Positive ANA

Jazi · Post by **Jazi** » Tue Apr 16, 2013 9:33 am

Does anyone know what that means? I had a lot of blood work done and that was the only positive result. I could ask my boss who is a physician but I don't view physicians the way I used to... it's sad.

Zizzle · Post by **Zizzle** » Tue Apr 16, 2013 9:52 am

Anti-Nuclear Antibodies are a first screen for autoimmunty. They are not specific for any one disease, but it does mean you need follow-up tests to look for more specific antibodies. Do you know your result? A low level like 1:40 might be meaningless, meaning lots of healthy people have low levels. Hoigher numbers like 1:320, 1:640 or 1:1280 are a greater cause for concern (They double as they go up). You also want to find out the pattern, speckled or homogeneous. Speckled is less specific, homogenous is found often in Lupus.

Jazi · Post by **Jazi** » Tue Apr 16, 2013 10:00 am

Thank you Zizzle. You guys are fast around here.

Reference range is: <1> or=1:1280
Speckled.

Jazi · Post by **Jazi** » Tue Apr 16, 2013 10:20 am

I don't think that looks right. I tried editing it but I don't think it worked. Reference range is less than 1. My results are greater than or equal to 1:1280
Speckled.

Zizzle · Post by **Zizzle** » Tue Apr 16, 2013 1:39 pm

That's been my result for the past 8 years. 1:1280 and speckled, which is considered very high. I think they stop counting after 1280. It raises eyebrows and REQUIRES further testing. My docs were surprised I didn't have obvious autoimmune issues when my ANA was this high. In retrospect, it was certainly predictive of things to come...sorry. The good news is a speckled pattern is not predictive of Lupus and other serious autoimmune diseases. I was diagnosed with Undifferentiated Connective Tissue Disease for some time until my skin rash fully declared itself. Sorry, I don't know your history. Do you have other health issues beyond MC? Joint pain? I've been fine thanks to the GF/DF/SF diet, except for my failing skin. I am convinced my diet and supplements are also responsible for my slow progression and very mild disease.

My most recent ANA level before starting prednisone was 1:320. I wonder what it would be now. The other antibodies they discovered after my ANA 8 yrs ago were ASMA (Anti-Smooth Muscle Antibody) and Rheumatoid Factor, which continue to stay elevated. I don't think these have any firm correlation with MC, other than the fact that MC causes permeable intestines, and that eventually leads to food sensitivities and autoantibody production. I also have the celiac and autoimmunty gene, HLADQ2.

All my doctors have recommended twice yearly blood testing for liver and kidney function (chem panels), muscle damage (CK) and a complete blood count (CBC) to monitor any signs of autoimmune damage, even when I'm feeling well.

fluffypoodle · Post by **fluffypoodle** » Tue Apr 16, 2013 3:48 pm

Hi wanted to chime in here. I have a homogeneous pattern 1:640, have had it for a few years. No other positive tests but a bunch of symptoms. Working with a rheum and wondering if and when symptoms will get specific enough to diagnose. For now he is writing down uctd.

Post by **tex** » Tue Apr 16, 2013 8:08 pm

This is just my opinion, but I have a strong hunch that as long as all your food sensitivities are carefully avoided at all times (so as to minimize inflammation), that should prevent most autoimmune diseases from progressing.

Tex

fluffypoodle · Post by **fluffypoodle** » Tue Apr 16, 2013 8:15 pm

Funny enough, Tex, that is precisely what the rheum suggested last time. He said how certain foods like gluten and dairy are known to cause inflammation, and since I am not taking anything for any autoimmune issues right now with the stop of plaquenil, he recommended staying off gluten and dairy to see what happens with my aches and pains.

Yay for smart doctors!

Post by **tex** » Tue Apr 16, 2013 9:19 pm

Kudos to him.

Tex

Zizzle · Post by **Zizzle** » Tue Apr 16, 2013 11:30 pm

He said how certain foods like gluten and dairy are known to cause inflammation, and since I am not taking anything for any autoimmune issues right now with the stop of plaquenil, he recommended staying off gluten and dairy to see what happens with my aches and pains.

I'm in shock that a Rheumatologist uttered these words!

Why did you start and stop Plaquenil? Any issues with it?

Tex,
While I desperately want to agree with you, my stupid disease, DM, is largely regarded as needing an infectious or environmental trigger (other than food). I'm not confident remission is achievable 100% through diet, as many have tried and failed. Diet does reduce inflammation and slows the disease process. But I'm afraid the disease gene is triggered forever, much like MC. Healing intestinal permeability is my goal.

Jazi · Post by **Jazi** » Wed Apr 17, 2013 4:29 am

Zizzle, thank you for your post

As for my history, I don't really have joint pain. I have knee pain and that began in 2008-2009 when I decided to take up running. I do get a little stiff when sitting for long periods but my job requires a lot of sitting. It doesn't hurt to stand up though.

I do 30-45 minutes of either weight training or aerobics approx 4-5 days a week without a problem

I do have asthma, had that since I was 5 (I'm 48 now) I'm on a steroid inhaler (Qvar 80mcg) daily. And I still need my Albuterol inhaler, more so lately. I am having some lung issues which the doctors are stumped about.

I had breast cancer in 2008 (DCIS). No chemo, just radiation for six weeks and I've been cancer free for five years.

