Another pattern observed in my recent ANA blood test

[Hoping]

I was on tetracycline for 3 years. Then in April/May I tried minocycline. I probably did it too much too soon, I got the Herx. Then I switched back to tetracycline for a couple months. Now I am trying doxycycline. Recently I had blood tes t done. Under the ANA reading, other than my usual “centromere” pattern, this time it also showed the “nuclear membrane” pattern. I get stressed out. It seems like it's getting more complicated. Anyone has any idea?

[Maz]

[user=1182]Hoping[/user] wrote:

I was on tetracycline for 3 years. Then in April/May I tried minocycline. I probably did it too much too soon, I got the Herx. Then I switched back to tetracycline for a couple months. Now I am trying doxycycline. Recently I had blood tes t done. Under the ANA reading, other than my usual “centromere” pattern, this time it also showed the “nuclear membrane” pattern. I get stressed out. It seems like it's getting more complicated. Anyone has any idea?

Hi Hoping,

Sorry to hear your tests are stressing you out. I know how you feel as I went through a bit of that in the springtime…but was reassured by the immunolgist I saw that bloodwork is a moment in time and is changing constantly. I hope this reassures you, too.   

Just wondering….do you still have the GI problems you were experiencing before or are they now sorted with the GI doc? Is your AP doc running full liver function tests regularly? What do those look like?

Also, were you able to get to Dr S in GA or did you find another AP doc in FL to help you?

Peace, Maz

[Hoping]

Thank you Maz. I am impressed that you still remember the details of my conditions.
I went to see a GI specialist back in April. She did an endoscopy on me, and my esophagus and stomach are still in good shape (thank God). I am still taking Prilosec (the PPI) to make sure the acid reflux is under control. I am gradually lowering the dosage from taking them once a day to about 3-4 times a week. I really want to get out of it eventually.
Yes, I had the hepatic panel blood test done, and all liver functions are normal. All results are normal except for a slightly low WBC count and the positive ANA readings. I read about the ANA “nuclear membrane” pattern, and a lot of the writings pointed to Primary Biliary Cirrhosis, which scared me quite a bit.
About the GA AP doc, for now, I am sticking with the current FL AP doc. A few months ago, I communicated with a FL lady who happened to be also a patient in my doctor's office (it's a father and son team). She has achieved remission, so I think they are o.k. My doc is willing to listen, and he let me try mino and doxy.
My local family doctor refer me to a local conventional rheumatologist. I am hesitating to see him because I know he will send me to a bunch of tests such as CT scans, lots of X-rays, etc.
So you are saying I don't need to be alarmed by the additional ANA pattern? What if something bad is going on in my liver/gall bladder?

[Maz]

[user=1182]Hoping[/user] wrote:

Yes, I had the hepatic panel blood test done, and all liver functions are normal. All results are normal except for a slightly low WBC count and the positive ANA readings. I read about the ANA “nuclear membrane” pattern, and a lot of the writings pointed to Primary Biliary Cirrhosis, which scared me quite a bit.

So you are saying I don't need to be alarmed by the additional ANA pattern? What if something bad is going on in my liver/gall bladder?

Hi Hoping,

When I was searching on the ANA “nuclear membrane” test, I also pulled up a lot about Primary Biliary Cirrhosis, which is why I asked about liver function tests. This is really good, Hoping, that your liver panel is all in normal ranges. 😀 I didn't want to mention those 3 words and worry you…just thought it might be good to point you back to your doc to ask why he ran the test in the first place. It could be that was what he was looking for with your earlier GI questions (?), but as you've covered those corners and everything is clear, this is great news! If you're worried about your liver/GB function, then it might not hurt to ask for a scan just to put your mind at rest.

