Today is a question grab bag – we tackle your questions about seronegative disease and handling abnormal autoantibody results.
What is a Sero-Negative Autoimmune Disease?
First off, let’s talk about what “sero-negative” means. “Sero-” refers to blood, and “negative” means that when we run auto-antibody blood tests, they come back negative. So, a sero-negative autoimmune disease is one where these specific blood tests don’t pick up the antibodies we typically look for.
Now, you might wonder, if the tests are negative, does that mean there’s no disease? Not at all. There are several autoimmune diseases that can be sero-negative. For example, psoriatic arthritis is always sero-negative, while rheumatoid arthritis can be either seropositive or seronegative.
Why Would an Autoimmune Disease Be Sero-Negative?
There are a few reasons why an autoimmune disease might be sero-negative. One reason could be that the level of autoantibodies in the blood is just too low to be detected. This might happen due to a generally weakened immune system or specific organ dysfunction, like liver failure, but these scenarios are usually obvious to your doctors right away.
Another reason is that we might not yet know which autoantibody to test for or how to test for it effectively. Take rheumatoid arthritis (RA), for example. For many years, the only antibody test we had for RA was the rheumatoid factor (RF). When the anti-CCP antibody test was developed, many patients previously labeled as having seronegative RA were found to have this antibody.
Diagnosing Sero-Negative Autoimmune Diseases
But how do we diagnose a sero-negative autoimmune disease if the tests are negative? It takes patience, persistence, and time. Diagnosing these conditions can be tricky because the lack of positive blood tests can lead to misdiagnosis or delays in diagnosis. Essentially, it becomes a diagnosis of exclusion, where your doctor needs to rule out other possibilities before concluding that you have a sero-negative autoimmune disease.
What Does a “sky high” Autoantibody Results Mean?
An abnormal autoantibody result, especially if it’s “sky high,” can be alarming. But remember, we don’t treat blood test results; we treat people. An elevated autoantibody result doesn’t always mean there’s something new or urgent to address. For instance, if you’re being treated for rheumatoid arthritis and your RF is still positive but you’re in remission, this result may not change anything about your current health status or treatment plan.
High Autoantibody Results: What to Do Next
When you get a high autoantibody result, the first step is to understand why the test was done in the first place. Was there a specific symptom or concern? Let’s say your centromere antibody, which is associated with CREST syndrome (a type of systemic sclerosis), comes back high. The next step would be to check for symptoms related to CREST syndrome.
High autoantibody results usually lead to more testing, but it’s crucial to avoid unnecessary tests. Discuss with your doctor which additional tests are necessary to get a clearer picture of your health. Sometimes, a high result doesn’t lead to an immediate diagnosis but rather a plan to “watch it.” This means knowing what symptoms to look out for and when to contact your doctor.
Communication is Key
The most important thing is to maintain open and honest communication with your doctor. They are the medical experts, but you are the expert on your own life. Don’t hesitate to bring up any questions or concerns you have about your symptoms or test results.