ANA Titer 1:1280 pattern homogeneous and speckled o/w negative work-up

Posted by trspac @trspac, Dec 6 2:26am

Hello. Desperate for help and don’t know where to turn since Rheumatologist stated they don’t know what is causing my symptoms. November 6,2024 first high positive ANA titer 1:1280 pattern homogeneous and speckled with a repeat test on Nov 14,2024 showing highly elevated ANA titer (1:1280) with a speckled pattern only after repeat, alongside negative results for other specific antibodies like anti-dsDNA, anti-Smith, SM/RNP, SCL-70, negative anti-Ro/SSA, negative anti-La/SSB, normal RF, normal C-Reactive Protein, ESR, Folate, Complement C4, Complement C3, Serum Iron, TIBC with low normal WBC, low normal HGB, low Unsaturated iron binding and a normal urinalysis, normal lip salivary gland biopsy with TMJ pain and dry mouth, globus sensation and a feeling of leakiness or fluid coming from the gums, normal parotid ultrasound, muscle aches, and fatigue. Being referred to tertiary care ENT by Rheumatologist since original diagnosis was glossitis after being referred to an ENT initially from Internist for nasal polyps. ENT on Oct 31st determined no polyps and after one look in my mouth said likely systemic due to large tongue and dryness. Tongue only gets swollen if teeth irritation causing sores due to dryness. I have been struggling since Jun 2024. Rheumatologist was kind enough to prescribe pilocarpine with a 4 week f/u but this is with a diagnosis of glossitis unknown etiology. I will start this today, Dec 6,2024. I have an allergy consult next week. I’m just lost looking for direction as my own advocate through this journey. Any suggestions will be greatly appreciated.

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@windyshores

Just to be clear, if the ANA is positive it will always be positive. Doctors don't seem to care about the actual numbers and say they do not correlate with severity of illness. They don't even test mine anymore.

I did request an ANA reflex panel after years of a systemic lupus diagnosis. It tests for lots of antibodies that can cause the positive ANA. Positive for scleroderma is >1 and high antibodies is >8 and I am >8. Same situation as you. Yes I have GI symptoms, some heart and lung issues, kidney eGFR dropped, arthritis, nystagmus, and the skin on my forearms is tough and bumpy. But no scleroderma diagnosis yet in spite of the high antibody test. I go to an endo now who specializes in it because a general rheumy was not useful.

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@windyshores - Glad to know you are now being treated by the right specialist. Not only do they not seem to care about numbers, I really see no care about the quality of life for others. Their job was to see me, do whatever tests they felt necessary and moved me around the system until I find someone who cares enough to get me the right treatment. Very frustrating

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@trspac

@larak - Thank you for providing this source. Unfortunately, I am at the mercy of those who provide me with medical treatment. Essentially during the last contact with the clinic the doc asked me do I want pilocarpine or not and it was my choice but kept stating my workup was all normal this referral to ENT and for what I'm not sure but send with the diagnosis of glossitis

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Mine all indicate systemic sclerosis. Some indicate Sjogren's or lupus as well. None of my five patterns correlate with the standard antibody testing rheumatologists normally run. (Most of those you listed.) My ANA is also 1:1280. Normal folks can have elevated ANA titers but usually not that high.

My genetic results suggest either Behçet's or systemic sclerosis. My understanding is that it would be rare to have both.

But something is clearly up.

I have high IL-10, IL-6, and IL-2R cytokines and occasionally elevated C3. CRP and ESR are fine, though. I have a positive HLA-B51 antigen test. I also have atopic dermatitis, a 5 cm ascending aortic aneurysm, a dilated pulmonary artery, IBS-C, GERD, hair loss with occasional lesions (follicitis?), and my eyesight is getting worse. Elevated pressures, small cataracts, wicked dry eye, and I'm losing perception in my infranasal region in my right eye on field tests.

I also get mouth sores.

I'm taking pictures of whatever I can now: hair lesions, rashes, mouth sores, red eyes. I'm gathering all my records.

It's insane trying to get an autoimmune/autoinflammatory diagnosis. You really do have to be mid-flare or do all the work yourself, even with an ascending aortic aneurysm.

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@trspac and others the author of the book I mentioned got relief seeing an integrative doctor. I have also seen a functional medicine/integrative medicine doctor. They look at the whole picture rather than one organ system at a time and generally accepting and empathetic. Treatments can be expensive if supplements are involved but it is worth trying that route regardless.

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@windyshores

@trspac and others the author of the book I mentioned got relief seeing an integrative doctor. I have also seen a functional medicine/integrative medicine doctor. They look at the whole picture rather than one organ system at a time and generally accepting and empathetic. Treatments can be expensive if supplements are involved but it is worth trying that route regardless.

