Scleroderma
Scleroderma is in fact a rheumatic and connective tissue disease. It owes its name to the Greek words 'sclero' and 'derma' meaning hard skin. Scleroderma can manifest in many forms. Scleroderma results in thickened and tightened skin and connective tissues at different locations on the body. While scleroderma may be noticed initially on the face and hands, it can appear all over the body. Scleroderma can manifest as localized scleroderma or systemic sclerosis. When scleroderma is localized, it is limited to skin and muscle. The skin affected by scleroderma becomes thickened and tough. In severe cases, scleroderma affects the blood vessels and internal organs. Systemic sclerosis can be fatal. Effects of scleroderma can be mild or serious, depending on the extent of the disease.
Scleroderma occurs when there is overproduction and accumulation of collagen in body tissues. Symptoms of scleroderma include numbness in the hands, cheeks and ears. Raynaud's phenomenon is often one of the first signs of scleroderma. There may be stiffness in the joints of the fingers. The skin becomes itchy and puffy and even the smallest task becomes difficult. Often there is difficulty in swallowing and digestion.
Blood tests of patients afflicted with scleroderma show higher proportion of antibodies produced by the immune system. While there are no medicines to stop collagen from being produced in excess, appropriate medication can reduce or prevent the complications arising from scleroderma. Topical corticosteroids creams can give some relief. Medicines to improve blood circulation may be prescribed. NSAIDs can help alleviate joint pain and stiffness. It is important to check if the digestive and respiratory systems are affected.
ANA blood test
Antinuclear antibodies (ANA) refer to the unusual antibodies that are detectable in the blood. ANA are gamma-globulins type of antibodies that are found in patients with certain autoimmune diseases. ANA are directed against certain components found in the nucleus of a cell in the body. These antibodies have the capacity of binding certain structures within the nucleus of the cells. The ANA test was first designed by Dr.George Friou in 1957. The laboratory blood test exposes the antibodies in the serum of the blood to cells. It is then determined whether or not antibodies are present that react to various parts of the nucleus of cells. Hence the term 'anti-nuclear' antibody is used.
Fluorescence techniques are adopted to detect the ANA antibodies in the cells. Thus ANA testing is sometimes referred to as fluorescent antinuclear antibody test (FANA). Nowadays, a method to detect antinuclear antibodies called enzyme linked immunosorbent assay (ELISA) is replacing the previous method of immunofluorescent assay technique. The ELISA method is less likely to produce false positive ANA result than the previous method.
Patterns also give doctors a clue as to the type of illness to look for while evaluating a patient. For instance, the disease Scleroderma shows in nucleolar pattern. If a person does not have any autoimmune disease, it is defined in speckled pattern. An ANA blood test is used in patients who might be suffering from Sjogren's syndrome, rheumatoid arthritis, polymyositis, scleroderma, Hashimoto's thyroiditis, juvenile diabetes mellitus, Addison's disease, vitiligo, pernicious anemia, glomerulonephritis and pulmonary fibrosis. ANA can also be found in patients with conditions that are not considered autoimmune diseases such as chronic infections and cancer.
The result of ANA test is expressed in titers. A titer of 1 to 80 (1:80) means that antibodies could be last detected when 1 part of the blood sample was diluted by 80 parts of another liquid. Usually this other liquid is a diluted salt solution. A larger second number indicates that the antibodies are present in greater concentration. Therefore a titer of 1 to 320 indicated higher concentration of antibodies in the blood than a titer of 1 to 80. The normal values of ANA blood test is : Titer below 1: 20 or 1:40 depending on the test method used.
Positive ANA test result is suggestive of autoimmune disease. It can also mean that the patient has drug induced lupus. Some drugs and infections can also induce false positive ANA test results. Steroids can cause a false-negative result. Medications, especially antibiotics such as isoniazid, penicillin, and tetracycline, birth control pills, lithium and some diuretics such as chlorthalidone can interfere with the test and affect the accuracy of the ANA test result.
Bibliography / Reference
| 