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What do my blood test results indicate?

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Posted on Mon, 16 May 2016
Question: Hi, I have a question about my daughters blood work. She has an app with a Rheumatologist next week. Her ANA is positive with a titer of 1:640, Scl-70 Abs,EIA is 3.5 and Anti-SSB is 7.4. She had blood work the first week of Dec and it showed the same thing. She hasn't been feeling good since the first week of Dec. Her right side close to the bottom of her ribs and to the side hurts all the time. She has lost 12 pounds also since the first week of Dec. She can't hardly eat because she feels sick when she does. She had her gallbladder out the first week of January because they thought that might be the problem but she feels the same as she did before. She also hurts around her breast bone and it hurts just to touch that area. When she takes a shower her legs turn blotchy with purple and her knees will be orange and feet bright red. Her knee hurts all the time too. We went to a Dr 2 weeks ago and he acted like it was all in her head. I really don't think it is because other then what is going on she is very happy 16 year old. When the Dr. did that she said to me mom I really honestly don't feel good and the Dr. didn't believe me. I was just wondering if any of this could fall under an autoimmune disease. It also said that the ANA had a atypical pattern. Thanks
doctor
Answered by Dr. Naval Mendiratta (45 minutes later)
Brief Answer:
Is it connective tisssue disease

Detailed Answer:
Good evening

Thank you for writing on health care magic

Well, her ANA is very strongly positive. I am not sure about the cut off range for Scl 70 and SSB...But if you could attach the report it would be helpful...

Her not feeling well, with weight loss can all be due to ANA..But somewhere symptoms are not fitting into the disease, maybe that s why your GP didnt believe you. But usually when a disease begins, it presents with vague symptoms rather than specific ones..

I would like to know a few more details before guiding you further:

1. Does she have any oral ulcers or dryness of mouth?/

2. Has her hair fall increased recently?

3. ANy rashes on the face/legs/back/abdomen?

4. THe purple color change, does it happen on exposure to cold also or just water?

5. ANy cough or difficulty in breathing?? Does the side of her ribs hurt when she takes a deep breath?

6. Why was her ANA and ENA carried out...??What about the other blood reports like CBC, LFT, ESR...ARe they within normal range??

7. Any swelling in the knee joints apart from pain?Or any other joints?

8. Does she have lot of acidity/reflux on eating??

Do let me know these queries. Would give me some idea where we are heading and I will be able to guide you better

REgards
Dr Naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Naval Mendiratta (46 minutes later)
She has had a couple of sores in her mouth the last couple of weeks. Her legs change colors mostly when she showers. Sometimes when she is out in the sun the will get orange blotches and everybody will ask what is wrong with them. I haven't noticed any rashes. Her side hurts about anytime. It hurts when she touches it and and when she is just standing. She has said her chest hurts when she is breathing and and it feels cold. I'm not really sure why they checked her ANA out back in December. I'm not sure about the other blood reports I couldn't find that on her report. When she was around 3 her right hip bother her and she limped some. We took her to the Dr. and they said it was just growing pains. This past summer her hip on her right side bothered her a lot and she did physical therapy for it. Her right knee bothers her a lot even when she isn't moving. She doesn't have a lot of reflux when eating. She says she feels nauseas a lot and sometimes after she is laying down she's says her legs tingle and will get headaches.
doctor
Answered by Dr. Naval Mendiratta (14 hours later)
Brief Answer:
Autoimmune disease

Detailed Answer:
Good evening

Sorry for the late reply..Was occupied somewhere

Well pertaining to the history, it does feel like some autoimmune process is going on. I am only wondering why did they carry out ANA and ENA in the first place..and if it was positive, why wasnt it followed up earlier.

To summarize:

1. Oral ulcers
2. Photosensitivity: Rashes on sun exposure
3. Chest pain: I would like to get an X ray done to see if there is any fluid or is it just some inflammation
4. Knee pain: Not sure about the swelling

Well, it looks as if it is going towards an autoimmune disease. At this stage, I would label it as undifferentiated as few features and antibodies are present, but does not fit into any particular disease. Never the less, indication for starting treatment is needed. I would also like to see her other reports:( either you can get a fresh set done or track the older ones...

1. CBC
2. Liver function tests
3. Renal function tests
4. Urine routine
5. ESR, CRP
6. Complement C3 and c4
7. X ray chest

maybe you can get these done before you see the rheumatologist , so it will help narrow down the diagnosis earlier rather than wait for the results later on again

Hope the information was useful

PS: If you could take the snaps of the rashes on sun exposure, it would be helpful as well

Do let me know for more queries

REgards
Dr Naval
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Naval Mendiratta (20 hours later)
Her C3- 113
C4-21
The Dr. that did her blood work 2 weeks ago basically said I will do it again just to do it. He said that there was other blood work he could do but didn't see any use in it.
When they called about it they said they wanted to see her again. They made her rheumatologist app back in Dec with a pediatric rheumatologist. It just took a long time to get an appointment.

Her blood work in Dec was
SCl 70- 3.4
Centromere B Autoantibody 1.7
SSb(LA) 6.7

Does it make a difference that SSB went from 6.7 to 7.4 since Dec?

doctor
Answered by Dr. Naval Mendiratta (3 hours later)
Brief Answer:
Evolving disease

Detailed Answer:
Good evening

Well, complements look normal. So one way it is a good sign. The only significance of SSB increasing, is probably pointing that the disease is evolving. All these antibodies do change their titre and course of action during time and if not stopped, one may find many other auto antibodies to appear

But as such, she doesnt have any symptoms related to SCL 70.

I think they do think something is suspicious and want to keep a close watch on her, which is a good thing

When is your appointment with rheumatologist?? You can consult your GP and ask him if he s ok in starting hydrocychloroquine. It is a safe drug and can be started till you see the doctor

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

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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What do my blood test results indicate?

Brief Answer: Is it connective tisssue disease Detailed Answer: Good evening Thank you for writing on health care magic Well, her ANA is very strongly positive. I am not sure about the cut off range for Scl 70 and SSB...But if you could attach the report it would be helpful... Her not feeling well, with weight loss can all be due to ANA..But somewhere symptoms are not fitting into the disease, maybe that s why your GP didnt believe you. But usually when a disease begins, it presents with vague symptoms rather than specific ones.. I would like to know a few more details before guiding you further: 1. Does she have any oral ulcers or dryness of mouth?/ 2. Has her hair fall increased recently? 3. ANy rashes on the face/legs/back/abdomen? 4. THe purple color change, does it happen on exposure to cold also or just water? 5. ANy cough or difficulty in breathing?? Does the side of her ribs hurt when she takes a deep breath? 6. Why was her ANA and ENA carried out...??What about the other blood reports like CBC, LFT, ESR...ARe they within normal range?? 7. Any swelling in the knee joints apart from pain?Or any other joints? 8. Does she have lot of acidity/reflux on eating?? Do let me know these queries. Would give me some idea where we are heading and I will be able to guide you better REgards Dr Naval