I do recall being major fatigued in July of 2010. I was lucky if I could stay up past 7pm! I fired my personal trainer, stopped running, stopped exercising all together. Could barely get up for work and went right to bed when I got home. That lasted for quite some time (over a year?). Felt significantly better when I was put on Albendazole in August of 2012 for parasites that I was diagnosed with by a Chiropractor through a stool sample sent to Metametrix labs. My fatigue/mental fog improved but after six weeks, the distended belly and cramping came back. Albendazole and Flagyl stopped working. I can't begin to tell you how much money I spent on OTC parasitic meds as well as probiotics, prebiotics and whatever else I could get my hands on. My PMD gave up on me and so did my GI (idiot never did any tests). I found a new PMD who referred me to a new GI and he didn't hesitate to do an endoscopy and colonoscopy.

I was diagnosed with LC Friday March 22nd after suffering for a year. This Saturday will be my third week on Entocort, 9mg daily. I began GF, DF, SF faithfully since March 31st (this is my third week) although I did screw up last Friday by drinking Lime-a-rita's, apparently they're made with beer. I have also avoided all fresh veggies and fruits with the exception of a banana and an occasional avocado.

My physician did some other blood work for autoimmune diseases which came out fine. Which one's exactly are done for an autoimmune disease?

I almost forgot, I do have an odd looking rash on my left leg, my shin area. It's not a raised rash and no bumps. They're like light brown patches with redness around them.

fluffypoodle · Post by **fluffypoodle** » Wed Apr 17, 2013 8:18 am

Zizzle,

if you remember back to my whiney post regarding the worst GI appointment ever, he said he cant treat my LC while i take plaquenil. so with the agreement of my rheum, i stopped. wouldnt you know it--majority of my explosive D has stopped.... i mean, i am not healed or anything, but yeah, getting of helped for sure...

Joefnh · Post by **Joefnh** » Wed Apr 17, 2013 9:41 am

Hi Jazi,

Regarding the rash you are noticing on your shin, I would make sure to mention that to your rheumy and your GI doctor.

Rashes on the shins are sometimes due to a rash called Erythema Nodosum which can be an indicator of other IBD activity other than MC. In many patients with Crohns or UC one of the early signs are a rash on the shins. For me it was one of the earliest signs for my Crohns

It certainly does not mean that it's related to another IBD, there are several other causes but it is something you should mention to your doctors.

Look at the picture at the bottom part of this link, if it's similar I would call attention to it.

http://www.aafp.org/afp/2007/0301/p695.html

What causes erythema nodosum?

Erythema nodosum may occur as an isolated condition or in association with other conditions. Conditions that are associated with erythema nodosum include medications (sulfa-related drugs, birth control pills, estrogens), strep throat, Cat scratch disease, fungal diseases, infectious mononucleosis, sarcoidosis, Behcet's disease, inflammatory bowel diseases (Crohn's disease and ulcerative colitis), and normal pregnancy.

http://www.webmd.com/skin-problems-and- ... ma-nodosum

Post by **tex** » Wed Apr 17, 2013 9:53 am

Zizzle wrote:I'm not confident remission is achievable 100% through diet, as many have tried and failed.

I totally agree with you. Notice that I referred to "most autoimmune diseases" in my post. In your case, you will also have to avoid the other (non-ingested) environmental antigens (topical antigens) — most people who have the more common autoimmune diseases don't have that extra limitation.

And remember that according to research statistics, a high percentage of people who fail to respond, but claim to be faithfully following a GF diet, for example, are actually eating a cross-contaminated diet on a regular basis. Most people simply don't understand the difficulty and complexity of truly adhering to an exclusion diet. So just because many have "tried and failed", doesn't mean that they truly knew what they were doing and they did it correctly. In the following quote, NRCD stands for non-responsive celiac disease.

RESULTS: One hundred and twelve consecutive patients were referred with NRCD. Twelve were found not to have celiac disease (CD). Of the remaining 100 patients, 45% were not adequately adhering to a strict gluten-free diet, with 24 (53%) found to be inadvertently ingesting gluten, and 21 (47%) admitting non-compliance. Microscopic colitis was diagnosed in 12% and small bowel bacterial overgrowth in 9%. Refractory CD was diagnosed in 9%. Three of these were diagnosed with intestinal lymphoma. After 2 years, 78 patients remained well, eight had continuing symptoms, and four had died.

CONCLUSION: In individuals with NRCD, a remediable cause can be found in 90%: with continued gluten ingestion as the leading cause. We propose an algorithm for investigation.

Celiac disease: Management of persistent symptoms in patients on a gluten-free diet

Sure the gene is triggered forever, but that doesn't mean that you can't control the symptoms and prevent the progression of the disease.

Tex

P. S. I have one concern about the study I cited above: How could 11 % of the celiac patients in this study group have been misdiagnosed with celiac disease? While it's true that doctors fail to diagnose most celiacs (for every celiac diagnosed, another 19 or 20 are missed, according to statistics), how could they possibly diagnose celiac disease when it doesn't exist?

The diagnostic criteria are very selective.

Zizzle · Post by **Zizzle** » Wed Apr 17, 2013 11:13 am

My physician did some other blood work for autoimmune diseases which came out fine. Which one's exactly are done for an autoimmune disease?

Joanne,
I don't know if there is a routine set of antibody tests rheumatologists order after an elevated ANA. I suppose they look at clinical symptoms first and decide from there. Rheumatoid Factor and Thyroid antibodies should be fairly standard, lupus-specific antibodies (there are several), celiac antibodies if you haven't tested for them, really it's kind of like looking for a needle in a haystack if there are no symptoms beyond D. Maybe that's why they've coined UCTD, it's the garbage-can "IBS" of rheumatology. Not that it's a bad thing. Better to have mild Undifferentiated autoimmunity than a fully declared disease.