Q. I am worried about my ANA report. Please guide me.

Answered by
Dr. Kusumakar Srivastava
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 16, 2016 and last reviewed on: Nov 02, 2020

Hi doctor,

I have had a positive ANA for at least 12 years with no other positive tests for autoimmune disease. My other symptoms are fatigue and some joint pain in hands and knees. Recently, I had a positive ANA of 1:640 speckled pattern with a note saying dense fine speckled pattern is noted. DNA antibody and smith are negative at that time. Slightly elevated C3 of 186 and normal C4. The only other thing that is out of range was CRP of 6.6. I am hypothyroid and on 75 mcg of Levoxyl with my TSH being in range. The latest test was 4.62 up from 2.95 (four months ago). The ANA cascading reflex result was negative. Does that result mean that the ANA itself was negative? Or the antibody subtlest that are carried out if ANA is positive. I am trying to determine if the subtlest were actually performed or if they were not. I find it hard to believe that my ANA would have been negative at this point.



Welcome to icliniq.com.

  • You are fine. Please do not worry as nearly all your reports are fine (attachment removed to protect patient identity) and you are taking correct medicines also.
  • As per your ANA (antinuclear antibody) with dense speckled patters is noted, I must say that there are many false positives in the report as even in 20% to 25% patients this is false positive and most important thing is we have to treat you and not the reports.
  • CRP (C-reactive protein) is an acute phase reactant increased in response to activity of disease and becomes normal when activity comes down. So, repeat the test after a month.
  • Till then, I suggest Wysolone 20 mg (Prednisolone) daily after food for 10 days along with other medicines. Consult your specialist doctor, discuss with him or her and take the medicine with consent.

Revert back after 10 days to a rheumatologist online --> https://www.icliniq.com/ask-a-doctor-online/rheumatologist

Hi doctor,

Thank you for your reply. I have read that the dense fine speckled pattern can actually make it unlikely that I do have a systemic autoimmune disease. Could this be caused by Hashimoto's disease since I am hypothyroid?



Welcome back to icliniq.com.

  • Systemic lupus erythematosus - SLE cannot be there as you told anti-DNA is negative.
  • Now, for Hashimoto's disease there are many clinical symptoms other than fatigue like hair loss, unexplained weight gain, sensitivity to cold and dryness. If you want to confirm, then we can go for anti-TPO antibodies to have a look.
  • You are a subclinical hypothyroid, so let us have the report and then follow up. Do not worry.

For further information consult a rheumatologist online --> https://www.icliniq.com/ask-a-doctor-online/rheumatologist

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