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Dr. Gie
Dr. Gie, MD, Medical Specialist lll, Dept. of Health
Category: Medical
Satisfied Customers: 2298
Experience:  Chief Training Officer in a tertiary Teaching & Training Medical Center, MD, MS, MDA, MPH, CSEE, CESE
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Autoimmunity / ANA Pattern Question: please have a look at

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Autoimmunity / ANA Pattern Question: Hello, please have a look at my mom’s latest ANA results. She has a history of cancer (but has been in remission for 5 years); but her doctor tests her ANA regularly as part of her overall health and wellness check among many other tests.It’s always been slightly elevated in the past, but this time... her result was as attached.I’m confused because we only asked for a typical ANA test through Quest... and it appears here they’ve given us two reads:1:320 (Nuclear, Speckled)
1:40 (Cytoplasmic)Can you help us understand these results?
Hello this is Doctor Gie, Medical specialist. I am currently reviewing your concern. Pls note that all phone call requests are auto-generated and you may ignore these requests. Communicating through chat is just fine with me
May i know her age?
Customer: replied 15 days ago.
She is 70.
Customer: replied 15 days ago.
Especially interested in these AC numbers, which have never been reported on before.
Let me check this
The AC numbers or codes are the different types of patterns
Can you send the whole report? Im only getting a portion of the report
Customer: replied 15 days ago.
These two pages were the only two associated with her ANA...
Customer: replied 15 days ago.
Did you want to see all of the lab results from that day?
I understand. That’s ok. Hold on a sec let me review this
Customer: replied 15 days ago.
It is odd because we requested a simple ANA test, and they reported so much more substantially than they do normally... including these AC Codes. I will send you a spreadsheet of her lab history.
I understand. This is more comprehensive result. AC are codes for different types of patterns. You would need to do further testing to find our the specific pathology associated with the patterns
Customer: replied 15 days ago.
Here’s a little history of her ANA from the past 5 years.
Customer: replied 15 days ago.
Why would this be the first time they reported on the AC Codes? Never have they included that in previous?

And why if there was just a simple ANA test requested, would they provide two ANA results? Is that even possible?
Customer: replied 15 days ago.
Are you a rheumatologist?
I understand. Some laboratories report it with AC codes to be more specific with a certain pattern. Here let me attach an article for your reference
Here
Let me also post a link of different patterns of ANA
https://www.anapatterns.org/
Once we find out if ANA is positive and we have found out the pattern, a more specific test is done to rule in a certain condition
the AC codes are more specific report of the patterns seen
Customer: replied 15 days ago.
Yes, I understand that...

If it was the same lab, I just don’t understand why they only just reported AC Patterns. Wouldn’t those have been present for all previous tests?

Also - how is it possible to have two different ANA Titres and Patterns from the same test?

ANA (Nuclear, Speckled) 1:320
ANA (Cytoplasm) 1:40

How can there be both?
Yes there can be several patterns seen on an ANA test
Customer: replied 15 days ago.
With different levels of titres?
Yes. It is considered to be a mixed pattern
Customer: replied 15 days ago.
Ok.
Here let me attach som reference for you
Were you advisd to do further testing? If not yet, i would recommemd you check for anti-RO, anti-LA, anti DFS70 and anti scl-70
Is there anything else I can help you with? Or is there anything that is not clear to you? I would gladly clarify it to you
In the meantime, Dont forget to give me a five star rating on top of this conversation for the time and medical attention I have rendered answering your health concerns. Please note that you can help still continue your consultation even after you have rated me. Thank you so much
Customer: replied 15 days ago.
Is there anything else besides systemic sclerosis that can cause AC 29?
AC-29 pattern is highly specific for SSc especially the diffise cutaneous type and more aggressive forms pf SSc
Customer: replied 15 days ago.
Yes, I read that too.
Customer: replied 15 days ago.
Are you a rheumatologist, or what is your specialty?
I have been practicing for more than 30 years and have seen and handled cases such as this in the past. Your mother would need to do further testing to know specifically what her condition is.
Is there anything else I can help you with?
Dr. Gie and 10 other Medical Specialists are ready to help you
Customer: replied 15 days ago.
That’s it. Thanks.