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Negative ANA/Positive ENA?

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Hi everyone,


I have been researching endlessly on this. It appears that the only abnormality in my blood tests (apart from low haemoglobin and vitamin B12) is positive ENA (extractable nuclear antibodies) (SCL-70). However my ANA and all associated tests are normal. I have numerous symptoms tying in with connective tissue disease and I'm presuming this is why the ENA test was done. From what I've read though, this test is usually not done when the ANA is negative?


Does anyone else have a similar situation, and more specifically a definite diagnosis in the absence of abnormal ANA? Does this throw any doubt on the ENA result? I'm particularly curious as the B12 situation has only just come to light indicating a possibility of pernicious anaemia. If this proves to be the case this could account for some (but unfortunately not all) of my symptoms


I don't have skin involvement, and if anything my symptoms are more indicative of lupus, however the scl-70 is scleroderma specific..


Any thoughts anyone?



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Hi Pinnygig,


I always thought ENA's were usually done when lupus was suspected, but I'm not a doctor and could well be wrong. What does your doctor say? I'd certainly ask.


I hope you are keeping well otherwise,

Jeannie McClelland

(Retired) ISN Director of Support Services

(Retired) ISN Sclero Forums Manager

(Retired) ISN Blog Manager

(Retired) ISN Assistant News Guide

(Retired) ISN Artist

International Scleroderma Network

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Hi PG,


As I understand it (and keep in mind I have no medical training at all), about 25% of people with lupus have Scl-70 antibodies, and not scleroderma. That is why clinical symptoms are so very important in rheumatic diseases, and relied upon so heavily for diagnosis.


You can indeed have a negative ANA but a positive ENA. Many labs won't pursue a negative ANA to the point of also running an ENA, unless the clinician is specific about the symptoms/illnesses that they are concerned about.


I don't know how the pernicious anemia fits into the picture, because it has so many potential causes.

Warm Hugs,


Shelley Ensz

Founder and President

International Scleroderma Network (ISN)

Hotline and Donations: 1-800-564-7099


The most important thing in the world to know about scleroderma is

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Hello Pinnygig


Well I have diffuse scleroderma since 2007 most recently with heart involvement and my ANA is now and always has been negative. As Shelley said clinical symptoms are the important factor is diagnosis and treatment.


Take care.

Amanda Thorpe

ISN Sclero Forums Senior Support Specialist

ISN Video Presentations Manager

ISN Blogger

(Retired) ISN Sclero Forums Assistant Manager

(Retired) ISN Email Support Specialist

International Scleroderma Network (ISN)

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