What Does This Positive ANA Test Report Indicate?

Posted on Tue, 7 Jun 2016

Question: Hi,
I received some blood tests results that may indicate an autoimmune disease. The ANA blood test came back positive and indicated that it was homogeneous and nucleolar. What does the mixed pattern mean?

Answered by Dr. Naval Mendiratta (2 hours later)

Brief Answer:
ANa positivity

Detailed Answer:
Good evening

thank you for writing on health care magic

Well, ANa does indicate some form of autoimmune disease going on, but then again it can be falsely positive in a lot of diseases. So it is important for us to know, why was it carried out in the first place. Like what symptoms did you have for the doctor to advise ANA???

2. ANA has many patterns, which do point towards an autoimmune disease...Like Lupus has a specific pattern, Scleroderma another. So mixed is an observation that some different patterns are seen. But more specific is ENA profile, which checks further subsets of ANA, like the antibodies which can be positive beyond ANA. I am not sure if they performed ENA for you

3. I would like to know why are being given steroids.??

If you could attach the ANa report, it would be helpful.

Do let me know these queries. Would help you sort out

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Naval Mendiratta (12 hours later)

Hi,
Thanks for responding. In relation to the questions asked, I can advise the following:

I was tested as I have had quite severe joint pain in my legs and wrist, as well as fatigue and a rash on my face?

No ENA has been carried out, but a dsdna was undertaken, which came back negative. Although it it noted that I was on Steriods when these tests were carried out. I was on the Steriods for the wrist pain. It is noted that whilst on Steriods, the joint pain and rash improved and has returned upon ceasing the Steriods.

I don't have a copy of the results, but my go advised that the and was positive, but only low 1:80), but indicated that the Steriods may have also impacted on the test. Additionally the results indicated the mixed pattern as outlined above?

Thanks in advance

Answered by Dr. Naval Mendiratta (13 hours later)

Brief Answer:
Autoimmune disease

Detailed Answer:
Good evening

Well, it does seem like you are having an autoimmune disease, probably a connective tissue variant...TO label which one, we need an ENA profile. ENA profile will help determine which sort of disease you have and which are the organs to watch out for in the future.

Steroids normally dont impact the ANA value. This antibody will stay life long. So we normally dont monitor this.

I would suggest you get the following tests done if it hasnt been carried out:

1. ENA profile
2. Complement C3, C4
3. Urine routine
4. Coombs test( direct and indirect)

As for the treatment, you need to start on Hydroxychloroquine as well...Steroids should be tapered off in due course of time to minimum possible needed. ( Although examination would be superior), but since you have symptoms of CTD with a good response to steroids, it goes more in favor of autoimmune disease itself.

I hope your family is complete, as the medicines and the disease can interfere in the long run

Hope the information was useful

Do let me know for more queries

Regards
Dr Naval

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar