DITTO to everything that Oluwa said. 95-98% of persons with lupus have a positive test for ANA. Therefore, less than 5% of people can have a negative ANA test, and still have lupus!!! Lupus patients who have a negative ANA test usually have a positive test for anti-Ro (also called anti-SSA) or anti-La (anti-SSB). Therefore, if you have some symptoms and signs that suggest lupus, but with a negative ANA test, you should be very carefully evaluated for a large number of conditions that can have a positive ANA test. These conditions (which can mimic lupus) with a positive ANA test include:
* mixed connective tissue disease
* undifferentiated connective tissue disease
* rheumatoid arthritis and several others.
It may take a while before you can get a definite diagnosis because the evolution of these diseases (including Lupus) may take some time.
For a Lupus diagnosis (even with negative ANA), the antibody tests must be accompanied by symptoms, since antibodies alone, with no symptoms, do not diagnose the disease. If you have symptoms plus diagnostic antibodies or biopsy proof of disease, then you will probably be diagnosed with Lupus. If you lack all four, the diagnosis will only be presumptive, even in the presence of illness. This is probably what is happening with you right now :?
Doctors cannot agree on how best to describe patients who have lupus sympts and who lack all four of the unequivocal features. Doctors will say that you have a "lupus-like" illness, "mixed connective tissue disease," "undifferentiated connective tissue disease," and "forme fruste (meaning incipient, or hidden form) lupus". Each of these illnesses have specific and separate meanings and each describes a different form of illness.
Most summaries report anti-DNA antibody in about half of patients, anti-Sm in about one-third, and ANA in 87-94% of patients with unequivocal SLE.
It is a complicated process, even for doctors, to diagnose Lupus. Using ANA titer, related antibodies, complement levels and symptoms to determine a diagnostic certainty is difficult. However, as many as one-quarter of patients referred for suspect SLE fall into the "not-quite-lupus" category, while patients who have any one of the four unequivocal features listed above are given a definate diagnosis of SLE.
Whether to diagnose a patient as having lupus or lupus-like disease is not so much a question of the doctor being right or wrong; it is more a question of the doctor's style, unfortunately. In either case, the treatment options should always be the same. ANA-negative lupus does exist, with a large number of buts, and ifs, and whens. More importantly is the fact that the question itself is not very important. It is never critical to say definitively that a given patient does or does not have lupus. What is important is to evaluate your current symptoms, to put the symptoms into an overall context that includes blood tests, duration of symptoms, other illnesses, and medications, and to develop a treatment plan based on the total information in your case, rather than on a blood test alone. That is what you should insist that your doctors do!
Best Of Luck
Look For The Good and Praise It!