razz

Clarification for interpreting ANA and scl 70 scores

16 posts in this topic

Hello everyone!

 

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.

 

Hugs

Razz


Live well, Laugh often, Love much

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Wow Razz Thank you for your time!

 

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?


Take care,

Barefut

 

Serena Justis

ISN Blogger

International Scleroderma Network (ISN)

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Hi, Barefut.

 

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.


Warm wishes,

Jefa

 

Carrie Maddoux

(Retired)ISN Sclero Forums Support Specialist

(Retired)ISN Sclero Forums UK Chat Host

International Scleroderma Network (ISN)

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Razz,

 

Thank you and your doctor so much for the information.

 

With gentle thoughts,

 

Judy


A happy heart is good medicine.

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Razz,

 

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.

 

Thanks again,

Nina Lynn

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Hi Razz

 

Thanks so much for getting clarification on this for us! :)


Sending good wishes your way!

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Hi Everyone,

 

OK....now I am really confused. Razz's site says one thing and the government site indicates another.

 

http://www.medicinenet.com/antinuclear_antibody/article.htm

 

"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.""

 

BUT.........

 

http://www.haps.nsw.gov.au/Research/Auto-A...y_Patterns.aspx

 

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.

Margaret

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Hi Margaret,

 

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.

 

Nina Lynn

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Hi Margaret,

 

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.

 

Warm hugs,

Razz


Live well, Laugh often, Love much

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Hi Nina Lynn ,

 

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.

Margaret

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Hi Elizabeth,

 

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.

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Hi Zerenity,

 

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.

:emoticons-group-hug:


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 sclero.org.

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Hello, My SCL 70 range was 1.0. Does that mean I am positive or negative?

 

This was my latest lab work and I am confused

  • ANA 9 on 10/26/2016
Details
  • ssDNA - 43.00 Range: 0.00-99.00 - U/mL
  • dsDNA - 5.00 Range: 0.00-40.00 - I.U.
  • Sm - 6.00 Range: 0.00-89.00 - U/mL
  • RNP/Sm - 10.00 Range: 0.00-83.00 - U/mL
  • SSA (Ro) - 10.00 Range: 0.00-91.00 - U/mL
  • SSB (La) - 5.00 Range: 0.00-73.00 - U/mL
  • Scl-70 - 1.00 Range: 0.00-32.00 - U/mL
  • Chromatin - 27.00 Range: 0.00-99.00 - U/mL
  • Centromere - 5.00 Range: 0.00-99.00 - U/mL

 

Dr. posted on the patient portal with no notes. Can anyone please explain?

Thank you in advance!

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Hi Trena,

 

Welcome to these forums!

 

Please keep in mind that none of us are doctors and we cannot diagnose you, nor explain your test results as they apply to your health. Basically, ANA tests can be positive in people who are entirely healthy, and negative in people who are entirely sick. By themselves, they do not automatically indicate disease. Blood tests are not the be all and end all and are really only a beginning on the road to your diagnosis and the most important thing, by far, are your clinical symptoms. I've included a link to our medical page on What are Autoantibodies?, which I hope you'll find helpful.

 

I would suggest that you go back to your doctor and ask him for an explanation of your blood test results.

 

Kind regards,


Jo Frowde

ISN Assistant Webmaster

SD World Webmaster

ISN Sclero Forums Manager

ISN News Manager

ISN Hotline Support Specialist

International Scleroderma Network (ISN)

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Hi Trena,

 

The "Range" means that anything within those numbers are Normal. As far as I can tell (and I'm not a doctor, in fact I have no medical training at all), the numbers you listed are all in the Normal range.  I can't tell where your ANA number of 9 comes from, or whether or not that is Normal.  Most online systems will flag values that are too high or too low, but keep in mind too that many items can be out of range without signifying a big problem.  For example, usually when we are dehydrated, a lot of values will be high or low, but the doctor can easily infer that it was only some dehydration.

 

Therefore, it really helps to review blood work with your doctor. And like Jo said, blood tests are not the be all and end all of scleroderma diagnosis. The really important question is, what symptoms are you experiencing that triggered the testing in the first place?

 

Please let us know what you find out from your doctor, as well.

 

:hug-group:


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 sclero.org.

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