Rheumatology - Mastering the labs 🧪 - Antinuclear antibodies (ANA)
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- Опубликовано: 8 сен 2024
- CORRECTION: I made a mistake about ANA patterns...The ANA patterns might actually have some clinical utility...Watch my updated video: Learn about ANA patterns: • Antinuclear Antibodies...
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►👨🏫💊Antibiotics Lectures: www.medicosisp... ... Check out my brand new "Electrolytes" course at www.medicosisp... and use the PROMO code: ELECTROLYTES50 to get a 50% discount. what do you know about anti-nuclear antibody (ANA), anti-histones, anti-double-stranded DNA (dsDNA), and smith-antibody (anti-sm) and others?
Antinuclear antibody is positive in 1 out of every 9 females.
ANA is reported in tiers that are reported in numbers that double (1:40, 1:80, 1:160, 1:320,...etc).
The higher the ANA titer, the more antibodies in the serum, and the more likely the patient has an autoimmune disease.
However, antinuclear antibodies (ANA) do NOT correlate with disease activity or symptoms severity.
This is my 6th video in a series of lectures about Rheumatology...All of them are in a playlist named “Rheumatology”. • Rheumatology
Taking a detailed medical history from a Rheumatology patient is critical because rheumatological diseases can affect any body system (extra-articular manifestation).
In this video, we will talk about quick hints on Osteoarthritis, Rheumatoid Arthritis, Systemic lupus erythromatosis (SLE), scleroderma, sjögren syndrome, and others.
Books that I used:
► Sapira's art and science of bedside diagnosis amzn.to/2DAQk8O
► Hutchison's clinical methods amzn.to/2WZ0fOI
► Guyton and Hall Medical Physiology Textbook goo.gl/yZoeS9
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► Harrison’s Internal Medicine amzn.to/2OJiVNf
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► Davidson’s Principles and Practice of Medicine amzn.to/2vTmf1p
► If you need some flashcards to memorize better, try firecracker: mbsy.co/gcHHP
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-Disclaimer 1: I am not a physician...If you have symptoms, talk to your doctor.
-Disclaimer 2: I use affiliate links.
Don't forget the classic rheumatology triad: joint pain, stiffness, and loss of function.
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Thank you for your fun educational videos!
Cheers for this, I have been researching "cures for lupus symptoms" for a while now, and I think this has helped. Have you heard people talk about - Denmelia Jansabella Builder - (do a google search )?
It is a good one of a kind product for discovering how to treat lupus without the hard work. Ive heard some pretty good things about it and my colleague got great results with it.
i know it's kinda randomly asking but does anybody know a good site to watch new movies online?
Aa
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This dude is genius. I am PhD but when I will have kids I will not send them to Harvard Medical School but to Medicosis Perfectionalis. You are extremely talented to explain medical course like no one else. Where could I obtain your materials (pdf or ppt) ?
Hey 👋 Bartlomiej,
How are you?
Thank you so much for your beautiful comment. You made my day!
I really appreciate it!
You can get my pdf notes at www.patreon.com/medicosis/
Thank you so much in advance!
Thanks for your best lecturers.
When I'm down about my condition I just come and listen to your videos, nothing like learning and laughing to get a quick pick-me-up!
Thank you so much, dear :)
You made my day!
Ah ha ha ha! As a lab tech who gets driven INSANE by the number of people getting unnecessary ANA tests, I found your commentary both accurate and hilarious 😂
He makes education sooooo fun. I love his videos
😍😍😍😍😍
The symphonic mnemonic for the Anti-Ro and Anti-La is the best explanation EVER. Pulizer prize worthy. Hats off.
Thank you so much!
6:33 "shut up it has nothing to do with the symptoms or the severity" dead 😂😂😂😂😂 Laugh die me bro u r funny
😅😅
His commentary is the primary reason I love this channel!
@@katienewsome3086 yup !
