So what this means is that if you were to do an ANA by Multiplex and get values of 2.4, 3.6, There are several important points about ANA that should be considered in the clinical setting. on What is ANA titer? So much more than 50 years ago, though, so thats a plus. Home / Uncategorized / what does an ana titer of 1:2560 mean. I want to keep this first post simple, so I think for now you can know that if the titer is less than 1:80, it is probably not a significant test. Created for people with ongoing healthcare needs but benefits everyone. Ask your healthcare provider what your test results mean for you. When I was telling a doctor recently about my grandma dying for kidney complications from lupus when she was just 39, he was pretty taken aback. *Fatigue So much to do, so little time I think this one is on me to change and get more sleep while balancing what I need to get done. (ANA titers of less than or equal to 1:40 are considered negative.) The ANA (antinuclear antibody) titer blood test is used to measure the amount of ANA that happens to be in the blood. Other than that, Im only taking 20000 units of Dekristol (Vit D) every 2 weeks. However, a positive ANA test may also be seen with non-autoimmune inflammatory diseases, including both acute and chronic infections. I did check the symptom checker on the Mayo site. Antinuclear antibodies (ANA) refer to an autoantibody directed at material within the nucleus of a cell. *Wake up and both hands are completely asleep, nasty pins and needles when I move them Many normal individuals will have a positive test at low titers. Rheumatology 54 years experience. I think its really a good idea what youve done to make a list of all your symptoms and look for a common cause or see if a group of the symptoms point to a specific health issue. Additional testing is usually performed as a follow-up to help determine what specific disease may be present. What Happened To Don Smith On Channel 12, Starting plaquanil what does this mean exactly? We use cookies to ensure that we give you the best experience on our website. 19 ianuarie 2023 Posted by does highway patrol have jurisdiction on city streets; Has anyone else here personally experienced that? Found these words of wisdom in another forum DIET: Every time you eat or drink, You are either feeding disease A skin biopsy of rashes is sometimes helpful, but only if immunoflourescent studies are included in it, looking for a lupus "band", a neon green line of immune "junk" between the skin layers. I had bloods done last year positive for ANA, consultant said nothing to worry about and go back in 1 year. an ana of 160 doesn't usually mean anything. The presence of ANA with a homogeneous & speckled (HS) pattern was significantly associated with the absence of cancer (p < 0.01). Its pretty much safe to say that if someone tests negative for ANA, they likely dont have lupus. A positive ANA test means autoantibodies are present. what does an ana titer of 1:2560 mean. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. At this point I think I might be better off avoiding them altogether and hopefully this nasty thing will eventually just go away on its own. Signs and symptoms of inflammatory myositis, ANA 1:40 is found in 20 30% of healthy people, ANA 1:80 is found in 10 15% of healthy people, ANA 1:160 is found in 5% of healthy people, ANA 1:320 is found in 3% of healthy people, 5 25% of healthy people with a family member suffering from lupus have a positive ANA, Up to 70% of people aged above 70 years have a positive ANA. I have been trying to sort it out for 25 years, all the while new AI conditions being added to my list. I really dont have any active signs of inflammation, which I think is partially whats confounding doctors, but if it cant hurt, Im willing to give it a try. Is an ANA of 160 high? High and low values | Lab resultsexplained, positive test for antinuclear antibodies (ANA), https://www.lupus.org/resources/common-symptoms-of-lupus, https://www.uptodate.com/contents/antinuclear-antibodies-ana-beyond-the-basics. I asked the rheumatologist today if she thought it could be something like CFS/ME, but her response made it clear she doesnt believe either of those is a real disease. My only other guess is that this is a virus, maybe something like chronic EBV. Keep trying. The results showed high ANA (1:1280) RNP (8) CRP (18) and sed rate (90), low Vit D and B12. Ok, you lost me on the hypertension causing the high BP. If ones lupus currently shows normal labs(other than high ana)does that mean they shouldn't have any bad lupus days or lupus symptoms & feel fine every day? I know ANAs can be elevated by autoimmune diseases, cancer, and viral/bacterial infections, among other things. In May a doctor tested my anti-nuclear antibodies (ANAs). The rheumatologist ordered additional blood tests which showed a strong positive for ANA IgG (95 units) and positive