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ANA levels in bloodwork
9/23 17:22:09

Question
My Doctor referred me to a Rheumatologist after having bloodwork done during my annual exam.  She told (by phone) that there was something about my ANA level (I believe she said they were low) and she recommended that I consult with a Rheumatologist. Could you shed any light on this?

Answer
You're not mentioning any symptoms that may have caused your doctor to test for antinuclear antibodies, but I'm assuming there are some.  If you misunderstood her call, and the ANA's were positive with a low titer, she's sending you, your symptoms, and your test results to a rheumatologist for further evaluation.  If you heard her right, she may still be sending you to a rheumatologist because your symptoms strongly suggest a diagnosis but your ANAs don't help her support it.  

ANA's are used to support a diagnosis of a connective tissue disease based on symptoms, medical history, and the appearance that the rheumatologist sees.  For instance, in my case, I had symptoms of fatigue and swelling, a history of joint pain and relatives with rheumatic disease, and the  beginnings of finger contractures. My rheumatologist knew just from these that a connective tissue disease was likely.  The positive ANAs supported this.  But even that needed more information to verify a diagnosis of systemic scleroderma and I had a skin biopsy that finally gave me a firm diagnosis.

You may see information online about the types of ANAs indicating what the disease is, but this is not reliable.  For instance, I do not have either of the distinct ANAs that are positive in systemic scleroderma.  

And keep in mind that 5% of the "normal" population has positive ANAs, so if yours were positive, that alone still doesn't mean much.  

Sounds like you have an excellent primary care doctor who listens to your symptom complaints, gets more information, and knows when to refer you to someone with more experience.   That's a good thing!

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