One very interesting piece of information that piqued my interest in Wikipedia was that gluten intolerance/sensitivity is suspected in cases of Primary Biliary Cirrhosis, because these antibodies seem to be elevated in these folk. This might be moot in your case, but have you ever been tested for celiac or gluten intolerance? It's just a thought, but it might be worth a trip to an immunologist to have this testing done. Your liver clearly isn't in imminent trouble, but I half wonder if elevated nuclear membrane auto-antibodies might be a good head's up to check into a gluten intolerance possibililty if you haven't already. You said in your sig line that have Lupus with a crossover of sclero and others with sclero here often mention that gluten intolerance is a pretty common GI complication for those with sclero (and rheumatic disease in general). 

http://en.wikipedia.org/wiki/Primary_biliary_cirrhosis

“57% of patients with acute liver failure have anti-transglutaminase antibodies[4][/suP] suggesting a role of gluten sensitivity in primary biliary cirrhosis, and primary biliary cirrhosis is considerably more common in gluten sensitive enteropathy than the normal population.”

Also another thought that came to mind is that your WBCs are low and, as these are our frontline soldiers in fighting infections, it might be a sign of immune-suppression or compromised immunity. This might be another good question to put to an immunologist, because they deal with suppressed immunity and IVIG might be something you could research and discuss with such a doc. Of course, there may be other reasons for lowered WBCs (e.g. anemia or bartonella henselae infection) and this is just a fellow patient suggestion. 😉

What I meant by labwork being a moment in time is just that. Labwork can fluctuate a lot from blood test to blood test. Also, my immunologist remarked that when patients are immune-suppressed, auto-antibodies are produced at random with no clear-cut reason for their existence. When immune function recovers, however, it seems that these extra-curricula auto-antibodies are no longer produced, looking for something to do and serving no good purpose. We had a bit of a discussion about this on Tisch's thread (lower down thread re: IVIG) recently that you might find of interest:

http://rbfbb.org/view_topic.php?id=2932&forum_id=1

I wish my memory was that good, Hopeful! I cheated and looked back through your past posts to refresh my memory, as I remembered you, but just not all the details. 😉  If you ever want to look back through yours or anyone's past posts, it's very easy. Just click on their user name and select “view profile.” Then click on the tab that says “posts.” It's a pretty cool way to look back on your own progress while on AP.

Wishing you all the best in your researches, Hoping! Glad you found a doc you feel you can work with. 🙂

Peace, Maz

[Trudi]

[user=27]Maz[/user] wrote:

If you ever want to look back through yours or anyone's past posts, it's very easy. Just click on their user name and select “view profile.” Then click on the tab that says “posts.” It's a pretty cool way to look back on your own progress while on AP.

Hi Maz–

That is so very good to know–thanks!!  I bet this site has all kinds of neat features that we're not aware of :)!

Trudi

Lyme/RA; AP 4/2008 off and on to 3/2010; past use of quinolones may be the cause of my current problems, (including wheelchair use); all supplements (which can aggravate the condition) were discontinued on 10/14/2012. Am now treating for the homozygous MTHFR 1298 mutation. Off of all pain meds since Spring '14 (was on them for years--doctor is amazed--me too). Back on pain med 1/2017. Reinfected? Frozen shoulder?

[richie]

Hi

Both are indicators but not definite of types of scleroderma —centromere is CrEST while nucleolar is diffuse –you have reflux –do you have any skin involvement –Very often an early dx of CREST turns out to be diffuse as more symptoms show up —

richie

[ideamktg]

Hoping,
I live in Southwest Florida, Port Charlotte, Florida.  I do not know of any AP doctor around me.  I notice that you have an AP doctor in Florida.  This is probably in northern Florida, but if it isn't, would you e-mail the doctor's name to me?  My e-mail address is ndpblake@comcast.net  Thanks,    Nancy

[Hoping]

Nancy,

I have sent you an email with the info.

[Hoping]

Richie,

Does reflux mean diffuse scleroderma is likely? But I don't have anti-SCL 70… Actually, even though I was diagnosed with sclero CREST, I don't have any hardened skin at all. I have lost a patch of scalp hair in 2005, which then was diagnosed as Lupus.

Max,

I'll look into gluten. About my slightly low WBC count. I had that problem in the past, my family doc always asked me to be retested with no fasting. When I didn't fast, the count came back up to be normal – very strange.

[richie]

Hi-

Scl 70 is just another inexact marker –however without skin involvement doctors tend to call it CREST –the R in Crest stands for reflux —

riche

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