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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17325
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My ANA came back positive,ANA TITER 1 40,ANA PATTERN homogeneous.

Resolved Question:

My ANA came back positive,ANA TITER 1:40,ANA PATTERN homogeneous. Also RDW-CV and NEUTS are high and LYMPHS low.Bilirubin mod and ICTOTEST pos what does this all mean?
Submitted: 5 years ago.
Category: Medical
Expert:  Dr. D. Love replied 5 years ago.
Do you have the actual values for the different tests?
Was the bilirubin level in the blood checked?
If so, what was the level?
Customer: replied 5 years ago.
yes negative for bilirubin What do u mean by actual values?

Expert:  Dr. D. Love replied 5 years ago.
When performing the test,there is an actual number for the total white blood count and the neutrophils and lymphocytes. The neutrophils and lymphocytes can be high or low either by the percentage or the absolute count. There also should be a number for the amount of bilirubin in the blood. Do you have these numbers?
Customer: replied 5 years ago.
No number on bilirubin.RDW-CV is 15.2 NEUTS 72 LYMPHS19
Expert:  Dr. D. Love replied 5 years ago.
What is the total white blood count (WBC)?
Customer: replied 5 years ago.
Expert:  Dr. D. Love replied 5 years ago.
Thank you for the additional information. There are several issues involved in these lab results:

The ANA (anti-nuclear antibodies) is a screen for certain autoimmune disorders, and particularly lupus. However, there are many people without an autoimmune disorder that have a positive ANA, so a positive result is not sufficient to make the diagnosis. In a person withe symptoms that are worrisome for having lupus, a positive test is a sign that further testing is warranted. It may require an evaluation by a Rheumatologist, a specialist that deals with autoimmune disorders.

A moderate amount of bilirubin and a positive Ictotest are both saying that there is bilirubin in the urine. It is not possible to make any diagnosis based upon the presence of bilirubin in the urine. The next step is to measure the amount of bilirubin in the blood. The most common condition that causes a slight increase in the amount of bilirubin in the blood and urine is Gilbert's syndrome, a genetic condition affecting the enzyme in the liver that metabolizes bilirubin. It is benign and is considered a normal variant. It is fairly common, occurring in ~5% of the US population, and higher in certain ethnic groups. With further testing of the level of bilirubin in the blood and other liver tests, your doctor can determine the cause of the bilirubin.

The RDW is a measure of the differences in size of the red blood cells. Although the RDW can help guide the evaluation of anemia, it is generally not a concern if the RDW is abnormal in the absence of anemia.

The neutrophil and lymphocyte numbers are not a problem. When counting the white blood cells, the total and the number of each type is reported. To determine the different types of WBC, the percentage of each is determined by counting a sample of the WBCs. Then the percentage is used to calculate the absolute number of each type of WBC. When this calculation is done, both of the absolute counts are within the normal range for each type of WBC. Since each type of WBC can vary independently, it is not unusual for the percentages to be slightly out of range, but it is not a concern if the absolute counts are within the normal range.

You would need to discuss the positive ANA and bilirubin tests with your physician, who can best determine what would need to be the next step.
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