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Hi, Sheila.

I'm going to try to make this as clear as I'm able(?!), so I hope others answer to clarify, correct, and pad out what I say here. This will probably make you feel :dizzy:

ANA has various aspects, the first being whether it is positive or negative; but a positive does NOT mean you have lupus. The stats I've read (from one of the two "big lupus names" in the U.S.) are that 10 million Americans have a positive ANA, but less than 1 million of those have SLE. Why? Other diseases cause a positive ANA (e.g., RA and scleroderma); healthy relatives of those with autoimmunes can have a positive ANA; and a positive can also be caused by simple aging, certain viral infections, and certain prescription drugs.

Second aspect: the so-called "titer", i.e., how weak or strong the positive finding actually is. In the lab, the sample is repeatedly diluted to ascertain the point at which the finding fades out; the more dilutions it takes, the stronger the levels. According to this same U.S. "big name", anything greater than 1:1280 (or greater than 30 International Units) is "strong".

Third aspect: the ANA pattern detected. Various patterns are seen in SLE, and these patterns carry varying diagnostic "weights". They are "rimed" (specific to SLE); "homogeneous" (which generally correlate to SLE); and "speckled" (seen both in SLE and other autoimmune processes).

My explanation may give you some insight as to why doctors can't explain ANA easily; or don't understand it well enough to explain it clearly; or don't care to explain it because they are going to repeat your labs anyway, so your labs are still taking on shape and meaning and it's thus premature to say much of anything; or why you now really, really wish SOMEONE ELSE had answered your questions first! :D

Ain't it awful, how confusing even this so-called "threshold test" is?

I hope others chip in soon for you. With my best wishes to you, from Vee





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