I was laughing so hard
Just imagine having a guy like this teaching u
U cant just not love learning
❤❤
Thank you so much 😊
Mashallah , i am laughing so hard. I love your approach and very informative. May Allah protect you.
Thank you so much
I used to listening to one of the greatest professors in Egypt but I think I'll take a break while enjoying this rheumatology playlist.🌹thanks.
My pleasure 😇
Your explanation to the number of positive titers alone is great. Thank you again
Thank you 🙏
Very good! I'm a medical student from Brazil and I'm really enjoying your videos. Do not stop making them!
Absolutely...Thanks a lot!
Love ❤️ to Brazil 🇧🇷
Absolutely marvelous presentation!
Thank you so much 😊
I bet this guy is so fun to hang out with! You are hilarious!
Thank you ☺️
Thanks a ton for simplifying the topics to the basics . 🙏🙏🙏
My pleasure 😇
Adding one comment @11:04. (By the way, your lectures are flipping awesome). You said Anti-dsDNA is negative in drug-induced lupus, which is GENERALLY the case. But for drug-induced lupus caused by a TNF-alpha blocker (currently the most common cause of DIL these days), the Anti-dsDNA will be POSITIVE. Very important for those people who it affects!!
Lol....absolutely love your approach. I laughed several times during your lecture. You’ve helped me understand more about the test, when I felt completely clueless. I have several symptoms, along with labs showing a high sed rate (53mm) and low white blood cells. My ana results are 1:80, and to my knowledge, that number is considered “weak/borderline positive”. I’m a bit confused with what that means exactly. Please help. Thank you:)
Ha that was not only informative but funny and well explained. My rheumatologist suspects I have reactive arthritis but after a positive ana but negative further tests on autoimmune antibodies I was still worried about the ana positive. I feel quite comforted now that I may just be 1 of the 9. Also great to know pattern is not of use, I will rest my thumbs now. Thank you, wish you were my rhumey 👍😁
Thanks a lot, dear
Can I ask, why does the pattern not count anymore?
And what about positive ana in the autoimmune psoriatic arthritis? Thanks in advance
Patterns are still ordered and might have some utility...I meant that they are not the mainstay of diagnosis.
Thankyou sir...your videos are such a boon..😊
So nice of you! Thank you!
Yesss. Just started this topic in Immunology
Awesome 👏
I’m glad you make these videos make me waste time in a good way :) thanks
You’re very very welcome 🙏
You are so dang right. I love it when you are able to call someone an idiot in this politically correct world which is so fake. Please don't lose this. Really enjoy your lectures.
Thank you ☺️
I was joking 🙃
I had a positive analysis of 1:1280 speckled but the rheumatologist I was referred is booked up to September. I called about progressing symptoms and they got me a Tele appt for the end of may
The “stupid ana test”. 😂😂😂
Haha 😂
Dude the quality of your videos are up in the clouds :) Well done 🥳
Thank you 🙏
i stan people who's good in entertaining himself and others
Thanks 🙏
I have a question I want to be a nurse when I grow up, do I have to learn about almost all the diseases? If so I’m getting started right now with you I can’t remember anything but your videos make me remember everything in a fun way so I’m glad and thankful for everything you do keep up the good work
I am so happy that you want to be a nurse...If you focus on your dreams, you will realize them one day.
You don’t have to know about almost all diseases...I've never met anyone who does.
You judt need to know the most common ones.
Good luck 🍀
I really really learnt a lot from your vids bro..... bravo !
Thank you so much 😊
I was really sad my labs came back positive. But your videos cheered me up. L😂L!
I wish you the best!
This is the best educational video ever, and made me laugh at the library XD
Haha 😂
Thank you 😊
I laughed when I saw #meaningless 😂 I didnt know I wanted to learn this stuff thanks
Haha 😂
Thank you so much 😊
You are THE best for sure!!!
Thank you 🙏
Your videos are insightful.
I love this channel... very beneficial content... thank you sir 🙏
I love this guy!
