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What Do Positive ANA With Nuclear Dot Pattern And Normal Liver Function Tests Indicate?

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Posted on Wed, 1 Jul 2015
Question: I had a positive ANA with multiple nuclear dot pattern but my Doctor ruled out PBC because my previous liver function tests were normal. Shouldn't she run an AMA or some further testing?
doctor
Answered by Dr. Naval Mendiratta (1 hour later)
Brief Answer:
ANa Implications

Detailed Answer:
Good evening

Thank you for writing on health care magic

Well ANA with a nuclear dot pattern can be positive in a few conditions. I would like to know why was it carried out in the first place?? Did you have any symptoms for which the test was performed??

If your liver function tests are normal and there are no complaints of fatigue/itching there wont be need to perform AMA as such.

1. I would like to know the titres of ANa positivity?

2. Why was it carried out in the first place?

3. Do you have any associated thyroid disorder?

I Would suggest you ask your doctor to do ENA profile, as it will check the multiple antibodies within the ANA and we will know if ANA is really significant( as it can be present in 7-10 % normal population also).

Do let me know these queries

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta (41 minutes later)
My titre was 1:80. I went to the doctor for a complaint of pain in many of my joints so they originally did the test to rule out rheumatoid arthritis. I was also seen recently for fatigue. I have recent digestive issues, bloating. I have had hypothyroidism for many years, also osteoporosis and low vit. d levels. I do have itching in my lower legs. I am a type 1 diabetic.

My doctor did run more lab tests after the positive ANA, but none seem to deal with PBC as far as I can tell.
The panel included: Urine ph,Actin Smooth Muscle Ab, anti-ssdna Ab Igg, ESR, Rf, Centromere Ab, XXXXXXX Ab +Rnp Ab, Sci-70 Ab, Jo-1 Ab, Sjogren Antibody Panel

All of these came back negative
doctor
Answered by Dr. Naval Mendiratta (4 hours later)
Brief Answer:
ANa Interpretation

Detailed Answer:
Good evening

Well, that s good that they have sorted out the other tests as well. Since all of them are negative, we are at least sure it is not a serious disease.

Your ANA titres are not too high and this positivity can be seen with Hypothyroidism as well. But yes do get your Vitamin D Levels corrected as vitamin D Deficiency can cause lot of fatigue and weakness.

As for AMA, if your liver function tests are good we need not worry about it too much. Even if it is positive, the doctors wont start treatment before doing Detailed evaluation of the biliary Tract( Either through MRCP/ERCP). CAuse both the antibody and the Radiological findings need to go together for anyone to consider treatment.

SO, your ANA I believe is postive through hypothyroid. Never the less, keep a watch out for symptoms like joint pains/oral ulcers/excessive hair fall/Raynauds. But dont stress your daily routine with it as well.

I hope the information was useful

Do let me know for more queries

Regards
Dr Naval
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. Chakravarthy Mazumdar
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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What Do Positive ANA With Nuclear Dot Pattern And Normal Liver Function Tests Indicate?

Brief Answer: ANa Implications Detailed Answer: Good evening Thank you for writing on health care magic Well ANA with a nuclear dot pattern can be positive in a few conditions. I would like to know why was it carried out in the first place?? Did you have any symptoms for which the test was performed?? If your liver function tests are normal and there are no complaints of fatigue/itching there wont be need to perform AMA as such. 1. I would like to know the titres of ANa positivity? 2. Why was it carried out in the first place? 3. Do you have any associated thyroid disorder? I Would suggest you ask your doctor to do ENA profile, as it will check the multiple antibodies within the ANA and we will know if ANA is really significant( as it can be present in 7-10 % normal population also). Do let me know these queries Regards Dr Naval