Patient's Query
Hello doctor,
I had a sudden hearing loss twice and because it happened twice, I was sent for a plethora of blood tests. My ANA was negative, but I noticed two markers out of range. I was wondering if you could give any insight into these blood test results.
Hi,
Welcome to icliniq.com.
I am glad you chose icliniq for your medical-related queries.
I understand your concern and will try to help you with it.
I went through your post and investigations (attachment removed to protect patient identity). There are two things which I presume you think are abnormal. CK (creatine kinase), it is an enzyme produced by heart muscle and skeletal muscle. So, it is elevated in people with muscle or heart disease, but low levels have no significance and are common in people with a sedentary lifestyle who do not exert much. Anti-histone antibodies are seen in people with drug-induced lupus so if one does not have other features of lupus as in your case the hearing loss is not a criterion for lupus (ACR criteria for SLE). It has little or no importance. I think there is a possibility of Meniere's disease for which you should get investigated that can cause sudden temporary hearing loss.
I appreciate your trust in icliniq.com and for giving me the chance to serve you.
Our goal is to prioritize your health and help you according to your preferences and needs.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
What about the glycoprotein 1 being out of range under lupus testing as well?
Hi,
Welcome back to icliniq.com.
I read and understand your concern.
Anti-beta 2 glycoprotein is a marker of APLA (antiphospholipid antibodies) the diagnosis of which requires two or more abortions or DVT (deep vein thrombosis) unprovoked and it has to be positive again after 12 weeks. Yes, it is a criterion for lupus but one has to fulfill at least four criteria for making the diagnosis of lupus. Secondly, these antibodies are induced by a lot of factors, especially the viral and bacterial infections. So, isolated form have little significance because they rise and fall in short intervals of four weeks.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
I am seeing a hearing or balance specialist as well and he suspects borderline Meniere's, but I do not have vertigo.
Hi,
Welcome back to icliniq.com.
I read and understand your concern.
I reviewed your investigations and case history. One thing that stands out is that you have been diagnosed with Rheumatoid Arthritis. While Lupus has been discussed, there is currently no diagnosis of Lupus based on your history and investigations.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
She now has me on Plaquenil.
Assessment and Plan
The following list includes any diagnoses that were discussed at your visit.
Plan of Care:
1. Rheumatoid arthritis
2. Systemic lupus erythematosus
3. Antiphospholipid syndrome
Hi,
Welcome back to icliniq.com.
I read and understand your concern.
Yes, that may be, but generally, when a diagnosis of any rheumatic disorder is made, the score is always mentioned. For example:
Rheumatoid arthritis: EULAR 6/10 with DAS 3
(EULAR means the criteria fulfilled and DAS means Disease Activity Score)
For Lupus, it should be listed as SLE with ACR 5/11 or a minimum of 4/11. In your case, it is only 2/11. The problem here is that she has done everything in a hurry without mentioning the criteria you are fulfilling for lupus. This is not right because labeling someone with lupus means a lifelong disease that requires regular monitoring, investigations, and a significant number of daily medications.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
I sought a second opinion and had more bloodwork done with a lab that performs more sensitive autoimmune testing. However, I am having a hard time figuring out the results. I cannot decipher if the ANA is positive or not. I feel as though it is, which is why the further testing occurred, but it is hard to read. Please advise?
Hi,
Welcome back to icliniq.com.
I read and understand your concern.
I am unable to download it. Please send it to the email address of icliniq, and they will forward it to me. Thanks.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
Try this perhaps?
Hi,
Welcome back to icliniq.com.
I read and understand your concern.
Kindly upload a PDF.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
Ok, I did that before, but scanned in another scanner. Kindly check attached file.
Hi,
Welcome back to icliniq.com.
I will review and get back to you.
Thanks.
Patient's Query
Hi doctor,
I have sent it again. Please check.
Thank you.
Hi,
Welcome back to icliniq.com.
I read and understand your concern.
Ok, I got your reports. They are essentially normal, except that C3 is on the lower side. However, low complement levels are not a criterion for the diagnosis of SLE.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
Ok, but my ANA is positive and 'speckled' - it says 1.40. Any thoughts on that? I have not had a positive ANA before, but the doctor used a much more sensitive lab this time that specializes in autoimmune testing. As a reminder, I have experienced sudden hearing loss twice. Additionally, about three to years ago, I had scleritis in one eye, one time.
Hi,
Welcome back to icliniq.com.
I read and understand your concern.
You have UCTD (Undifferentiated Connective Tissue Disease), so it is better to keep watch. You can take hydroxychloroquine 200 milligrams in the morning and evening, which will help keep the autoimmune process under control.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
What is UCTD?
Hi,
Welcome back to icliniq.com.
I read and understand your concern.
UCTD is undifferentiated connective tissue disorder.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
I have one more question. I have never had a positive ANA before, but this lab used more sensitive testing and my ANA appears to be a low positive. I had bloodwork done on a Thursday, and the following Monday, I was completely down with a 24-hour stomach bug. I do not know if it was food poisoning or a quick virus. If it was a virus, could it have spiked my ANA a few days before, or is that unlikely? I was not sick when I had the blood drawn, just a few days later.
Hi,
Welcome back to icliniq.com.
I read and understand your concern.
Yes, an infection can induce ANA. It should be tested once a person has no fever and no signs of infection.
Looking forward to your response in order to help you.
Thank you.
Was this conversation helpful?
Answered byDr. Ashaq Hussain Parrey
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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