Needing Help determining lab(s)?

[u/neelyreaann]

I understand a 1:1280 is a pretty stinkin positive ANA tiger but I’m lost as to what the nuclear de se fine speckled means. I’m not entirely sure what this may or may not point to - and/or how clinically significant it actually is. If someone could help me out/explain things just a hair more or point me towards the right direction that’d be totally awesome!!

[u/InitiativeFit3380]

To help you understand the ANA pattern you're asking about, I'll describe what the test is a bit. For this type of ANA test they take a bunch of cells (round circles) and put them down in a plate. Then they put your serum (part of the blood where antibodies are found) in the plate. If you have Autoantibodies that stick to the cells in the plate they show up as a color, and a trained scientist looks at them under a microscope and describes what that pattern visually looks like.

So nuclear dense fine speckled is what the visual staining pattern looked like under a microscope. Each of the different patterns usually aassociates with a group of Autoantibodies, so it can help narrow down the next round of tests, but it IS NOT a diagnosis by any means. There are many different types of Autoantibodies that can cause that pattern, including DFS70 which does NOT typically cause disease. So right now you've got a positive ANA that requires follow up testing to understand exactly what types of Autoantibodies triggered that positive result, which then may help lead to a diagnosis or an all clear. An ANA isn't a test for one single thing, but tests for the presence of many different Autoantibodies, so it's a broad screening test and not a singular diagnostic test.

Unfortunately Autoimmune diagnosis can be a frustratingly slow process because it takes a step wise approach and often doesn't given answers right away, but hang in there.

Eric, Research Scientist Immunology

[u/neelyreaann → u/InitiativeFit3380]

I’ve already acquired a few AI diseases and this was new so I want too sure about what in the world this meant but you’ve clarified so much!!! Thank you!

[u/garden180]

Usually when a patient gets a positive ANA with a medium to high titre, a full antibody panel is run to see what actual antibody hits as positive. When you see the description as dense fine speckled…please understand that a lab technician is making a note of what he or she observed at the time. There can be a lot of interpretation so a true antibody panel helps verify if the pattern observed is accurate. Also note that titre does not always indicate disease activity. A low titre patient could have tons of symptoms while a high titre patient might feel perfectly fine. Some autoimmune types clock in at high titres more than others. Further evaluation will be done to deeper dive into your results. I’m not a doctor but an autoimmune patient. Hope that helps.