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On 9/15/2019 I Tested Positive For Ana, Ssa/ssb Antibodies With

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Posted on Thu, 13 Aug 2020
Question: On 9/15/2019 i tested positive for ana, ssa/ssb antibodies with a level of 8.0 which i think is the highest the test goes up too. Everything else was negative. Fast forward to 6/11/2020 i still tested positive for ssa/ssb at the same 8.0 level, but my ANA was negative.

-Does higher ssa/ssb levels indicate higher disease activity?
-What is the highest ssa/ssb levels can go? What test could give me a definitive number?
-Why would my ANA result change to negative when everything else has stayed the same?
-Does testing positive for ANA in the begining increase the chances i could have lupus or could i still have a positive ANA with primary sjogrens? All other lupus markers were negative so im trying to see if my blood work points more to lupus or sjogrens.

With my ANA Changing to negative i am more confused than ever.I have mild eye dryness but other than that no symptoms at the moment.I am attaching some labs. Thank you

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Follow up: Dr. Divya Agarwal (0 minute later)
On 9/15/2019 i tested positive for ana, ssa/ssb antibodies with a level of 8.0 which i think is the highest the test goes up too. Everything else was negative. Fast forward to 6/11/2020 i still tested positive for ssa/ssb at the same 8.0 level, but my ANA was negative.

-Does higher ssa/ssb levels indicate higher disease activity?
-What is the highest ssa/ssb levels can go? What test could give me a definitive number?
-Why would my ANA result change to negative when everything else has stayed the same?
-Does testing positive for ANA in the begining increase the chances i could have lupus or could i still have a positive ANA with primary sjogrens? All other lupus markers were negative so im trying to see if my blood work points more to lupus or sjogrens.

With my ANA Changing to negative i am more confused than ever.I have mild eye dryness but other than that no symptoms at the moment.I am attaching some labs. Thank you

doctor
Answered by Dr. Divya Agarwal (3 hours later)
Brief Answer:
see below

Detailed Answer:
hi
yes the levels of SSA/SSB in your case are very high.sometimes high antibodies may be present years before you get the actual disease and sometimes you may never get the disease.
ANA is sometimes negative by IFA in people with positive SSA/SSB, as these are cytoplasmic antibodies.
so I dont think the ANA is of any consequence the antibodies are probably similar to what they were in 2019.
a definitive number for SSA depends on the method used by the lab, however it is not required, what we know is that the test is strongly positive that itself is significant.
your markers give an indication that this is primary sjogrens, not lupus.
I dont think these tests need to be repeated again and again, maybe the SSA/SSB can be repeated to confirm the previous reports.
hope that helps.
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Divya Agarwal (0 minute later)
Brief Answer:
see below

Detailed Answer:
hi
yes the levels of SSA/SSB in your case are very high.sometimes high antibodies may be present years before you get the actual disease and sometimes you may never get the disease.
ANA is sometimes negative by IFA in people with positive SSA/SSB, as these are cytoplasmic antibodies.
so I dont think the ANA is of any consequence the antibodies are probably similar to what they were in 2019.
a definitive number for SSA depends on the method used by the lab, however it is not required, what we know is that the test is strongly positive that itself is significant.
your markers give an indication that this is primary sjogrens, not lupus.
I dont think these tests need to be repeated again and again, maybe the SSA/SSB can be repeated to confirm the previous reports.
hope that helps.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Divya Agarwal (9 hours later)
I've read that its a little unusual to have your ANA switch from positive to negative or vice versa especially in a short time like in mine. So what do you think mine switching from positive to negative could mean?

-I read somewhere that people that test positive for ssa/ssb usually have a more serious disease course. Is this accurate?

-My amylase levels have been elevated for the past year. Last reading was 137. (Test range is 31-125). My lipase is normal at 42. (Test range 12-72) Rheumatologist attributes my elevated amylase levels to sjogrens stating that it could be my glands causing this. Is this accurate? I had a primary sjogrens panel that showed no involvement at the moment so im wondering if this is a legitimate explanation.

-What other tests should i look into to see why my amylase levels are high? Ive had a colonoscopy, endoscopy and endoscopic ultrasound for abdominal pain i had and all the tests came back clean.
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Follow up: Dr. Divya Agarwal (0 minute later)
I've read that its a little unusual to have your ANA switch from positive to negative or vice versa especially in a short time like in mine. So what do you think mine switching from positive to negative could mean?

-I read somewhere that people that test positive for ssa/ssb usually have a more serious disease course. Is this accurate?

-My amylase levels have been elevated for the past year. Last reading was 137. (Test range is 31-125). My lipase is normal at 42. (Test range 12-72) Rheumatologist attributes my elevated amylase levels to sjogrens stating that it could be my glands causing this. Is this accurate? I had a primary sjogrens panel that showed no involvement at the moment so im wondering if this is a legitimate explanation.