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@windyshores - I reached out to one a few weeks ago. Just trying to locate someone with lots of experience but definitely will keep that in mind. Thank you for the great advice. I'm very appreciative

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@larak

Mine all indicate systemic sclerosis. Some indicate Sjogren's or lupus as well. None of my five patterns correlate with the standard antibody testing rheumatologists normally run. (Most of those you listed.) My ANA is also 1:1280. Normal folks can have elevated ANA titers but usually not that high.

My genetic results suggest either Behçet's or systemic sclerosis. My understanding is that it would be rare to have both.

But something is clearly up.

I have high IL-10, IL-6, and IL-2R cytokines and occasionally elevated C3. CRP and ESR are fine, though. I have a positive HLA-B51 antigen test. I also have atopic dermatitis, a 5 cm ascending aortic aneurysm, a dilated pulmonary artery, IBS-C, GERD, hair loss with occasional lesions (follicitis?), and my eyesight is getting worse. Elevated pressures, small cataracts, wicked dry eye, and I'm losing perception in my infranasal region in my right eye on field tests.

I also get mouth sores.

I'm taking pictures of whatever I can now: hair lesions, rashes, mouth sores, red eyes. I'm gathering all my records.

It's insane trying to get an autoimmune/autoinflammatory diagnosis. You really do have to be mid-flare or do all the work yourself, even with an ascending aortic aneurysm.

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@larak - First, I hope that you find some relief with all that you have going on. I wish I could help you and everyone struggling with autoimmune conditions. I am beginning to realize you are your own best advocate. I have been doing lots of research on my own so I can be sure to ask the right questions. Based on my research anything above that high is more likely an autoimmune condition. Maybe just not flared enough during lab testing. I don't want to imagine being any worse than I am now. I just want to be treated properly so I can be coming my own body again. Keep fighting for yourself and don't give up.

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@trspac

@larak - First, I hope that you find some relief with all that you have going on. I wish I could help you and everyone struggling with autoimmune conditions. I am beginning to realize you are your own best advocate. I have been doing lots of research on my own so I can be sure to ask the right questions. Based on my research anything above that high is more likely an autoimmune condition. Maybe just not flared enough during lab testing. I don't want to imagine being any worse than I am now. I just want to be treated properly so I can be coming my own body again. Keep fighting for yourself and don't give up.

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@larak @trspac I can certainly tell that both of you need to find good doctors. The following 2 organization keep of qualified rheumatologists around the country so you may have to treat yourself to an outing
https://rarediseases.info.nih.gov/
https://rarediseases.org/
Let me know if you have any luck finding a doctor! Remember, though, that you may be a distance away from the offices so may have a drive! It’s worth it!

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@becsbuddy

@larak @trspac I can certainly tell that both of you need to find good doctors. The following 2 organization keep of qualified rheumatologists around the country so you may have to treat yourself to an outing
https://rarediseases.info.nih.gov/
https://rarediseases.org/
Let me know if you have any luck finding a doctor! Remember, though, that you may be a distance away from the offices so may have a drive! It’s worth it!

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@becsbuddy - Thank you! I am looking into the Mayo Clinic or a University Doc. Exploring my options but need to try and get sóme relief first while I continue to look

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I had that same pattern. I ended up having an autoimmune disease called Celiac.

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It is very possible that you have sero-negative Lupus or Rheumatoid Arthritis w/o RH factor (I have both). Unfortunately, many rheumatologists are loathe to diagnose those of us who fall into these categories, so we have to be our own advocates and stay in their faces (sometimes, you might need to exaggerate your symptoms, which is ridiculous), or seek out a new medical professional.
My tongue now seems to be permanently swollen and the dry mouth certainly doesn't help matters as well as comfort, but I keep biotene gel or spray in my bathroom and use it when I get up in the middle of the night. I also use the lozenges during the day.
I wish you the best on finding a rheumatologist who will pay attention to YOU and your symptoms.

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@ceriselu - I don't expect a diagnosis but I do expect to get something for comfort. My quality of life has diminished significantly. At this point I am beginning to realize I need to learn how to live with this until I can find someone who actually cares and understands what I am going through. I have inner cheek swelling and was asked was I biting my cheeks. Yes I do but not intentionally, they are in the way. One day at a time I keep telling myself. I am looking into acupuncture. I am all over the place because I don't know what to do. I'm the meantime lots of mouth care. I wish you the best as well and I certainly how you feel. Sorry that you have to go through this and I hope you get better.

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