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Red spots that do not blanch, blood work normal, not anxiety-induced, disappears on scratching. Confused about DNA double-standed test

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
I asked this earlier but it seems to be lost in cyber space I cannot get into my account. If this is assigned to the same or different doctor I apologize for the inconvenience

I will try to make this short and sweet. Since October of last year I had little red dots on me that didnt blanch. I was nervous after what i read about petechiae so I went to the er and was told it was a rash if it doesnt go away to come back. It did not go away so I went back and they ran blood tests everything was normal, they did a basic draw up cbc,wbc so forth. ( i had 3 blood counts tested by 3 diff docs all were normal ranges)

After a while of still having these I went to my primary who was not concerned and I went to a derm. My derm said they do look like blood vessels but my situation is weird BECAUSE these dots go away within three days and if i scratch them they go away. She gave me a slip for an XXXXXXX my titer was 1:40 normal and nothing of concern. Then my primary to rest my mind did a huge amount of blood work. They took 5 vivals of blood and tested for dna double stranded...and a bunch of other stuff. All of my blood came out perfect and my doctor said im healthy and not to worry.

I am worried though. At this point if it is something just find it already because Im going crazy. This October will be a year that Ive been having these and i have no other symptoms other then this stupid anxiety its causing me ( no these are not stressed induced)

My blood work indicates nothing so im left to worry and people are starting to think im a hypochondriac. What if it is something and the doctors are missing it?

im a little confused with the dna double stranded test. the lab who ran my work has <30.0
( negative) my reading was a <12. 3 negative does this mean i have some of these antibodies in me?? and does everyone have dna antibodies double stranded in their blood. im worried now because it was a 0 it was 12.3 so i must have this presently in my blood right? dont you NOT want these in you at all?

i am a 25 female
im sorry i meant it wasnt a 0 it was 12.3 so i must have this presently in my blood right? dont you NOT want these in you at all?
Posted Wed, 23 May 2012 in X-ray, Lab tests and Scans
Answered by Dr. Hema Yadav 7 hours later
Hello ,
Thanks for posting your query.
I understand your concern and appreciate your efforts as a health conscious individual.
Usually our body or immune system produces certain proteins ( antibodies ) to attack any foreign antigens (virus, bacterial etc)like in case of infection.
When in certain illness the body produces antibodies against self antigen which are harmful to self its called autoantibodies, in autoimmune diseases like for example systemic lupus
The anti double stranded dna antibodies are autoimmune antibodies i.e antibodies which are produced against the self dna , which is usually found in SLE or other autoimmune illness.It, is rarely found in healthy people .Its not impossible for a normal person to have these antibodies but its very rare.
Also there are various laboratory techniques for their detection and each has its limitation,
depending on which the lab sets its criteria for normal range.
When the test indicates presence of anti dsdna in the blood sample it's repeated with serial dilutions of the same until the test becomes negative.Thus a titre of 1:12.3 means that at this dilution your sample didn't show any antibodies .This titre is very low and hence reported as good as normal or negative.
Now considering your entire clinical history and reports following conclusion can be drawn.
1.You are suffering from a mild petechial rash which could most probably due to a subclinical lupus or any viral or drug induced illness.Since all your investigations are within normal limits the exact diagnosis would be very difficult to confirm.
2.Since it is mild and short lasting, symptomatic treatment with oral medications would hardly be needed at present weighing the risk benefit ratio.
3.It is advisable to consult a rheumatologist or a specialist in autoimmune diseases for a second opinion and further follow up.
4.The tests may be repeated after three to six month interval to watch for rising titres and if needed clinical correlation should be done to either confirm the diagnosis or term you as absolutely healthy.
Meanwhile you should avoid sun exposure, lead a healthy lifestyle with a balanced diet and regular exercise schedule.
Please do not stress yourself and no, you are not a hypochondriac.
Believe yourself to be a vigilant health conscious individual and develop a positive attitude towards life.
As of now these lesions don't seem worrisome at all.
Hope I have answered your queries..
Wishing you good health.
Above answer was peer-reviewed by
Follow-up: Red spots that do not blanch, blood work normal, not anxiety-induced, disappears on scratching. Confused about DNA double-standed test 2 hours later
What exactly is clinical lupus? My doctor did a send out for rf factor and it was negative, so is this still worth seeing a rheumatologist?
also, if this was any kind of lupus would i have developed more symptoms by now such as fatigue? headaches and overall just feeling ill. I feel very well and I am active
Answered by Dr. Hema Yadav 6 hours later
Thanks for the follow up.
Clinical lupus or SLE) is a chronic, usually life-long, autoimmune disease characterized by unpredictable exacerbations and remissions with variable clinical manifestations.In Lupus SLE there is a high probability for clinical involvement of the joints, skin, kidney, brain, lung, heart, and gastrointestinal tract. The symptoms depend on the part involved like a skin rash, arthritis, nephritis (kidney), pneumonitis (lung) etc.
The etiology of Lupus (SLE) remains unknown. A genetic predisposition, sex hormones, and environmental trigger(s) likely result in the disordered immune response that causes production of auto antibodies against various tissues.
The main tests to diagnose lupus are XXXXXXX and anti dsdna, serum complement levels and antibodies to certain specefic antigens.Though RF test can be positive in lupus its mainly used to diagnose rheumatoid arthritis or sjogrens syndrome.Since all your tests are negative I do not think its mandatory for you to consult a rheumatologist as of now but if your symptoms persist or worsen over time and repeat testing after 6mths is sugesstive of increasing titres then you should consult a rheumatologist to be on the safer side.
Hope that answers your query.
Wishing you good health.
Above answer was peer-reviewed by
Follow-up: Red spots that do not blanch, blood work normal, not anxiety-induced, disappears on scratching. Confused about DNA double-standed test 1 hour later
Thank you for your replies. My last question would be does everyone have Anti nuclear anti bodies and anti double stranded anti bodies in their blood. And if so are the titres are important only if it exceeds a particular titre it is attributed to a specific disease?

Answered by Dr. Hema Yadav 40 minutes later
Hello ,
Thanks for the follow up.
Answer 1 .No , Anti nuclear antibodies (ANA)and Anti double stranded dna(dsdna) antibodies are not present in majority of normal people, some statistics say that it might be found in 5% of normal healthy individuals.
Answer 2. XXXXXXX and Antidsdna are more specefic for the disease systemic lupus erythematosis (SLE) however they can be present in other autoimmune disorders like mixed connective tissue disorders, rheumatoid arthritis,etc.There is no clear cut off regarding the titres and their correlation to specefic disease.However the titres and the clinical presentation are correlated before commenting on the diagnosis XXXXXXX titres are more sensitive whereas Antidsdna titres are more specefic for SLE mostly seen in about 70%_80% of those having SLE.
The numerical value of the titre alone is not diagnostic however rising titres indicate more chance of disease progression .
Hope that answers your query.
Above answer was peer-reviewed by
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