ANA test results for my niece - need help understanding this

[Hopeny]

My niece lives out of the country, has had PANS symptoms for maybe 8 years and finally got dx'd about two years ago. Has constantly high ASO (>400). Last summer had a test come back indicative for Lyme. I was emailing my brother scans of her bloodwork that I picked up from Dr. B last summer as she is getting ready to see Dr. O', and I noticed something I missed before.

ANA Titer: POSITIVE NEGATIVE

ANA Titer: Diffuse Pattern Titer 1:80

ANA screen is under abnormal summary.

Read a but on line and started getting a bad feeling in my stomach. I don't think this result was ever discussed with my SIL.

Anyone have experience with this?

My niece has been suffering for years, tics (severe facial and others) , bad ocd, rages, joint pain, psych issues, sensory issues from a young age.

 

[rowingmom]

DD11 (lyme/bart/pans) has a positive ANA speckled pattern 1:10 "consistent with mixed connective tissue disease, scleroderma and sjoogrens sicca complex". DD11 had all the symptoms your niece has, except the bad ocd - hers was fairly minor.

 

We have not retested since treatment began, but her symptoms certainly have improved.

 

A quick search found:

 

"Homogenous (diffuse) - associated with SLE and mixed connective tissue disease"

 

My first thought a couple of years ago when I saw the positive ANA "consistent with mixed connective tissue disease" was that it was the result of the effects of lyme on her connective tissue - it just made sense to me. Doctor's don't seem to have a handle on the causes of autoimmune diseases effecting joints and connective tissues. Lyme seemed to be a good bet. I haven't followed that path any further.

Edited April 10, 2013 by rowingmom

[Mayzoo]

Not sure if this helps:

 

"What does the test result mean?

 

ANA tests are performed using different assays (indirect immunofluorescence microscopy or by enzyme-linked immunoabsorbant assay, ELISA) and results are reported as a titer, often with a particular type of immunofluroscence pattern (when positive). Low-level titers are considered negative, while increased titers, such as 1:320, are positive, indicating an elevated concentration of antinuclear antibodies.

ANA shows up on indirect immunofluorescence as fluorescent patterns in cells that are fixed to a slide that is evaluated under a microscope. Different patterns have been associated with a variety of autoimmune disorders, although overlap may occur. Some of the more common patterns include:

• Homogenous (diffuse) - associated with SLE and mixed connective tissue disease
• Speckled - associated with SLE, Sjogren syndrome, scleroderma, polymyositis, rheumatoid arthritis, and mixed connective tissue disease
• Nucleolar - associated with scleroderma and polymyositis
• Centromere pattern (peripheral) - associated with scleroderma and CREST (Calcinosis, Raynaud's syndrome, Esophogeal dysmotility, Sclerodactyly, Telangiectasia)

An example of a positive result might be: "Positive at 1:320 dilution with a homogenous pattern."

A positive ANA test result may suggest an autoimmune disease, but further specific testing is required to assist in making a final diagnosis. ANA test results can be positive in people without any known autoimmune disease. While this is not common, the frequency of a false positive ANA result increases as people get older.

Also, ANA may become positive before signs and symptoms of an autoimmune disease develop, so it may take time to tell the meaning of a positive ANA in a person who does not have symptoms. Most positive ANA results don't have significance, so physicians should reassure their patients but should also still be vigilant for development of signs and symptoms that might suggest an autoimmune disease.

About 95% of those with SLE have a positive ANA test result. If someone also has symptoms of SLE, such as arthritis, a rash, and autoimmune thrombocytopenia, then she probably has SLE. In cases such as these, a positive ANA result can be useful to support SLE diagnosis. Two subset tests for specific types of autoantibodies, such as anti-dsDNA and anti-SM, may be ordered (often as an ENA panel) to help confirm that the condition is SLE.

A positive ANA can also mean that the person has drug-induced lupus. This condition is associated with the development of autoantibodies to histones, which are water-soluble 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 syndrome: Between 40% and 70% of those 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). About 90% or more of people with Sjögren syndrome have autoantibodies to SSA.
• Scleroderma (systemic sclerosis): About 60% to 90% of those with scleroderma have a positive ANA finding. In people 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 may show up in people with Raynaud's disease, rheumatoid arthritis, dermatomyositis or polymyositis, mixed connective tissue disease, and other autoimmune conditions. For more on these conditions, visit the American Autoimmune Related Diseases Association patient information page.

A doctor must rely on test results, clinical symptoms, and the person's history for diagnosis. Because symptoms may come and go, it may take months or years to show a pattern that might suggest SLE or any of the other autoimmune diseases.

A negative ANA result makes SLE an unlikely diagnosis. It usually is not necessary to immediately repeat a negative ANA test; however, due to the episodic nature of autoimmune diseases, it may be worthwhile to repeat the ANA test at a future date if symptoms persist.

Aside from rare cases, further autoantibody (subset) testing is not necessary if a person has a negative ANA result."

 

http://labtestsonline.org/understanding/analytes/ana/tab/test

[michelew]

My son had a positive ANA of 320:1, nuclear pattern. He also was positive for Myco P. and Lyme at the time. The LLMD who was treating him at the time, told us that the ANA would get better after treatment, and he was right. We have had him tested several times since the original positive reading, and each time his test has come back negative.

[Hopeny]

Thanks everyone that is so encouraging. I'm hoping with Lyme treatment that will improve. That result is after a year of zith