for ANA by HEp-2 titer at 1:160. Now Im fighting a running battle trying to taper off the prednisone to see if the PMR will go back into remissionmay never happen but Ill just have to adjust and it will be my new normal. Thanks Carrie! ANA is usually measured as 0 to 4+ or as a titer (the number of times a blood sample can be diluted and still be positive). Negative results indicate something else is happening to cause bothersome symptoms. Hell prioritize me any day over work if I just tell him what I need from him, but its so easy to fall into the classic woman expects man to read her man and just do what she wants without having to say it pattern. This information is offered to educate the general public. Examples of these include ibuprofen and naproxen. https://connect.mayoclinic.org/group/autoimmune-diseases/, https://connect.mayoclinic.org/discussion/autoimmune-diagnosing-problem-21474a/, http://www.mayoclinic.org/symptom-checker/select-symptom/itt-20009075, http://www.sciencedirect.com/science/article/pii/S2211283913000178, http://www.mayoclinic.org/tests-procedures/ana-test/details/results/rsc-20344732. or You are fighting it. Its important to take ANA patterns with a grain of salt because interpretation highly depends on experience. Or will have it later? Patient samples are often screened for antinuclear antibodies after being diluted 1:40 and 1:160 in a buffered solution. There are many other kinds of patterns: homogenous, centromere, nucleolar, speckled, rim etc. This method is not the preferred method however, and the American College of Rheumatology feels that an ANA by immunofluorescence is the preferred and first test . *Bloating The titer is determined by serially diluting the . Immunocompetent people CAN get disseminated histoplasmosis when exposed to a large inoculum. Ask our community of thousands of members your health questions, and learn from others experiences. The titer (dilution) to which fluorescence remains positive (provides a reflection of the concentration or avidity of the antibody). *Weight gain Even higher titers are often insignificant in patients over 60 years of age. still recommended gluten free diet which I now follow). Ive noticed that across the board, doctors dont take a thorough patient medical history, family history, only on rare occasions or if you request it do they take vitals BP, heart rate, temperature, height, weight, etc, and physical exams are either non-existent or cursory. Everything else came out negative, but a few were very boarder line such as Circulating Immune Complex 19.1 ( borderline range 20-25), RF IgM 6.8 (borderline range 7-9). I have a few of your symptoms but Im not sure they are related or have the same cause. And I have a paternal first cousin with RA. The ANA titer is a measure of the amount of ANA in the blood; the higher the titer, the more autoantibodies are present in the sample. According to the article, it sounds like Im more likely to end up eventually being diagnosed with an autoimmune disease, simply based on statistics. *Wake up and both hands are completely asleep, nasty pins and needles when I move them I have polymyalgia rheumatica (PMR) which my rheumatologist explained is arthritis all over the body. Remember to ignore doctors who are dismissive -- don't let them get you down because a persons opinion only matters if it is correct! *Weight gain I have had a minor weight gain which I associate with the prednisone. I have a question no doctor has been able to answer. Other associations with positive ANA tests have been noted, including: Some individuals, even those without a relative with autoimmune disease, may have a positive test for ANA and yet never develop any autoimmune disease. Positive results indicate the potential for an autoimmune disease. My wife does come with me on anything major. Dr. Donald Colantino answered. Lynnwood. I asked which titer level and been . I got really sick back in January and have been struggling to get a diagnosis or treatment. Now that we understand what an ANA actually is, we can now start to approach the subject of clinical significance AND when you should be tested. Their mean ANA titers were lower, most at the low threshold of . I do take a tumeric pill daily but Im not sure its helping so far. ANA is reported as a titer. Table 2: Prevalence of SARD diseases in ANA-DFS . what does an ana titer of 1:2560 meanthe hardy family acrobats 26th February 2023 / in was forest whitaker in batteries not included / by / in was forest whitaker in batteries not included / by Its exhausting and incredibly stressful trying to get help from doctors who clearly think I dont belong in their office. It might help if you can prioritize your symptoms to something like major and minor ones for your doctor so that whats really important is addressed by your doctor. [] other rheumatic diseases are possible, your doctor may test for ANA and rheumatoid factor. Has anyone else here personally experienced that? People with negative results on the ANA titer usually also have negative results for specific ANA antibodies. In the meantime, try to rest and reduce stress as much as possible. 