Clarification for interpreting ANA and scl 70 scores
Posted 17 November 2008 - 05:51 PM
Barefut posed two questions in my last post entitled Costochondritis. I promised I would e-mail my doctor and ask her if she could clarify the scores in layman's terms for me. She was so kind to reply with the following:
"Basically, an ANA test is given when an autoimmune disease is suspected. It is pretty non-specific, meaning that the presence of a positive ANA does not tell us much more than that the patient has auto-antibodies. Additionally, the level of the titer does not really correspond with disease severity or progression. Some patients have a positive ANA without having any type of autoimmune disease. However, if a patient has a very high-titer ANA (like you, [me Razz]), it makes us more suspicious of an underlying disease, even in the absence of symptoms. The ANA sample is diluted up to a certain point, and I believe that at our institution it does not get diluted past 1:2560.
I did not find any website that explained the Scl-70 very well. It is a test that is relatively specific for diffuse scleroderma, but can be found in other autoimmune diseases as well. If a patient is diagnosed with scleroderma, we check the Scl-70 for prognostic purposes. Having a positive Scl-70 indicates a worse prognosis, and likely more rapid course of the disease. It is not useful to track progression of the disease, and is used more as a one-time marker, than as something we follow."
Unfortunately the link to the website she gave me as a source does not work. But I found this link on the Sclero.org page on Autoantibodies:
Antinuclear Antibody Test (ANA). MedicineNet.
I hope this helps.
Posted 17 November 2008 - 07:14 PM
Thank you and your doctor so much for your answers. I still wish there was more on the scl-70 out there. When she says a positive outcome is means a worse prognosis and likely a more rapid course. Do you think she means the higher the number, the worse the prognosis?
Posted 17 November 2008 - 11:33 PM
I think she means that having a positive scl-70 indicates a greater likelihood that the disease will be more progressive than if you have a negative scl-70.
This link (also found on the page linked in the post above) explains a little more but does not answer your question on whether the degree of involvement is equivalent to the level of the test results. Perhaps someone else can answer.
Anti-scl-70.Evidence-based guidelines suggest that anti-Scl-70 antibodies are very useful in the diagnosis and clinical management of SSc patients and also to establish prognosis in these patients, particularly those with diffuse skin involvement. PubMed. Autoimmunity. 2005 Feb;38(1):65-72.
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Posted 18 November 2008 - 05:33 PM
Thank you and your doctor so much for the information.
With gentle thoughts,
Posted 19 November 2008 - 11:02 AM
Thank you for the information. I was never told that I had the scl-70, so I don't think I do. When I asked about my ana she told me, very high ana with speckled nuclear. I guess I should ask more questions next appointment.
Posted 19 November 2008 - 12:12 PM
Thanks so much for getting clarification on this for us!
Posted 20 November 2008 - 03:56 PM
OK....now I am really confused. Razz's site says one thing and the government site indicates another.
"For example, the nucleolar pattern is more commonly seen in the disease scleroderma. The speckled pattern is seen in many conditions and in people who do not have any autoimmune disease.""
Speckled and Nucleolar ANA --- Scl-70 (Anti-topoisomerase-1) -----
Diagnostic Prognostic ----- Scleroderma (Specific)
Interstitial lung disease
These are both on the Antibodies and Scleroderma page on sclero.org.
It is all so very confusing.........and I have a medical background!!!
Take care, Everyone.
Posted 21 November 2008 - 03:37 AM
It is confusing and I have read different things form different sources. I asked my rheumatologist yesterday in an e-mail about it. I have a very high titer speckled and nucleolar ANA but negative for Scl-70.
My doctor wrote:
at last check your anti-Scl 70 was negative and it certainly does not have to be positive for one to have diffuse systemic sclerosis - you are correct. For limited scleroderma the most common pattern of the ANA is anti-centromere, not Anti-Scl-70.
According to her, she has seen things progress different in all the different blood types. She said each case has been so different and time will only tell how a person will progress.
Posted 21 November 2008 - 07:14 AM
I agree this can be confusing. These tests are used for diagnostic purposes. Although two patients could have identical Scl 70 scores, they could display different symptoms, severity and progression. The webmd website my doctor recommended should work, it is www.arthritis.webmd.com/antinuclear-antibodies-ana.
Posted 21 November 2008 - 07:29 AM
Gareth is also negative for Scl-70 but positive for the ANA - speckled pattern , diffuse cytoplasma and positive for the Anti-RNA Polymerase 1/111. He's got the official diagnosis of UCTD now even though they originally called it sine Sclero.
Take care, Everyone.
Posted 12 August 2011 - 05:26 PM
I wondered how things went now a few years on following the positive Scl 70 without Sclero symptoms.
I had positive SCL-70 with some neuropathies and fatigue. But my primary care physician says all my organs, blood pressure, sugar, CRP, ESR etc. are normal, including my skin.
Posted 16 August 2011 - 02:24 PM
I'm sure things would be easier to determine if you didn't have any sort of symptoms at all.
As it is, it sounds like you don't have any choice at all but to "wait and see" if or when anything else develops, because scleroderma is diagnosed based only on the constellation of certain symptoms and never by blood test alone, and fatigue and neuropathy don't "count" towards the diagnostic criteria, even though they can be part of scleroderma (and so many other diseases!).
Thus it's possible that you might be in this sort of limbo for a very long time. So then I guess the question becomes, how to deal with all the uncertainty?
We're always here for you, come what may. Here's some warm hugs to tide you over a bit.
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