By Gail Kansky

Go ahead and admit it. Wouldn't you rather have just about any other disease instead of CFIDS? At least people wouldn't look at you as if you were crazy. Maybe the ER doctor would be nicer. Your sister might be more helpful and your doctor more sympathetic. And maybe it's true! You got a positive ANA! Doesn't that indicate lupus?

Diagnosing many autoimmune illnesses isn't like taking a pregnancy test that tells you yes or no. CFIDS isn't the only illness that doesn't have a diagnostic marker. There's no diagnostic marker for lupus, multiple sclerosis, scleroderma, etc., etc., etc.

The antinuclear antibody (ANA) screening test is often used to rule out lupus because 95% of normal, healthy people will have a negative ANA. There's still 1% of lupus patients that have a negative ANA and even those positive often take years before that is seen! The most commonly known pattern found in an ANA shows a patient's blood antibodies that bind to all parts of the nucleus. It's also a commonly seen pattern in healthy people! A "speckled" pattern is seen in many illnesses as well as in a small number of healthy people. A positive ANA could point to lupus, rheumatoid arthritis, Sjogren's syndrome, scleroderma, mononucleosis, autoimmune thyroid, liver disease, or even CFIDS. Even certain medications can cause a positive ANA. According to The Lupus Foundation of America, "At least 95% of the people who have a positive ANA do not have lupus."

If you have a positive ANA, your physician must then look at your symptoms to see where your diagnosis will fall. Lupus usually develops quite slowly. You don't see an abrupt onset.

A "borderline" ANA simply means that the test value is in the upper edge of the normal range or, perhaps, slightly over. Even a "high" ANA doesn't necessarily mean lupus. Other criteria must be factored in. As James A. Goeken, M.D., who has a laboratory in Iowa that specializes in autoimmune serology detection, says, "There is no universal normal range for the ANA. Normal levels vary from lab to lab. There is no limit to how high the ANA can go."

The National CFIDS Foundation * 103 Aletha Rd, Needham Ma 02492 * (781) 449-3535 Fax (781) 449-8606