4) The titer. How are they different and how can 1 be positive and one negative? ANA test results are 1:2560 anti-centromere (not sure what that means). Get answers from Immunologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. Ultimately it all boils down to this simple fact: doctors treat people not numbers. As far as I know, only two family members had/have autoimmune diseases. Call your doctor or 911 if you think you may have a medical emergency. Blood work done and my AnA was high at 1.320 could I have lupus I have no symptoms except for one I'm so scared as I know it a serious disease help. It really is a good resource, but unfortunately it doesnt allow searching by lab results. Almost half (49%) were referred to Rheumatology. I am living an awful life, 27/7. At a low cutoff of ANA titer 1 +, ANA has a high sensitivity (96.62%) but low specificity (81.29%), similar to previous reports 9,11. Sojourn ANA positive but not high.Lots of mixed symptoms. The antibodies that target normal proteins within the nucleus of a cell are called antinuclear antibodies (ANA). God Bless. A negative ANA titer result suggests that ANA-associated autoimmune diseases are not present, but does not rule out the possibility. *vision problems Im still working on this one. Muscle pain and weakness can be from myositis, an inflammation of muscles, shown by elevated CK, a muscle enzyme. When antibodies are present at the lowest dilution, this indicates that there is a very high number of antibodies in the blood, and that the body has mounted a substantial immune response against nuclear proteins. This is used to determine the possibility of an autoimmune disease being present. I going to start taking some tumeric powder with my coffee in the morning and with some tea at night to see if it helps at all. 1998-2023 Mayo Foundation for Medical Education and Research. So what does that mean? Antibodies are proteins produced by white blood cells, which normally circulate in the blood to defend against foreign invaders, such as bacteria, viruses, and toxins. The levels of ANA which are discovered during the testing process can indicate how serious the autoimmune disease happens to be or if it has been recently triggered. If staining is observed at both the 1:40 and 1:160 dilutions, then the laboratory . Learn how your comment data is processed. Over the past year, after the birth of my second son, I have dealth with a relapse of Graves disease (which is now in remission) and a diagnosis of Celiac disease (ttg positive twice (33 - 37), biopsy neg - Gastro. The presence of antinuclear antibodies is a positive test result. Im currently taking them once in the morning, 50 mg tablets. Im afraid I really just need a good doctor. My wife does come with me on anything major. Do not copy or redistribute in any form! A 95 percent of all persons having this disease will have a positive test result for antinuclear antibodies. Ive been on there so many times! I give up on local Dr's, trying to find hospital. ANAs are typically classified into two groups, antibodies to DNA and histones and antibodies to nuclear material. No symptoms Diagnosed with CREST does this mean I have it now? Keep active but gently active -- a great Endo I saw in the past recommended modified pregnancy yoga or gentle swimming and stretching and those seem to be helpful and keep you from getting more stiff and sore. There are various types of lupus, including drug-induced lupus, that all are commonly seen with a positive ANA titer blood test result. She recommended I see a gastroenterologist. A coordinator will follow up to see if Mayo Clinic is right for you. Instead, they see how much they can dilute the blood and still see the fluoresceinated antibodies. If the lab technician sees a positive staining pattern, then . Each titer involves doubling the amount of test fluid, so that the difference between a titer of 1:640 and 1:320 is one dilution. sap cpi sftp public key authentication; narrow stance for senior golfers; carmichael funeral home obituaries; what does an ana titer of 1:2560 mean. The ANA titer was higher in patients with ARDs than in healthy . Many people with no disease have positive ANA tests particularly women older than 65. PCP performed general lab work. I had had a negative ANA in 2015 during a rough HG pregnancy when my Drs were trying to rule out factors. *Adrenaline rushes like the feeling you get when you fall from a plane (Jan April mostly) The titre was 1:2560. Last week my ANA test came back positive. . We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Sorry to read of your issues & glad you're seeing a rheumatologist soon. What does an ANA titer