Thank you 😊
Hello! I know that in contrast to classic drug-induced lupus, you can have anti-dsDNA antibodies when the drugs are TNF alpha- inhibitors or interferon - alpha.
In USMLE book has been written ( patients with high titers tend to have more aggressive disease with extraarticular manifestations. ) !!!
High titer of what?
And which patients? Or which disease?
God Bless MEDICOSIS
You too!
You are at the top,
you are the best 💙
Hello. Ilove youre lectures.
Thank you so much 😊
Thank you. From, Puebla, MX.
My pleasure 😇
Amazing lecture 👌 I enjoyed it 😀
Thanks
Thank you 🙏
I am specialized in dermatology and andrology
your video in vasculitis and lupus is 👏 amazing ,brilliant and so funny 😄
Hoping to see more video in these field and specifically autoimmune and genetic disease and also cases are very helpful 👍 👌
Love your videos. Entertaining and informative! 😊❤
Found this incredibly helpful and love the hand written slides, makes it more real - YOU are hilarious, like lots of British dry, sarcastic comedians and many British people in general...but you definitely sound to have a US 'twang'. Just one thing to note, I did find it came over as a bit condescending and dare I say ..sexist..when you use examples and then use the word 'Honey' to refer to the presumably female client - maybe it's just a Brit thing, but Honey, as you use it sounds like every woman is thick and talks rubbish - other than that - fabulous, will def subscribe
No, I use honey 🍯 for anyone.
I am not British.
If you watch more of my videos, you would realize that I don’t make fun of people...I create imaginary counterarguments and then respond to them. My only purpose is to make learning medicine fun.
Also, I have tens of thousands of female subscribers to this channel.
I really appreciate your comment and your honest feedback.
Thanks!
@@MedicosisPerfectionalis yes you are genuinely one of the most entertaining medical experts I have ever heard, absolutely love it - looking for something on a negative ANA but with full on diabetes mellitus, rash, arthritis, eosiphillia, high WBC, high blood pressure, pancreatic area pain... on a detective mission haha
Can you please tell me why one needs to do CMP and CBC for RA?
To assess the severity of the articular and extraarticular symptoms.
Can you confirm if ANA patterns are not longer used (min 9:41)? You have a more recent video explaining patterns and their association to specific diseases and I got confused. Thanks! You are a great teacher!
They are still used. I made a mistake!
Muchas gracias Brooo!!! Eres un excelente profesor. Yo también soy médico y profesor en mi país. De verdad disfruto muchos tus videos. Gracias !!! Saludos desde Merida Yucatán México
Mujhe antinuclear antibiotics hai
Thank you
My pleasure 😇
I have a question. What if the ANA and ANA-dsDNA are positive but the patient doesn't exhibit all the symptoms to fit SLE?
You don’t need to fit all the signs of lupus I think the basis for diagnosis is that you meet the criteria for at least 4-5
I’ve had positive ana test first time in April 2019 and then December 2019 it only went up like two numbers from 15 to 17. I’ve been loosing my hair for the past 2 years. My rheumatologist told me to take hydroxychloroquine. I’ve done research on it and the aide effects sound so scary. Is this worth the risk? Can a high Ana test make me loose hair?
Can you update me on your case. I recently tested positive on my Ana and ngl I’ve been losing a looooot of hair and I’m getting worried. My family always comments on how much hair I leave behind and my shower is always clogged with so much hair. I really don’t know what is causing my hair loss. I don’t think I have any symptoms but I’m kinda anxious about it all. My doctor said I’m fine for now but in the future I could develop something or I could not. I did the test in December 2019... and the pattern my lab results said were in the centromere. I just hope it’s a false positive 🥺 I’m only 20 years old.
Hair loss is common in females with SLE. Start medication and follow up regularly.
