Positive ANA

My ANA test has come back positive. The titer is 1:40 (low) with a speckled pattern. The anti-centromere, anti-scl 70, anti-sm, anti-rnp, anti-ro, anti-la, anti-ds dna, C3 and C4 compliments and RPR all came back negative/within normal limits. In addition, my sed. rate is borderline high at 20 and my CRP is elevated at 1.9.

My follow-up with the rheumy is not until March 29th. Since I have other symptoms, I am guessing this is not a false positive, but you never know. The last ANA I did was negative and my CRP was lower. Could that suggest I'm in the early stage of whatever it is I have? (sclero or mctd or something else) Maybe the titer/levels will continue to rise? Has anyone else had a similar situation when diagnosed?

And now the waiting continues..... I'm very curious to see what the doc says about all of it.


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Bump to see if anyone has had a similar situation..... :-)

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I think you may be right. A normal titer is 1:32, so 1:40 isn't much. Additionally, I've never seen one that is more than 32 but less than 64.

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Hi Spudnic,

I didn't have the same issue but thought this might help you, it's from an article in the Rheumatologist:

"The combination of low titers of antibody (<1:80) and no or few signs or symptoms of disease portends a much smaller likelihood of an autoimmune disease. As a result, these patients with low ANA titers need to be reevaluated less frequently—yearly unless clinical symptoms evolve to suggest an autoimmune disease."

Complete article for reference:
http://www.the-rheumatologist.org/details/article/873239/Know_Your_Labs.htm l

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I'm not sure what you mean. I thought that ANA titers are negative if no autoantibodies were found in dilution and positive in a dilution starting at 1:40. Since the amount of dilution fluid is doubled the titers increase from 1:40 to 1:80 to 1:160 to 1:320 to 1:640 and so on. I've seen many people on inspire with ANA titers in the thousands.

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Topaz- you are right about low titers and no symptoms. If I only had a low positive ANA I would not be very concerned. But I do have Raynauds, joint pain, reflux, abnormal nailfolds and possibly telangiectasia (they are tiny little spots that the rheumy did not think were t-spots. I disagree).

I have read that many people here fluctuate between positive and negative ANAs. I'm curious how many people were diagnosed early with a low ANA that went higher the more the disease progressed.

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You are correct in that it increases by doubling. Regarding 1:40 being considered positive that depends upon the lab.

A titer is determined by repeating the positive test with serial dilutions until the test yields a negative result. The last dilution which yields a positive result (fluorescence) is the titer which gets reported. For example, if a titer performed for a positive ANA test is:
1:10 positive
1:20 positive
1:40 positive
1:80 positive
1:160 positive
1:320 negative

1:160 would be the positive ANA titer here.

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Sorry, I can't help ya. I'm a bouncer. I've been going between 1:320 and 1:640 for twenty plus years. I was asymptomatic until the past seven or so years (with the past four being bad).

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I was just diagnosed after months and months of issues with my GI. My ana is 1:5120 having ana that low odds are not much is going on

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I've seen 1:40 reported online as both positive and negative. My labs were done by RDL and specifically state that it's a positive level, with <1:40 being negative. It also indicated a speckled pattern, with no pattern being negative. I read that a speckled pattern is the most common and least disease specific.

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I've read the same thing regarding the speckled pattern Spudnic. Will you post to let us know how it goes with your rheumy on the 29th? With the symptoms you describe it seems like you have some disease activity present. I hope it goes well for you and your rheumy is decent.

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