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QUESTION: What can cause a positive homogeneous ANA
1:320 and elevated compliment 3 and 4? Prior to taking plaquenil in addition to the compliments and ANA, my C-reactive protein,  send rate, IGg and SS Anti Dsna were all elevated. My vitamin D was low, RDW and MCV were elevated. After a year on plaquenil, all numbers normalized except Homogeneous ANA 1:160 and elevated compliments.  What disease is this indicative of?

ANSWER: Amy,
Positive homogenous ANA is seen in Lupus. But other lab tests are suggestive of rheumatoid arthritis and sjogren's. Sometimes these auto immune disorders co-exist in a person. We need to clinicaly corelate to conclude the diagnosis. But the Plaquenil works for all 3 conditions. But looking at reduction ANA count we can say good improvement is there. i.e. autoimmune reactions are under control. So continue to the same medicines.

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

QUESTION: Thank you for your response.
Everything I read about autoimmune disease and compliments, talks about low compliment levels.  The only thing I have found about ELEVATED compliment levels was rheumatoid arthritis. I do have osteoarthritis, but no symptoms of rheumatoid arthritis. What other conditions can be associated with chronically elevated compliments?

Answer
Amy,
Elevated complements is seen in rhematoid arthritis, hashimoto's thyroiditis, heamoglobinuria etc. rheamtoid arthritis, lupus n sjogrens are all connective disorders. Sometimes these present themselves as mixed connective tissue disorders. And it takes years to completely develop into a specific connective tissue disorders. Sometimes they overlap and patients have mulitple types of auto antibodies.

Thanking you!


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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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MBBS, Internship in Internal Medicine

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