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Positive ANA

Positive ANA

Clinical Summary

ANA (Antinuclear Antibody) was found positive at 2.2 (reference <1.0) on 2025-11-19 at DDRC Agilus Diagnostics. This was part of an autoimmune workup in the context of Pancytopenia.

Supporting Serology

Test Value Reference Interpretation
ANA 2.2 <1.0 negative Positive
Anti-dsDNA 29.1 IU/ml <100 negative Negative
Anti-CCP <7.00 U/mL ≤17.00 Negative
CRP 13.80 mg/L <5 Elevated
ESR 130 mm/hr 0–35 Markedly elevated
Complement C3 140.0 mg/dL 90–180 Normal
Complement C4 39.3 mg/dL 10–40 Normal
Ceruloplasmin 29.10 mg/dL 16–45 (F) Normal — Wilson's ruled out
Copper, serum 124.5 ug/dL 80–155 (F) Normal — Copper Serum

Interpretation

  • Positive ANA with negative anti-dsDNA and anti-CCP makes SLE and RA less likely
  • Normal complement levels further argue against active lupus
  • Elevated inflammatory markers (ESR, CRP) suggest active systemic inflammation
  • ANA positivity in an elderly patient can be non-specific — prevalence of low-titer ANA increases with age
  • Clinical correlation needed in context of pancytopenia

Additional Workup (Nov 2025) — Results Now Available

The following tests were initially reported as PENDING but final results are now available (from the final version of accession 4182YK007572):
- Serum protein electrophoresis (SPEP) — Inflammatory pattern, no M-spike. Rules out myeloma/paraproteinemia.
- Serum free light chains (Kappa & Lambda) — Kappa 36.81 (H), Lambda 26.73 (H), ratio 1.377 (normal). Polyclonal elevation — rules out monoclonal gammopathy.
- Copper, serum — 124.5 ug/dL (normal). Completes Wilson's disease rule-out alongside normal ceruloplasmin.

Peripheral Smear Context

The Peripheral Smear 2025 11 19 obtained simultaneously showed pancytopenia with eosinophil predominance (13%) and atypical lymphocytes (3%), adding eosinophilic disorders and reactive conditions to the differential at the time.

Follow-up

  • ANA pattern and titer not specified — may need further characterization (method was ELISA, not IFA)
  • Consider ENA panel (anti-Smith, anti-RNP, anti-SSA, anti-SSB) if autoimmune etiology pursued
  • Monitor serially in context of overall clinical course
  • The subsequent Aml diagnosis largely explains the pancytopenia, making the ANA positivity likely incidental

Updated automatically during ingest.