep being your DD's advocate and remember even if it is any of these things, they are all very treatable. I was diagnosed several years ago and I'm doing well now. I truly pray you find answers soon.

 

Many Blessings,

[TravelingChris]

Actually it isn't only with treatment for LYme that ANA can go down. I have been treated with disease modifying drugs for 13 years so far and most of the time they test ANA, it is negative. But when I have a bad flare, it is positive again. MOst of my doctors don't test it but since I move, a lot do test at the first visit. It is only because I have my old records and because I am on medications that are serious business that not all of them test.

[Shanti Thapa]

Hi I am suffering from body ache . My doctor tested for below things :

1) Uric acid - Normal

2) RA Factor - Negative

3) ESR - 50 mm/hr

4) Anti-cpp - Normal 

5) ANA - positive.

6) Anti ds DNA - <0.5(Negative)

I am taking prednisolone 40mg with an anti acid.

Doctor could not tell what exactly I am suffering from.

could you please let me know what it could possibly be?

[caffeineandbooks]

Ten year old thread resurrected by first time poster.  Shanti Tharpa, homeschooling parents are awesome, but we're better at answering homeschooling questions than second-guessing your doctor.