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What does ANA titer indicate?

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General & Family Physician
Practicing since : 2010
Answered : 157 Questions
My Blood test results ALT 59, XXXXXXX Screen IFA Positive: XXXXXXX Pattern Homogenous XXXXXXX TITER 1:40
Chronic fatigue+ Illness
What do you think?

Female, 55, 210 lbs.
Posted Sat, 28 Apr 2012 in Lupus
Answered by Dr. Sunil.N 2 hours later
Hi ,

Thanks for your query.
XXXXXXX titer of 1:40 is Negative . Usually a titer of >1:80 is considered Positive.
XXXXXXX screen IFA Positive and the pattern is Homogenous which suggest the possibilty of SLE, but it can be present in normal individuals also .
So now the Diagnosis is depended on the clinical features like :

1)Skin: Butterfly rash across the cheeks; ulcers in the mouth; hair loss.
2)Joints: Pain; redness, swelling.
3)Kidney: Abnormal urinalysis suggesting kidney disease.
4)Lining membranes: Pleurisy (inflammation of the lining of the lung); Pericarditis (inflammation of the heart lining); and/or peritonitis (inflammation around the abdomen). Taken together, these types of inflammation are known as polyserositis.
5)Blood: Hemolytic anemia (the red cells are destroyed by autoantibodies); leukopenia (low white blood cell count); thrombocytopenia (low number of platelets).
6)Lungs: Infiltrates (shadowy areas seen on a chest x-ray) that come and go
7)Nervous system: Convulsions (seizures); psychosis; nerve abnormalities that cause strange sensations or alter muscular control or strength.

If you had any of the features as part of your illness then there is a possibility of SLE is suspected. Otherwise there is no significance to the positive test.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Above answer was peer-reviewed by
Follow-up: What does ANA titer indicate? 11 hours later
Dear Doctor,

Thank you for your opinion.

Many of the aforementioned conditions have existed, and continue to exist over the last five years.

I thought I had Chronic Fatigue Immune Disorder, or Lupus, one of my doctors suspected Fibromyalgia, but of course these are problematic to prove definitively.
I did have elevated Epstien Barr (2000) factor on one of my tests.

I am sick and in pain almost almost all of the time with moments of wellness here and there;I have had to stop working almost completely--(I used to have tremendous energy and stength and used to work two jobs) and can only manage priorities, and a couple of hours of consulting a week.

If I work one day, I generally have to spend the next day in bed to recover.
Not much of a life, really.

I was hospitalized four times in 2010--MRSA, Pneumonia,anxiety attack, which we thought might have been a heart attack at the time.

If it is Lupus, what are typical protocols for treatment,+ how effective are they.

Is the best person to see a Rheumetologist, or do you suggest a different specialist,
Answered by Dr. Sunil.N 5 hours later
Hi Again ,

Thanks for following me up.

There is no permanent cure for SLE. The goal of treatment is to relieve symptoms and protect organs by decreasing inflammation and/or the level of autoimmune activity in the body. The precise treatment is decided on an individual basis. Many people with mild symptoms may need no treatment or only intermittent courses of anti-inflammatory medications. Those with more serious illness involving damage to XXXXXXX organ(s) may require high doses of corticosteroids in combination with other medications that suppress the body's immune system.

People with SLE need more rest during periods of active disease. Researchers have reported that poor sleep quality was a significant factor in developing fatigue in people with SLE.

The Drugs available are :

1. NSAIDS(Non Steroidal Antiinflammatory Drugs) are helpful in reducing inflammation and pain in muscles, joints, and other tissues. Examples of NSAIDs include aspirin, ibuprofen (Motrin), naproxen (Naprosyn)

2. Hydroxychloroquine(Plaquenil) is an antimalarial medication found to be particularly effective for SLE people with fatigue, skin involvement, and joint disease. Consistently taking Plaquenil can prevent flare-ups of lupus.

3. Medications that suppress immunity (immunosuppressive medications) are also called cytotoxic drugs. Immunosuppressive medications are used for treating people with more severe manifestations of SLE, such as damage to XXXXXXX organ(s). Examples of immunosuppressive medications include methotrexate (Rheumatrex, Trexall), azathioprine (Imuran), cyclophosphamide (Cytoxan). All immunosuppressive medications can seriously depress blood-cell counts and increase risks of infection and bleeding.

4. In recent years, mycophenolate mofetil (CellCept) has been used as an effective medication for lupus, particularly when it is associated with kidney disease. CellCept has been helpful in reversing active lupus kidney disease (lupus renal disease) and in maintaining remission after it is established. Its lower side-effect profile has advantage over traditional immune-suppression medications.

5. Most recent research is indicating benefits of rituximab (Rituxan) in treating lupus. Rituximab is an intravenously infused antibody that suppresses a particular white blood cell, the B cell, by decreasing their number in the circulation. B cells have been found to play a central role in lupus activity, and when they are suppressed, the disease tends toward remission. This may particularly helpful for people with kidney disease.

As I said earlier the treatment is individualized based on the symptoms and the severity.

You can consult a Rheumatologist who have experience in treating lupus cases and follow his advice.

Hope this helps you.

Wish you speedy recovery.

Above answer was peer-reviewed by
Follow-up: What does ANA titer indicate? 2 days later
Thank you for your response Doctor. I have more concrete information from you in this brief interaction, than I have had from my primary care doctor in the past six years.

I will see a rheumatologist soon.

Is the presence of Lupus considered a disability? I find that between the osteoarthritis and the illness, weakness and fatique, the asthma, the migraines, and most recently a car accident involving concussion, neck and back sprain,
that it is unrealistic to attempt to continue my career, and was considering applying for disability.

My family doctor has issued me the handicap status for driving (disabled parking) etc for the osteoarthritus... but until there were any blood markers, I have been reticent to apply without the posibility of a formal diagnosis.

The head trauma from the accident has caused me to be forgetful, disoriented, confused, and makes it dificult to do the precise work--(designer and Professor) that I am trained to do. (I have a history of multiple head injuries).

Thank you for your kind efforts on my behalf
Answered by Dr. Sunil.N 17 hours later

Good to hear from you again.

Lupus can be considered a disability if it is presented with skeletal abnormalities or if it causes restriction in your daily routine activities and if unable to earn a living. It would be certified by Rheumatologist after examination. Please discuss about this with the Rheumatologist on your appointment.

Hope this helps you,

Wish you a good health.


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