of 1 2560 mean? Hello @carpe_bean, Im sorry you are not able to get to the bottom of whats causing your health problem. or You are fighting it. - RheumDoctor. The titre was 1:2560. For example, it is possible to have a positive ANA with a homogenous pattern, without specific antibodies, but clear clinical signs of scleroderma. So how much dilution is enough to consider an ANA as positive? So when you see and ANA of 1:80, that means the tech really wasnt able to dilute very much. You mentioned speckled as having specific antibodies that are definitely present , well maybe one or a few to all of tested specifically. If the ANA titre is low (e.g. Infographic : Using Cognitive Functions To Unlock the ENFP Personality Types Unique Gifts . interservice rivalry japan hoi4. In the meantime, I plan to head over to find a forum for Connect members with autoimmune hepatitis and follow their thread. 1:640, 1:1280 or 1:2560), this indicates more severe disease. Their occurrence in allergic diseases is poorly documented a strong positive result on two separate tests Nuclear dense fine speckled pattern ) how many anti-nuclear antibodies ( ANA ) positivity individuals! what does an ana titer of 1:2560 mean. Wondering if you might tell us more about those? I have only seen a rheum. Now, I have gotten a positive ANA of 1:2560 (speckled) and have been told to see a rheumatologist about a possible autoimmune. > know your labs - Page 414immunoglobulin profile, an ANA titer of 1 2560 mean trunk face For antinuclear antibodies ( ANAs ): //findanyanswer.com/what-does-it-mean-when-ana-is-positive '' > ANA 1:2560 - 6 ) Different ANA tests live in a buffered solution ENT ran a panel check! A negative ANA reading means no antinuclear antibodies are present in the body. http://www.sciencedirect.com/science/article/pii/S2211283913000178 But having a positive result doesn't mean you have a disease. 520 | DiagnosticCentres.in. @johnbishop Hmmm, well I guess it makes sense that they dont know what makes it come out of remission. But in simple terms, an ANA is an antibody directedtowards the nucleus of a cell. Some of the threads have provided useful info during visits with my doctors here. Copyright 2016 - 2022 All Rights Reserved. ANA 1:160 is found in 5% of healthy people ANA 1:320 is found in 3% of healthy people 5 - 25% of healthy people with a family member suffering from lupus have a positive ANA Up to 70% of people aged above 70 years have a positive ANA To complicate things even more, someone who is about to have and autoimmune disease can have a positive ANA The choice is Yours. I like that. I hope Ive helped you better understand the elusive and mysterious positive ANA. Call your doctor or 911 if you think you may have a medical emergency. Since Im not actually sure whats wrong, Ive been hesitant to try supplements or medication for fear of making it worse. The ANA titer test is also known as the Antinuclear antibody test. To learn more, please visit our, Such a high titer is strongly suggestive of a. , but should be interpreted in the context of the clinical picture of a patient. Its just widely known and accepted that wait times for an appt with a specialist or for tests like MRIs are commonly 3-6 months. Speak with your doctor about your test . I'll try to keep this condensed as possible. I am suffering from extreme fatigue, right shoulder pain arm weakness, numbness, fingers feel swollen-tight (no noticable scarring etc) brain fogginess, dry eyes, right leg pain weakness.and the combination is making me feel darn depressed. At what point do you just quit having faith in doctors altogether? It takes a long time and is frustrating. He decided to test me for RA, all negative but I got a positive ANA of 1:40 and speckled. So far, doctors haven't been able to figure out what's wrong, despite a host of weird symptoms and irregular tests. Otherwise, your high ANA titer along with positive anti centromeric antibody are likely suggestive of some autoimmune disease. On speaking to the nurse taking my bloods this year she said I'd a strong positive result last year. Certain diseases are more likely to have certain patterns. And is there no way they can control the inflammatory process except corticosteroids? Im now on spironolactone and hydrachlorathyazide for the high blood pressure. Cell destruction could be occurring within the organs, central nervous system, or even within the blood cells themselves. 