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What Does A Positive RNP Test Mean?

Posted on Fri, 8 Sep 2017

Question: Hello,
Thank you for reading. I could really use some insight. My husband has seen a hematologist, immunologist, and gastroenterologist. I think we have more questions than answers. This started back in November 2016 when he went to the hospital for chest pain. It turned out to be his gallbladder and his heart was in good health. However, when the gastroenterologist ran a CBC a few times, he noticed that my husband has mild low platelets (now 96k).

The hematologist has been monitoring him since, but my husband requires no treatment. All other blood work came back normal except for IgE which was high (116). We went to go see an immunologist who was not concerned as his IgE was not that high and IgG, IgM, and IgA was normal in his last blood work in April. She decided to just run some blood work and re-ran anti-M2 antibody and ANA with reflex. The M2 antibody tested positive in November 2016, but has been negative in March and now July, 2017.

However, now he is ANA-Direct positive. Note: in November 2016 this was negative. This was not an IFA version of the ANA so I do not know the titer level or the pattern.

The only specific ANA-related antibodies to test high was RNP (>8 when the normal range is 0.0-0.9). However, XXXXXXX has no symptoms of Mixed Connective Tissue Disorder or even ITP (thank God). No rash, no joint pain, no unusual fatigue, no petechiae, no bleeding.

The immunologist that ordered the test is out of town. What do these results mean? Does he have to go see a rheumatologist? Could the ANA and RNP go back to negative if my husband was tested again like the M2 antibody did? Do these results really mean anything without symptoms?

Thank you.

Best,
XXXX

Answered by Dr. Divya Agarwal (13 hours later)

Brief Answer:
Yes not much to worry about

Detailed Answer:
hi
yes it is possible.
I agree that there are a number of antibodies which are positive,h however if there are no symptoms there isn't anything to worry about.
the disease needs to be treated and not the blood reports.
I suggest not to repeat the antibodies unnecessarily . do them only if there are symptoms.
regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Divya Agarwal (8 hours later)

Does the presence of these anti-bodies suggest anything? Is he more likely to develop MCTD or Lupus later on? Or is he no more likely than anyone else?

Is there anyway for him to calm down his auto-immune system as it seems it's reacting to something? Thanks again.

Answered by Dr. Divya Agarwal (3 minutes later)

Brief Answer:
More like mctd

Detailed Answer:
it definitely puts him at a higher risk.
however it is the same as everyone else.
exercise have a balanced diet avoid smoking and alcohol.
keep vitamin d and calcium levels good.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Divya Agarwal (3 minutes later)

Can you clarify? It puts him at higher risk but then you said "however it is the same as everyone else"?

Thank you

Answered by Dr. Divya Agarwal (30 minutes later)

Brief Answer:
No the risk is higher

Detailed Answer:
Hi i meant the precautions for a healthy life like everyone else.
However the risk of disease is higher

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Divya Agarwal (1 hour later)

I see. Thank you for clarifying.

But it's not guaranteed that he will develop MTCD? He may go on and never develop symptoms?

How much higher is the risk?

Answered by Dr. Divya Agarwal (3 minutes later)

Brief Answer:
Yes he may never develop it

Detailed Answer:
Yes, he may never develop it.

It's difficult to quantify the risk however since it's been years since these antibodies are positive. Even if he develops it may be very mild.

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. Arnab Banerjee