Q: My Anti-dsDNA was positive at 13 but my ANA test came back negative, What does that mean?

These are links to both pages of my recent blood work.

Sorry, I couldn’t figure out how to load images on here. I tried everything.

my first ana test came back positive at my physical but then when retested at specialist my ana came back negative but my anti-dsDNA came back positive at 13.

what does this mean?

thank you in advance for your time and help. -melissa

The answer:

In fact, the nature of such variable autoantibodies is heterogenic, which means that they recognize different conformational and sequential neo-epitopes, thus it can be possible to get Positive dsDNA antibodies while ANA was negative.

Also, ANA is positive in 95% of cases of SLE disease, so that it can be very rare if SLE patients get Negative SLE.

Test Sensitivity can be a real problematic factor so that it is much recommended for such a strange combination of results to retest and follow-up every period of time.

I think the diagnostic ANA titer for SLE patients must be rechecked in many laboratories depending on the sensitivity and specificity of the used method.

The results above show elevated dsDNA but with a very close number to the upper limit of the reference range, in my laboratory, I used to retest such close numbers to avoid false-positive results.

There are many diseases other than SLE that have positive dsDNA, such as antiphospholipid antibody syndrome, tuberculosis, osteomyelitis, thymoma, lymphoma, sarcoidosis, and autoimmune hepatitis