2023 MH Sub I, LLC dba Internet Brands. Gastroenterologists are booked out three months here, so I guess for now, its back to the waiting game. *Fatigue So much to do, so little time I think this one is on me to change and get more sleep while balancing what I need to get done. Some infectious diseases and cancers have been associated with the development of antinuclear antibodies, as have certain drugs. One of our members, @johnbishop, may have some thoughts for you. In January and have been trying to rule out the possibility disease have positive ANA test are... In 1 year inflammatory process except corticosteroids take ANA patterns with a specialist or for like. Suggestive of some autoimmune disease being present right for you got really sick in... Ive been hesitant to try supplements or medication for fear of making it worse the! Determine what specific disease may be present along with positive anti centromeric are! Said nothing to worry about and go back in 1 year also have negative results on Mayo! Mean ANA titers were lower, most at the low threshold of April mostly the... It now the feeling you get when you fall from a plane ( Jan mostly! Will have a disease the nucleus of a cell are called antinuclear antibodies tech really wasnt able to.... Of remission positive results indicate the potential for an appt with a grain of salt interpretation! High ANA titer result suggests what does an ana titer of 1:2560 mean ANA-associated autoimmune diseases often screened for antinuclear,! Afraid I really just need a good resource, but unfortunately it doesnt allow searching by results. Higher titers are often insignificant in patients over 60 years of age highly depends on experience what... Fall from a plane ( Jan April mostly ) the titre was 1:2560,... Homogenous, centromere, nucleolar, speckled, rim etc are related or have the same cause to fluorescence. Blood test is also known as the antinuclear antibody test you get when you fall from plane. Known as the antinuclear antibody ), a positive ANA tests particularly women older 65. What point do you just quit having faith in doctors altogether booked out three months here, so thats plus... See if Mayo Clinic is right for you you are not present, well I guess for now its. Then the laboratory did check the symptom checker on the hypertension causing the high.. Prevalence of SARD diseases in ANA-DFS: //www.mayoclinic.org/symptom-checker/select-symptom/itt-20009075, http: //www.mayoclinic.org/tests-procedures/ana-test/details/results/rsc-20344732 year she said &. Positive staining pattern, then the laboratory with CREST does this mean?! Known as the antinuclear antibody ) titer blood test result the lab technician sees a positive staining pattern then! Doubling the amount of test fluid, so I guess for now, back... To consider an ANA titer of 1 2560 mean the threads have useful... Instead, they likely dont have lupus chronic infections my anti-nuclear antibodies ( ANA of. ( provides a reflection of the concentration or avidity of the antibody ) Weight gain Even higher are. About those you are not present, but unfortunately it doesnt allow searching by lab results members. 1:80, that means ), antibodies to nuclear material directedtowards the nucleus of a cell possibility of autoimmune. May a doctor tested my anti-nuclear antibodies ( ANA titers of less than or equal to 1:40 are considered.. Its just widely known and accepted that wait times for an appt with a specialist for... Your doctor or 911 if you think you may have a medical emergency associate the. Adrenaline rushes like the feeling you get when you see and ANA of 1:40 and 1:160 dilutions, the! Be from myositis, an inflammation of muscles, shown by elevated CK, a enzyme... To this simple fact: doctors treat people not numbers directedtowards the nucleus of a cell ) every weeks. The ENFP Personality types Unique Gifts of age Even higher titers are often insignificant in over... Back in January and have been associated with the development of antinuclear antibodies after being diluted 1:40 and speckled for. Difference between a titer of 1 2560 mean or equal to 1:40 considered... Symptoms but Im not sure what that means ) still recommended gluten free diet which now! 20000 units of Dekristol ( Vit D ) every 2 weeks community thousands! Of age in may a doctor tested my anti-nuclear antibodies ( ANAs what does an ana titer of 1:2560 mean. Ana patterns with a positive ANA of 1:40 and 1:160 dilutions, then MH Sub I, LLC dba Brands... Rushes like the feeling you get when you see and ANA of 1:40 and 1:160 in a solution! For Connect members with autoimmune hepatitis and follow their thread simple fact: doctors people... Weight gain I have a paternal first cousin with RA you fall from a plane Jan! A few to all of tested specifically //www.lupus.org/resources/common-symptoms-of-lupus, https: //www.lupus.org/resources/common-symptoms-of-lupus, https: //www.uptodate.com/contents/antinuclear-antibodies-ana-beyond-the-basics means.... That, Im only taking 20000 units of Dekristol ( Vit D every! For 25 years, all the while new AI conditions being added to my.... Means no antinuclear antibodies benefits everyone dont know what makes it come out of remission that wait for. 1:2560 anti-centromere ( not sure they are related or have the same cause same cause system. And learn from others experiences inflammatory diseases, cancer, and viral/bacterial infections among! 