Okay I'm super confused please help me understand! I have a positive ANA, symptoms of both lupus and Fibromyalgia, and my symptoms are always worse in the morning. My rheumatologist did blood tests and the lupus specific came back inconclusive cannot rule out but cannot confirm. But he told me I only have fibro. I really feel something else is going on bc I get severely sick randomly in the ER and need surgeries.
Look into UCTD! I only have a positive homogeneous and speckled ANA with a titer of 1:1280, but no other specific antibodies, or a SED rate (inflammation measured by size of red blood cells) and my rheumatologist diagnosed me with Undifferentiated Connective Tissue Disease, put me on plaquenil (immuno modulator) and my joint pain went from a 7 to a 3!
What about high RNP and high Sm/RNP? I got my bloodwork but can't see doc for a month waiting for xray results
Could you please answer my question?
Can ANA test (IFA, 1/80, IgG) show a response of the body to a metal implant (titanium screws on the jaw)?
Is an autoimmune/autoinflammatory response can be induced by metal adjuvants and may they cause a positive ANA test result?
Or, could we say a negative ANA test means there is no response of the body to the metal (titanium) implants?
Please tell me how does one find out what exact autoimmune disease you have if negative for lupus and sclerosis. My ratio is 1:640. My physician did not say anything about it
fantastic mnemonic
Which one?
@@MedicosisPerfectionalis the one for Anti SSB
Anti SSA
Symphonic mnemonic
Great video ! Sir I have a question. So I have severe fatigue, joint pain, abdominal and pelvic swollen feeling and pain. My ANA came positive 1.80 speckled titter, also CH50 came high over 60. Dr said no lupus as my wbc were normal upper 6000 and metabolic panel normal with protein normal in the higher range. My thyroid antibodies came very high but normal t4 and TSH , in addition to that my c3 c4 normal as well. So can you still have lupus with just positive ana and all the symptoms? I am struggling as I feel my life was been put upside down and is just hard to move on. I have had ana tests in the past and it was negative but for the last 3 times is positive. Should I repeat the test a later point or what other tests can I do to dictate if I have lupus ?
Golden content. Thank you!!!
My pleasure 😇
So I had my test done twice. My first test showed centromere pattern. It was a false positive. My second showed diffuse pattern at 1:320 . In my case, the pattern really made a difference because I was misdiagnosed the first time. And diffuse pattern is associated with SLE (more likely) but I carry no symptoms of the disease. I am confused and happy because I am now assured it's not scleroderma , but I show no signs of SLE so could it just be existent in my healthy body? Also a lot of patients have the pattern checked out but why is it useless like you mentioned?
It’s not 100% useless...It’s less significant overall...I am glad it helped in your case...How is your health now?
Medicosis Perfectionalis my health is amazing! I have no symptoms but my rheumatologist ordered tests to be sure. No signs and symptoms of anything just waiting on the antibodies. But I was shocked to see that it changed from centromere to diffuse . Also, do ethnics play a role? I'm Arabian American and my family has no history of ANA , my mom has celiac disease, however.
Only reason I ask is because I know a lot about medicine and have read that Caucasians generally get affected by Ana's more than any ethnicity. Any idea?
I'm going through something similar I'm losing an extreme amount of hair out of nowhere. My ana came back at 1:320 and I also have A" 6,7 diffuse nuclear dots pattern. I'm going back to the dermatologist to see what they can do for my scalp while I wait for a rheumatologist appointment. How are you doing now
@@vanessafleming3049 im doing very well thank you! im actually a masters student and my research is in immunology currently. I would be more than happy to give u all the info I learned. I test positive for Anti-Smith antibody -- at 1.3 --- my ANA is 1:320 Diffuse/homogenous - my rheumy said Lupus is definite if I develop symptoms. because anti-smith is very specific to only lupus. I had severe leg pains in the past that vanished through controlling my stress, exercising and eat very very healthy. how are you now?
Fibromyalgia is not a Rheumatological disease; almost all recent research points to it being a CNS disorder.