-What other tests should i look into to see why my amylase levels are high? Ive had a colonoscopy, endoscopy and endoscopic ultrasound for abdominal pain i had and all the tests came back clean.
doctor
Answered by Dr. Divya Agarwal (1 hour later)
Brief Answer:
see below

Detailed Answer:
hi
the variation in the ANA could also be related to the method by which the test was done, the difference in lab can also make a difference.
A positive SSA/SSB is associated with particular patterns of disease, not necessarily the severity of the disease.
In your case, since there are no major symptoms, it may not be relevant.
I think we should conduct tests only if there is some clinical indication, not on the basis of an elevated amylase.
The confirmation to the diagnosis can be done by getting a minor salivary gland biopsy/isotope scans are available for the salivary glands, however, the gold standard is a biopsy to look for inflammation.
regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Divya Agarwal (0 minute later)
Brief Answer:
see below

Detailed Answer:
hi
the variation in the ANA could also be related to the method by which the test was done, the difference in lab can also make a difference.
A positive SSA/SSB is associated with particular patterns of disease, not necessarily the severity of the disease.
In your case, since there are no major symptoms, it may not be relevant.
I think we should conduct tests only if there is some clinical indication, not on the basis of an elevated amylase.
The confirmation to the diagnosis can be done by getting a minor salivary gland biopsy/isotope scans are available for the salivary glands, however, the gold standard is a biopsy to look for inflammation.
regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Divya Agarwal (3 hours later)
-What are the particular patterns positive ssa/ssb are typical off?

-I did read somewhere that antibodies can show up years before actual symptoms as you mentioned. When you mentioned there are cases in which people never develop full on disease, how common is this?

-I take a multi vitamin, tumeric, fish oil daily and vitamin d once a week. Is there any other supplements you would recommend that can help an autoimmune condition?


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Follow up: Dr. Divya Agarwal (0 minute later)
-What are the particular patterns positive ssa/ssb are typical off?

-I did read somewhere that antibodies can show up years before actual symptoms as you mentioned. When you mentioned there are cases in which people never develop full on disease, how common is this?

-I take a multi vitamin, tumeric, fish oil daily and vitamin d once a week. Is there any other supplements you would recommend that can help an autoimmune condition?


doctor
Answered by Dr. Divya Agarwal (6 hours later)
Brief Answer:
see below

Detailed Answer:
hi
by patterns I mean, these are the commonest antibodies in sjogrens.
In lupus patients these antibodies are associated with skin disease, low blood cell counts, rashes etc.
it is common for people never to develop major symptoms , the larger the time gap between detection of antibodies and mild symptoms ,the greater the likelihood that the disease does not run a severe course.
these supplements seem fine, there may be contradictory views on the benefit of hydroxychloroquine , which is a drug commonly prescribed for lupus/sjogrens.
it is mild and relatively safe.so that can only be prescribed if your doctor feels so.
regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Divya Agarwal (0 minute later)
Brief Answer:
see below

Detailed Answer:
hi
by patterns I mean, these are the commonest antibodies in sjogrens.
In lupus patients these antibodies are associated with skin disease, low blood cell counts, rashes etc.
it is common for people never to develop major symptoms , the larger the time gap between detection of antibodies and mild symptoms ,the greater the likelihood that the disease does not run a severe course.
these supplements seem fine, there may be contradictory views on the benefit of hydroxychloroquine , which is a drug commonly prescribed for lupus/sjogrens.
it is mild and relatively safe.so that can only be prescribed if your doctor feels so.
regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Divya Agarwal (6 hours later)
Some people argue that starting hydroxychloroquine early even without symptoms is better as it could help delay any issues that might arise. What would you recommend for someone in my situation with only mild symptoms at the moment?

Thank you.
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Follow up: Dr. Divya Agarwal (0 minute later)
Some people argue that starting hydroxychloroquine early even without symptoms is better as it could help delay any issues that might arise. What would you recommend for someone in my situation with only mild symptoms at the moment?

Thank you.
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Follow up: Dr. Divya Agarwal (3 minutes later)
In regards to starting hydroxychloroquine early or not.
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Follow up: Dr. Divya Agarwal (0 minute later)
In regards to starting hydroxychloroquine early or not.
doctor
Answered by Dr. Divya Agarwal (27 minutes later)
Brief Answer:
SEE BELOW

Detailed Answer:
hi,
I would probably hold on for the time being, your symptoms being mild, however eye drops for eye dryness , tear supplements and cyclosporine in case the ophthalmologist suggests may be started.
regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Divya Agarwal (0 minute later)
Brief Answer:
SEE BELOW

Detailed Answer:
hi,
I would probably hold on for the time being, your symptoms being mild, however eye drops for eye dryness , tear supplements and cyclosporine in case the ophthalmologist suggests may be started.
regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Divya Agarwal (7 hours later)
Thank you very much for your time and advice doctor. It’s greatly appreciated. Regards.
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Follow up: Dr. Divya Agarwal (0 minute later)
Thank you very much for your time and advice doctor. It’s greatly appreciated. Regards.
doctor
Answered by Dr. Divya Agarwal (9 hours later)
Brief Answer:
see below

Detailed Answer:
thanks I hope I have answered you queries.
regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Divya Agarwal (0 minute later)
Brief Answer:
see below

Detailed Answer:
thanks I hope I have answered you queries.
regards
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
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Dr. Divya Agarwal

Rheumatologist

Practicing since :1999

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On 9/15/2019 I Tested Positive For Ana, Ssa/ssb Antibodies With

On 9/15/2019 i tested positive for ana, ssa/ssb antibodies with a level of 8.0 which i think is the highest the test goes up too. Everything else was negative. Fast forward to 6/11/2020 i still tested positive for ssa/ssb at the same 8.0 level, but my ANA was negative. -Does higher ssa/ssb levels indicate higher disease activity? -What is the highest ssa/ssb levels can go? What test could give me a definitive number? -Why would my ANA result change to negative when everything else has stayed the same? -Does testing positive for ANA in the begining increase the chances i could have lupus or could i still have a positive ANA with primary sjogrens? All other lupus markers were negative so im trying to see if my blood work points more to lupus or sjogrens. With my ANA Changing to negative i am more confused than ever.I have mild eye dryness but other than that no symptoms at the moment.I am attaching some labs. Thank you