Hematology/Blood work

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QUESTION: I'm a 39 year old female. I had some blood work that showed:

ANA 1:160 Nucleolar pattern. Negative ENA. Also, my WBC were slightly elevated along with Neutrophils and Monocytes. I had a virus (cold) at the time.

I have no symptoms. I'm terrified of this being Scleroderma. Is this pattern only seen in the most severe form of Scleroderma? Or is it seen in other diseases or even normal healthy people.

ANSWER: Katherine,
No no. Its not scleroderma. Dont worry. Since ENA is negative there is nothing to worry. But repeat ANA after 6 months. These variation in WBC count is normal in viral fever/flu etc. Its better you send test results to me next time. I mean the values.

Thanking you!

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---------- FOLLOW-UP ----------

QUESTION: Thank you for your very prompt response.
My concern was mostly with the specific staining pattern of Nucleolar. It seems that is an uncommon type and associated with system scleroderma. Can it also be seen in CREST (limited scleroderma). I also understand that there are other types of blood tests that can be done. Anti-Centromere antibodies and Anti RNA Polymerase 111. Is it worth getting these done?

Why would one have these ANA antibodies if it is not scleroderma.

Thank you

ANSWER: Katherine,
The tests are worth for diagnosing scleroderma. But since ANA is negative, we will repeat ANA after 6 months, if it becomes positive as time passes by, then I will guide you what other tests need to be done. Right now don't worry many normal individuals have 1:160 ANA. But nuclear pattern of staining, indicates scleroderma n CREST  only if ANA concentration is positive!

Thanking you!


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---------- FOLLOW-UP ----------

QUESTION: Thank you again for you answers. I appreciate it.

I would like to confirm:

I had a positive ANA (antinuclear antibody) of 1:160 Nucleolar pattern. so, ANA was positve.

Then I had an ENA (Extractable nuclear antibody) testing for anti-SCl-70, it was negative. With that information, is your answer the same?

Also, please clarify. Did you say that Nucleolar pattern is seen in BOTH CREST(limited form) AND diffuse scleroderma (more serious form)?

Thank you very much. Have a nice day.

Answer
Katherine,
Yes the answer is same just because ANA has nucleolar staining, it doesn't mean scleroderma is there! We do further testing like anti-scl-70 kd kinetochore test. It's a confirmatory test. Since it has come negative you will be negative for scleroderma as of now! Don't worry. Yes Nucleolar pattern is seen both in scleroderma n CREST.

Thanking you!

Hematology

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Dr.Shrinidhi Kulkarni

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I can answer all questions related to hematology. RBC, WBC, Platelet and blood forming organs etc and related questions. hematology also includes blood proteins, hemoglobin and disorders related to clotting abnormalities. So questions about all aspects of hematology are welcome!

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