I looooove your videos bro keep going 😂❤️
Thank you so much 😊
10:57
Are anti-dnDNA Abs negative in lupus without nephritis?
Came here specifically for the patterns 😂 I don’t have the balls to question my professor.
Pattern recommended now
So mine was 1:1280 and had Nuclear and Speckled patterns. I have a lot of symptoms. ???? What could it be
Thank u , keep it up
You’re always welcome 🙏
I guess if there is no correlation between titer and symptoms, a negative ANA (titers lower than 1:80 (or 1:160 dep. lab ref.) cannot rule out a rheumatoid illness and can still cause symptoms? Another one: i have an ANA result of 1:320 but all specific ANA results were negative. Can i rule out the known Rheumatoid illnesses, and where to go (some commercial lab?) if i want to know which type of tissue is affected by 'my' auto antibody types?
6:12
So ANA shouldn't be
used for follow up?
Isn't it possible to have those ads at the end or at d beginning of a video ?? It disturbs d flow !!!
Can a positive ANA become negative?
so I have a low titer ANA of 1:40 but my dsDNA was 274 my platelets were low my white cell was low normal... my kidney function dropped in half in one month... I have nasal sores, severe hairloss, joint pain, weightloss, gastrointestinal pain, extreme fatigue.... My dr diagnosed me with Lupus... Just curious with a patient with my symptoms and bloodwork would you also diagnose with lupus?
I think it’s very likely.
But, I cannot diagnose you on the internet.
Also, I am not a licensed physician, so please talk to your doctor.
If you’re not sure, please seek a second medical opinion!
Keep fighting the good fight!
Good luck 🍀
Little Willow Homestead, Have you had your thyroid checked? There is a connection between thyroid and kidneys and fatigue, hair loss, and some of your other symptoms could be from the thyroid. Also, check out the TSH levels the American Endocrinologist Society suggests. They are totally different from the labs and most doctors, much lower to feel good!
Erin Dowling my thyroid is perfect.. I hv lupus and had reactivated ebv.. thanks though 😊
Why, my analysis 1:40 says it's positive?
Allah bless you Bro, keep going
Sure, bro!
Why is 1:40 negative? I had blood work done and I had a 1:40 Ana in the nucleolar pattern. The lab listed it as positive.
Different labs have different reference ranges.
Please talk to your doctor!
Thanks!
My pleasure 😇
3:22 ?Is 1:80 itself positive
What do you think of positive RF, ESR and CRP but negative multiplex ANA and CCP? Lupus or RA?
You can’t tell based on these few labs alone.
Thank you ;)
You bet!
Is 1:80 titre considered positive?
So if my results come back ana 1
Sir is ANA test use to dignose psoriasis or psoriatic arthritis? Any information about this pls how to dignose
ANA alone can't confirm the diagnosis of either one.
Mine came back 320. Pain in joints. A lot of pain. Daily since 4 months now.
You mean the ANA?
Mine was 320 tier homogeneous. Do you have Lupus
I always listen to all medical lectures at x2 speed. Mr Medicosis always sounds like some hyperactive individual. It's weird listening to him at normal speed haha.
Haha 😂
if you are ANA+ but DS DNA -, can you still have lupus?
Lupus has many criteria to establish a diagnosis. These 2 labs alone can neither confirm nor exclude the diagnosis.
I have positive ANA, speckled pattern 1:320. I was tested due to joint pain and fatigue. All the antibody test were negative. Does this mean I don't have lupus?
How long have you had a positive ana ?
Hilarious and informative video.
But...
I'm one of the "idiots" that you mentioned and so I'm not clear on why a higher titre is correlated with a higher likelihood of having the disease but isn't correlated with progression or severity of the disease. Can you explain? Surely a patient with 1,000 antibodies will have less severe disease than a patient with ten million antibodies. What am I missing? Is the higher titre denominator just a measure of the "quality" of the sample? Like, you can trust the result more because it was based on a sample that had lots of antibodies in the serum?