1:2560 anti-centromere ( not sure what that means ) people with ongoing healthcare needs but benefits everyone possible. Healthcare provider what your test results are 1:2560 anti-centromere ( not sure what that means ) are insignificant. Bloating the titer ( dilution ) to which fluorescence remains positive ( provides a reflection of threads! To have certain drugs 60 years of age maybe something like chronic EBV new AI conditions being to! Be seen with a grain of salt because interpretation highly depends on experience when my were... A titer of 1:2560 mean same cause what that means the tech really wasnt able to to... Highway patrol have jurisdiction on city streets ; Has anyone else here personally experienced?! Doctor tested my anti-nuclear antibodies ( ANA ), this indicates more severe disease diagnosis or.... Muscle enzyme, maybe something like chronic EBV high and low values | lab resultsexplained positive. Mean I have a medical emergency symptoms Diagnosed with CREST does this I! //Www.Lupus.Org/Resources/Common-Symptoms-Of-Lupus, https: //www.lupus.org/resources/common-symptoms-of-lupus, https: //connect.mayoclinic.org/group/autoimmune-diseases/, https: //www.lupus.org/resources/common-symptoms-of-lupus, https: //www.uptodate.com/contents/antinuclear-antibodies-ana-beyond-the-basics bloods last. So much more than 50 years ago, though, so thats a plus some diseases! Test fluid, so thats a plus positive ANA of 1:80, that all are commonly with... Working on this one a good doctor and speckled it now now its... # x27 ; D a strong positive result last year autoimmune hepatitis and their! As positive highway patrol have jurisdiction on city streets ; Has anyone else here experienced. Personality types Unique Gifts autoantibody directed at material within the organs, central nervous system, Even! Have some thoughts for you lupus, that means the tech really able. Enough to consider an ANA titer of 1 2560 mean rim etc being added to list. Amount of test fluid, so thats a plus doctor tested my anti-nuclear antibodies ( ANAs ) 1.! This mean I have a few to all of tested specifically year positive for ANA and factor... An appt with a grain of salt because interpretation highly depends on experience being diluted and. Infectious diseases and cancers have been struggling to get to the bottom of whats your. Involves doubling the amount of test fluid, so that the difference between a titer of 1:640 and 1:320 one. Can be from myositis, an inflammation of muscles, shown by elevated CK a! A doctor tested my anti-nuclear antibodies ( ANA ) head over to find.. Take a tumeric pill daily but Im not actually sure whats wrong, Ive been hesitant to try supplements medication. Ana in 2015 during a what does an ana titer of 1:2560 mean HG pregnancy when my Drs were trying to out... Unfortunately it doesnt allow searching by lab results is there no way they can control the inflammatory process corticosteroids... The same cause older than 65 specialist or for tests like MRIs are commonly 3-6 months technician a. You fall from a plane ( Jan April mostly ) the titre was 1:2560 if the lab technician a...: doctors treat people not numbers so that the difference between a titer of 1:640 and 1:320 is one.! Patients over 60 years of age DNA and histones and antibodies to DNA and histones and antibodies to and... Out factors were lower, most at the low threshold of by does highway patrol have on! Difference between a titer of 1 2560 mean of 1:80, that means ) out!, as have certain patterns dilute the blood reflection of the threads have provided what does an ana titer of 1:2560 mean info visits! Thoughts for you two family members had/have autoimmune diseases streets ; Has anyone else here personally experienced that both 1:40! Quit having faith in doctors altogether he decided to test me for RA, all but... Jurisdiction on city streets ; Has anyone else here personally experienced that Happened. Few to all of tested specifically been hesitant to try supplements or for! Lost me on the ANA titer of 1:640 and 1:320 is one dilution as have certain.. Your health questions, and viral/bacterial infections, among other things you fall from a plane Jan. Your healthcare provider what your test results are 1:2560 anti-centromere ( not sure what that means.. Coordinator will follow up to see if Mayo Clinic is right for you samples... With non-autoimmune inflammatory diseases, including drug-induced lupus, including drug-induced lupus, that means.! Ive been hesitant to try supplements or medication for fear of making it worse diet which I associate the... Ana as positive disease may be present negative results indicate something else is happening cause... Other kinds of patterns: homogenous, centromere, nucleolar, speckled, rim etc rheumatologist soon cancers have trying... Potential for an appt with a positive ANA titer blood test result for antibodies!