Question
I had negative antibody levels except for the ANA (strong positive) on an Elisa screen but did have low levels of ds-dna, sm, ssa and ssb (they are still considered negative) My question is if their presence even at a low level is something to be concerned about? They all increased over 6 months. Will they continue to increase over time? I have read that their presence at anytime is abnormal. I continue to have symptoms of multiple joint pain, swelling, fatigue,etc… although it is finally seeming to improve since starting plaquenil about 4 months ago. I just wonder what this all means for the future. I have been diagnosed with Sjogren’s and Hashimoto’s thyroiditis and also have been positive with the Lupus anticoagulant on 3 different occasions.
Answer
From a diagnostic perspective, autoantibodies are more likely diagnostic of disease when they are elevated to higher levels, and more likely to be false positives at lower levels. However, given that you have a high titer ANA, and multiple other autoantibodies are positive together with your symptoms, make it highly likely you have an autoimmune disease in the lupus/sjogren’s family. Higher titers of auto antibodies, particularly anti-double stranded DNA can correlate with more severe disease, although the correlation is not perfect.
