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Diagnosis different autoimmune diseases

Q: Kristi Zemas wrote:
I am in the process of finding out if I have lupus or Sjogren's, there is a
family history and I will be number 9 with one or both. My blood work came back
with a word that my GP did not know and I asked the Health Educator at the Lupus
Foundation and she did not know either. So that brings me to all of you. Here
are my results: ANA                 positive
ANA titer                     >1:640
ANA pattern                homogeneous
ANA titer 2                  1:320
ANA pattern 2              coilin antibodies

rheumatoid factor        <7.0     0.0-14.0 (IU/ML)
TSH                           2.0       0.27-4.20 uIU/ML
albumin                      5.1       3.4-4.8 G/DL
alkaline phosphatase   119      35-104 IU/L
Bilrubin total                 1.1       0.2-1.0 MG/DL

Ok so any ideas what the coilin is I found a test called p-80 that tests for
proteins that cause autoimmune hepatitis - which I learned is another name for
my fatty liver that I have had since I was 17. Any help would be wonderful.

A:  Coilin is a structure inside the nucleus. Antibody to it is just another intranuclear antibody, which is a marker for autoimmunity (Pubmed ref: 10479391). Clinically, it is not helpful in distinguishing which type of autoimmune process is most active. To help distinguish between Lupus and Sjogrens Syndrome other antibodies that you may be waiting on, such as dsDNA, Sm, and SSA/SSB, can be helpful. Also, you may want to watch your values of albumin, alk phosphatase, and bilirubin going forward. These are associated with the liver, and smooth muscle and mitochondrial antibodies can be also seen in autoimmune liver disorders.

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2 Comments   »

  • Sandra waite says:

    Hi,
    Diagnosed DLE (discoid lupus) 2000, since then many symptoms like SLE, since recieving test results it's pointing to possible Sjogrens.
    I have been tested 3 times in the last 5 years,
    ANA titre between 1/320, 1/640 and the 320 again.

    Now the last set of test were done in April 09,
    This is what is written on the print out,

    ANA pattern: speckled 1/320.
    Nucleolar
    cytoplasmic speckled

    the primary ANA is a nucleolar pattern. Nucleolar antibodies are most commonly seen in patients with scleroderma, SLE and raynauds phenomenon.

    The primary indirect immunofluorescece pattern shows speckled staining of the cytoplasmic constituents, This may represent antibodies to ribosomes, endosomes, lysosomes or GW bodies or to mitochndria.

    ENA results:Sjogren's Syndrome A/Ro 60 Antigen high positive

    ENA interpretation:
    This patient has autoantibodies to SS-A/Ro 60. These antibodies are most commonly seen in Sjogrens syndrome and SLE. the antibodies may also be seen in neonatal lupus syndrome and subacute cutaneous lupus.

    I have been told that i don't have SLE.
    But have not been told anything about these test results, what do they mean? Do i have Sjogrens?

    And what do all the SOMES mean.
    I am so sick at times and yet i keep being told theres nothing wrong with me, but surely looking at these test results there is.

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