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Q. I had a positive ANA of 320 and my RVV normalized ratio is 1. 28. Should I be concerned?

Answered by
Dr. Ashaq Hussain Parrey
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 19, 2019

Hello doctor,

I had a positive ANA 320 but no symptoms. I went to a rheumatologist who did further blood tests. The only test that is positive was RVV, normalized ratio at 1.28. What does this mean? Should I be concerned? Please advise.

I am currently on Zoloft, Inderal, Valdoxan.

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

Hello,

Welcome to icliniq.com.

I went through your post and investigations simple ANA (antinuclear antibody) positive have a little significance and RVV ratio has no significance because the primary screening test is normal so you can relax, however, a watch every six months urine examination and dsDNA (double-stranded DNA) is important because the development of lupus may occur in 5-10% people with positive ANA in life time just keep a watch and forget about APLA (antiphospholipid antibodies).


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Thank you doctor,

What do you mean the primary screening test is normal? What is APLA?

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

Hello,

Welcome back to icliniq.com.

RVV is a screening test and is normal, that is a primary test ratio and it has no significance. APLA is antiphospholipid antibody syndrome and RVV is done for APLA, so to be simple the test is negative.


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Thank you doctor,

On my blood test result, it has highlighted in bold the RVV normalized ratio as being above the reference range. I have noticed that the RVV screen at 46.5 is actually above the referance range, however, it is not highlighted.

Please see the attached report.

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

Hello,

Welcome back to icliniq.com.

I have seen your report. (attachment removed to protect patient identity).

RVV is Russell's viper venom which is used to see the clotting and bleeding time, it has absolutely no significance if we are suspecting lupus, however, it has significance in APLA which may some times occur in lupus. The problem here is, first there should be lupus then we can look for APLA. I am assuring you that this ratio is nothing and has absolutely no significance so relax.


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Thank you doctor,

What about the RVV screen at 46.5 seconds with a normal reference range of 26 to 44. Is this reflective of a lupus anticoagulant issue? The blood test result says lupus anticoagulant detected.

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

Hello,

Welcome back to icliniq.com.

Let me try to explain what is RVV and how it is helpful. The RVV increases bleeding and clotting time in people with APLA and your screening is 46 which is more than normal second, once it is more than normal as in your case we do a normalized ratio that means patient value divided by normal value if it is more than 1.3 (1.28 in your case) then, the patient is tested for APLA syndrome which means patient has to do Anti beta 2 microglobulin IgG, IgA, IgM, and anti cardiolipin.

In your case, the ratio is less than 1.3 and screening time is less than 50 so nothing is needed. However, if you still are anxious you can do anti-beta-2 microglobulin IgG, IgA, IgM, anti cardiolipin IgG, IgM, and IgA. That will sort out the issue.


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