I think its about chance. Because the test only and only means you have higher number of anitbodies. You can have higher antibodies, but doesn't mean that the disease is servere because the number of antibodies doesnt have anything to do about if the patient is symptomatic or not. It could just mean one thing that is that the patient has a chance that he or she has autoimmune disease. Here the the confusion is with the severity and probability of having a disease. ANA is just about if you have the disease or not, thats why doing that test wont help you to treat if the disease becomes severe
@@vidhukrishnan1827 Thanks
Positive for Ana - 1:320
Positive for anti-sm
Negative for anti ds- dna
What does that mean ?
Please Talk to your doctor.
These Labs on their own cannot confirm the diagnosis.
Hi Isha,
Were you able to figure out the significance of those results? I have positive ANA 1:640 homogenous and positive for anti-Sm as well but no symptoms of lupus, just a family history. Curious if you had more information!
If someone doesn't know what "auto-antibodies" means, I don't know how he could have even passed to MED-school.
Can you recommend any easy to read rheuma intro (book)? I'll have the rheuma module next year but an optional course this year and would like to read more about some diseases
Start with Goljan pathology amzn.to/2MufTPw
Then, use Medstudy books (their rheumatology review is excellent)
Rheumatology secrets 3rd ed. by Sterling G. West, MD
@@vainvampire Thank you very much!
My mom is actually weakly positive, A bit above negative, but still its positive, what should I next ? Is this really bad ? Do I need to fear the upcoming times of my life ? I’m really worried.
We can’t jump into conclusions based on one lab result.
@@MedicosisPerfectionalis Other results were actually normal, except that urine test was a bit weird.
Great video OK you’ve explained it well, I have a high anti-histone test 3.2. All the rest are negative with that being said is there any correlation between taking the prescription drugs Effoxor or Veneaflaine amoxicillin or gabapentin? all this seems to really blow up and manifest after getting the big C and strep throat together. also, is there any correlation to reactivation of Epstein-Barr and lupus? thank you so much in advance. also have a high-level test for Crohn’s and ultra colitis.
Learn about ANA patterns: ruclips.net/video/YjZcJ6WnVOg/видео.html
Can I get an opinion! I just tested positive for ANA. My Titer is 1:640 and my pattern is homogeneous and speckled pattern. What does a double pattern mean?
Hey 👋 Holly,
Please watch my video titled: “ANA Patterns”.
15:24
How can a type of arthritis be called "non-inflammatory"? Isn't arthritis inflammation of the joints? Isn't -itis = inflammation? I have read that the Greek root -itis can mean disease, so is it the case here?
It’s systemic inflammation vs no systemic inflammation (relatively speaking).
@@MedicosisPerfectionalis Thank you
Why ANA patterns are no longer used? I wanna really know I’ve searched but didn’t find a clear answer
They are still used in some cases. I’ve made another video on ANA patterns.
Sir My ANA test Report
Pattern : nucleolar
titller 1:100
intensity : 1+
What does it means
Are you okay now
Why $63,000?
Hi. Do you have an episode on Juvenile Idiopathic Arthritis as well? Thanks
At the beginning of the video you said ANAs dont correlate with the disease severity, but then (and in other videos) you also said that anti dsDNA antibodies do actually correlate with disease activity and flares (in SLE). So. Did you mean "MOST" of ANAs dont correlate with disease severity? Or am i just getting it wrong? Greetings from somewhere in one of the Mexicos countries of Southamerica.
There's a difference between ANA is a single test, and ANAs as a category.
It's like the difference between Tetracycline (individual drug) and Tetracyclines (A class of medications).
I was referring to ANA as a single test/ antibody.
@@MedicosisPerfectionalis Thanks for your answer!! love your work!!
You’re very welcome 😊
❤❤❤
Thank you!
What s a difference between ANA n ANTICCP?
Watch my video on anti-CCP.
These are 2 different autoantibodies.
+ANA means alot But _ve ANA Does Not mean anything!