I HAVE A POSITIVE ANA! SHOULD I BE WORRIED?
A few weeks ago, there was news that @kimkardashian tested positive for antibodies that may be seen with lupus. She was forthcoming to the press about her concerns for having Systemic Lupus Erythematosus. What does this mean? Does she actually have lupus?
WHAT HAPPENS WITH IN OUR IMMUNE SYSTEM?
Our immune system makes proteins by white blood cells or B cells called antibodies. These proteins fight foreign infectious bodies that are exposed to the body by getting other cells and proteins to fight off the germs. In autoimmune diseases, these antibodies can sometimes incorrectly identify the natural proteins and attack the organs in our body instigating a pathway of inflammation. The “autoantibodies” called antinuclear antibodies or “ANA” target normal proteins within the center of a cell. Every human being has a small amount of autoantibody floating in our bodies around but when a large number is seen, autoimmune disease may be suspected.
WHAT DISEASES MAY BE SEEN WITH A POSITIVE ANA?
Some diseases like Lupus, Sjorgren’s Syndrome, Scleroderma, Drug Induced Lupus, Juvenile Arthritis, Psoriasis, Rheumatoid Arthritis, Vitilgo, Mixed Connective Tissue Disease, Autoimmune Thyroid Disease, Multiple Sclerosis may be seen with a large amount of antinuclear antibodies.
The important thing to remember is that a positive ANA test DOES NOT necessarily mean that a diagnosis of lupus or any other autoimmune diseases is confirmed. ANA antibodies can be seen in 3-15% of healthy individuals. The percentage is higher with low ANA titers (1:40). Sometimes the prevalence of ANA increases with age just like a rheumatoid factor (RF test). ANA can also be seen in viral illness, certain drugs, cancer and other conditions. ANA testing can be positive in patients with Fibromyalgia as well.
WHAT DRUGS CAUSE POSITIVE ANA?
- Hydralazine (blood pressure medicine) used in serious blood pressure crisis
- Methyldopa (used for high blood pressure)
- Isoniazid (used for tuberculosis)
- Minocycline (used for acne and sometimes rheumatoid arthritis)
- Quinidine (used to treat arrythmias)
- Procainamide (used for arrythmias)
- TNF inhibitors or biologic injections (used to treat rheumatoid arthritis)
WHY WOULD ANA BE ORDERED?
Your primary care doctor or rheumatologist may order an ANA if the individual is complaining of fatigue, joint pain, rashes, fevers, muscle pain or weakness, numbness and tingling, sensitivity to the sun among other symptoms.
WHAT TO DO WITH A POSITIVE ANA?
Please check with your rheumatologist if you have a positive ANA reading to exclude other conditions. The specialist may also look at the titer of the test and the pattern which may be associated with specific diseases. Also, depending on lab handling, the positive ANA may be a false reading so repeating the ANA is usually the next step.
DOES LUPUS HAVE ANY OTHER ASSOCIATED SYMPTOMS OR FEATURES?
Remember for a lupus diagnosis, other criteria has to be met. There needs to be certain organ involvement (lungs, kidneys, nervous system, heart) and other specific lupus tests or autoantibodies (dsDNA ab, sm ab, low complements, antiphospholipid antibodies) may be positive. There may also be abnormalities in the white blood cell count, anemia or platelets. Some lupus patients may also complain of oral or nasal ulcers, hair loss, sensitivity to the sun (photosensitivity), specific skin rashes (butterfly or malar rash on face involving folds around the cheek area) or specific skin lesions (discoid lupus or cutaneous lupus).
So if your primary care doctor tells you that you have a positive ANA reading, DON’T IMMEDIATELY PANIC! First look at the other symptoms you may be experiencing and review your medication list.
GET MORE TESTING!
Remember a positive ANA does not necessarily lead to autoimmune disease diagnosis. Kim Kardashian West was diagnosed with psoriatic arthritis instead of further evaluation.
Disclaimer: This blog contains my personal opinion based on personal and clinical experience, tips from trainers, health coaches and lastly research. This blog does not endorse specific treatments, procedures, products. You should always consult with a doctor, nutritionist, or other healthcare professional to discuss your own health and lifestyle goals and regimen based on your medical history. Thank you for reading!