Are my symptoms due to an infection or autoimmune disease?

Q. Kindly review my test reports and confirm if I have an infection or autoimmune disease?

Answered by
Dr. Ashaq Hussain Parrey
and medically reviewed by Dr. Himanshi Porwal
This is a premium question & answer published on Aug 06, 2022 and last reviewed on: Oct 09, 2023

Hello doctor,

Over the past year, I have had polyclonal B cell activation, raised IgM, and positive ANA (antinuclear antibodies) with systemic flu-like symptoms. However, doctors do not comment on anything because I have worsening symptoms. I experience fatigue, Raynaud's disease, skin rashes, petechiae, livedo reticularis, episcleritis, awful muscle aches, joint pain, awful headaches, fever, chills, hair loss, mouth ulcers, and light-headedness. Do I have an infection or an autoimmune disease? I have provided the details of my test results:

  1. ANA test: Positive six times but negative twice.
  2. Complements: Normal.
  3. FBC (full blood count): Normal.
  4. ESR (erythrocyte sedimentation rate): Normal.
  5. C-reactive protein levels: Normal.
  6. Liver and kidney function: Normal.
  7. Urinalysis test: Leukocytes are present.
  8. ELISA (enzyme-linked immunosorbent assay) for Lyme Disease: Positive.
  9. Western blot test: Negative.
  10. CT abdomen: Swollen spleen.


Welcome to

I went through your investigations (attachments removed to protect the patient's identity), and your symptoms suggest connective tissue disease. ANA (antinuclear antibody) test is positive, and you have oral ulcers, skin rash, and hair loss. All of them are suggestive of SLE (systemic lupus erythematosus). Therefore, I suggest you take the tablet HCQS (Hydroxychloroquine) 200 mg in the morning and evening.

Hello doctor,

Thank you for the reply. Could ANA levels fluctuate? Also, do you think the ELISA for Lyme disease is relevant, or is it false positive because of the negative western blot test? I have had conflicting opinions about this. My neurologist said it was a false positive. Meanwhile, my rheumatologist could not comment on anything. If it is a false positive Lyme test, could that be caused by autoimmunity?



Welcome back to

ENA (extractable nuclear antigen) test is a dynamic profile, so it will be positive if the disease is severe. Your ANA (antinuclear antibody) test is negative. Chronic Lyme disease can present anytime, and I think he should have treated you for that two weeks ago. I suggest you take the tablet Doxycycline for two weeks (consult a specialist doctor, talk with him or her, and take medications with their consent).

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