18 years
Thank you for your help.. I have ANA positive so an internal doctor subscribed me plaquenil(400mg per day) but my endo doctor didn't advise me to take it because she said it will damage my eyes..
Aug 13, 2014
The immune system manufactures several proteins called antibodies which are made in our white blood cells. Their main function is to recognize and fight infectious organisms. At times, the immune system gets confused and identifies normal, naturally-occurring proteins in our bodies as being "foreign" and dangerous. The antibodies that target “normal” proteins within the nucleus of a cell are called antinuclear antibodies (ANA). ANAs could trigger the body to begin attacking itself which can lead to autoimmune diseases, including lupus, scleroderma, and others.
A positive ANA test means that there are autoantibodies in our system. But a positive ANA test alone does not necessarily translate into the presence of an autoimmune disease or the need for therapy, because:
• Between 3 &15% of healthy individuals, some of them with a viral infection (for a short period of time), can have circulating ANA in their bloodstream. The production of these autoantibodies is strongly age-dependent, and increases to 10-37% in healthy persons over the age of 65.
• Some medications can cause a positive ANA.
The ANA test may simply be a “false positive” ANA, which means that the evidence is not there to make a diagnosis of lupus or any other autoimmune disease. To make a definite diagnosis, this should be based on the history of your symptoms, a thorough physical exam, eliciting a good family history, and more blood tests.
The majority of individuals (more than 95% of individuals) with lupus will test positive, so a negative ANA test can be helpful in excluding that diagnosis. Keep in mind though that only about 11-13% of persons with a positive ANA test have lupus and up to 15% of completely healthy people have a positive ANA test. Thus a positive ANA test does not automatically lead to the firm conclusion that you have lupus or any autoimmune or connective tissue disease.
Unless you have joint symptoms (redness, swelling, pain, morning stiffness that needs 30 min to resolve and that gets better with movement throughout the day), oral ulcers, other skin manifestations (like facial red skin rash, round rash, or rash on sun exposed skin areas), skin tightening, dental problems, a strong family history of rheumatologic diseases, ANA alone is not enough to make the diagnosis of lupus, as it could be lupus, or another condition called scleroderma. In order to confirm the diagnosis you need to run more tests (again, if and only if you have the symptoms I have mentioned above):
- Lupus: This commonly includes evaluation of antibodies to dsDNA, complement, and ANA subtypes such as Sm, SSA, SSB, and ribonucleoprotein (RNP) (often called the ENA panel), as well as screening anticardiolipin antibodies, lupus anticoagulant, and +/- beta-2 glycoprotein antibodies.
- Scleroderma: Anti-RNA polymerase III, anti-topoisomerase I (also called anti-DNA topo 1) and anti-centromere antibodies (ACA)
Treatment should be decided according to the final diagnosis. If your doctor chooses to give you colchicine, you should know that it does have harmful effects on the retina and that’s why you should have your eyes checked up every 6 months, and do liver enzyme levels frequently. All drugs have adverse effects, but as long as the benefit of a drug is more substantial than the harm, there is no reason why you should not receive treatment.
A positive ANA test means that there are autoantibodies in our system. But a positive ANA test alone does not necessarily translate into the presence of an autoimmune disease or the need for therapy, because:
• Between 3 &15% of healthy individuals, some of them with a viral infection (for a short period of time), can have circulating ANA in their bloodstream. The production of these autoantibodies is strongly age-dependent, and increases to 10-37% in healthy persons over the age of 65.
• Some medications can cause a positive ANA.
The ANA test may simply be a “false positive” ANA, which means that the evidence is not there to make a diagnosis of lupus or any other autoimmune disease. To make a definite diagnosis, this should be based on the history of your symptoms, a thorough physical exam, eliciting a good family history, and more blood tests.
The majority of individuals (more than 95% of individuals) with lupus will test positive, so a negative ANA test can be helpful in excluding that diagnosis. Keep in mind though that only about 11-13% of persons with a positive ANA test have lupus and up to 15% of completely healthy people have a positive ANA test. Thus a positive ANA test does not automatically lead to the firm conclusion that you have lupus or any autoimmune or connective tissue disease.
Unless you have joint symptoms (redness, swelling, pain, morning stiffness that needs 30 min to resolve and that gets better with movement throughout the day), oral ulcers, other skin manifestations (like facial red skin rash, round rash, or rash on sun exposed skin areas), skin tightening, dental problems, a strong family history of rheumatologic diseases, ANA alone is not enough to make the diagnosis of lupus, as it could be lupus, or another condition called scleroderma. In order to confirm the diagnosis you need to run more tests (again, if and only if you have the symptoms I have mentioned above):
- Lupus: This commonly includes evaluation of antibodies to dsDNA, complement, and ANA subtypes such as Sm, SSA, SSB, and ribonucleoprotein (RNP) (often called the ENA panel), as well as screening anticardiolipin antibodies, lupus anticoagulant, and +/- beta-2 glycoprotein antibodies.
- Scleroderma: Anti-RNA polymerase III, anti-topoisomerase I (also called anti-DNA topo 1) and anti-centromere antibodies (ACA)
Treatment should be decided according to the final diagnosis. If your doctor chooses to give you colchicine, you should know that it does have harmful effects on the retina and that’s why you should have your eyes checked up every 6 months, and do liver enzyme levels frequently. All drugs have adverse effects, but as long as the benefit of a drug is more substantial than the harm, there is no reason why you should not receive treatment.
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