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Forum Name: Rheumatology Topics

Question: Connective Tissue Disorder with + ANA & SSA


 AngelShan02 - Wed Aug 04, 2010 7:40 pm

I began experiencing symptoms of a Connective Tissue Disorder back in May of 2005. I was referred to a Rheumatologist who did ANA, SSA, SSB, C3, C4, and Hepatitis B blood testing. The ANA came back high, I believe it was 1:640 with a speckled pattern, and the SSA came back high. The other testing was normal . The doctor came to the conclusion that I had Sjogren's disease and began treating me without doing any additional testing. I recently participated in a research trial at a well known medical center and they said that I absolutely do not have Sjogren's syndrome. I know that I obviously have something with these abnormal antibodies and joint pains/fatigue but I just don't know what to do at this point. What additional testing should be done?
 Faye Lang, RN, MSW - Fri Aug 06, 2010 2:00 am

Hello AngelShan02,

Unfortunately, there is no single test that can confirm a diagnosis of an autoimmune disorder. The ones you have had (ANA, SSA) do indicate an autoimmune disorder. Your ANA result was indeed high, and a speckled pattern occurs in more than 95% of persons with systemic lupus erythematosus (SLE). Tests for anti-double-stranded DNA or anti-Sm antibodies and anti-ribonucleoprotein are also definitive for SLE. The diagnosis of an autoimmune disease is made after consideration of test results plus evaluation of the person's constellation of symptoms and physical examination. There are many autoimmune conditions, and most include symptoms of fatigue and joint pain. The Lupus Foundation has noted that the most common thing heard by persons with autoimmune disease is "You don't look ill, so how can you feel so sick?" The Lupus Foundation recommends that a person suspecting autoimmune disease investigate their family history, since there can be a familial influence, and to track their own symptoms. Keep a journal or record of symptoms and give details such as when the symptom happened, what you were doing at the time, what you were eating and drinking, what medications were taken, if any, and the duration of the symptom. Note if you have any sleep disturbances, including frequent wakening. Since Sjogren's Disease has been ruled out, the next step is to consider other autoimmune conditions; one of the diseases in the classification with Sjogren's Disease is SLE, so that might be the next thing considered by your physician. Seeing a rheumatologist is recommended, and seeking second or even third opinions unfortunately is fairly common in determining an autoimmune diagnosis. The important thing is for your rheumatologist to keep ruling out conditions until the most likely diagnosis can be made, and for you to have confidence in your physician. Treatment can include anti-malarials, prednisone, and immunosuppressive medications. Anti-malarials and prednisone are often the first options that are offered. If anti-malarials are effective at lower dosages, they have fewer side effects than prednisone, particularly in women with a family history of osteoporosis. Immunosuppressants and drugs such as methotrexate are used if the condition is not responsive to anti-malarials and/or prednisone, or if they are the most appropriate for the specific autoimmune conditon.

I hope this information is helpful to you. I wish you the very best of luck.

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