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Lupus Overview

What Is an Antinuclear Antibody Test

An antinuclear antibody (ANA) test is a sensitive screening tool used to detect autoimmune diseases, including lupus. Antinuclear antibodies (ANAs) are antibodies that are directed against certain structures within a cell's nucleus (thus, antinuclear antibody). ANAs are found in particular patterns in people with autoimmune diseases (those in which a person's immune system works against his or her own body).

An ANA test is done on a sample of a person's blood. The test determines the strength of the antibodies by measuring how many times the person's blood must be diluted to get a sample that is free of antibodies.

Does a Positive ANA Test Mean That I Have Lupus?

Not necessarily. The antinuclear antibody (ANA) test is positive in most people who have lupus, but it also may be positive in many people who are healthy or have another autoimmune disease. Therefore, a positive ANA test alone is not adequate for the diagnosis of lupus. There must be at least three additional clinical features from the list of 11 features for the diagnosis to be made.

How Is Lupus Treated?

The type of lupus treatment prescribed will depend on several factors, including the person's age, type of drugs he or she is taking, overall health, medical history, and location and severity of disease.

Because lupus is a condition that can change over time and is not always predictable, a critical part of good care includes periodic visits with a knowledgeable, accessible doctor, such as a rheumatologist.

Some people with mild features of the disease do not require treatment, while people with serious involvement (such as kidney complications) may require powerful medications. Drugs used to treat lupus include:

  • Steroids. Steroid creams can be applied directly to rashes. The use of creams is usually safe and effective, especially for mild rashes. The use of steroid creams or tablets in low doses can be effective for mild or moderate features of lupus. Steroids also can be used in higher doses when internal organs are threatened. Unfortunately, high doses also are most likely to produce side effects.
  • Plaquenil (hydroxychloroquine). Commonly used to help keep mild lupus-related problems, such as skin and joint disease, under control. This drug is also effective at preventing lupus flares.
  • Cytoxan (cyclophosphamide). A chemotherapy drug that has very powerful effects on reducing the activity of the immune system. It is used to treat severe forms of lupus, such as those affecting the kidneys or brain.
  • Imuran (azathioprine). A medication originally used to prevent rejection of transplanted organs. It is commonly used to treat the more serious features of lupus.
  • Rheumatrex (methotrexate). Another chemotherapy drug used to suppress the immune system. Its use is becoming increasingly popular for skin disease, arthritis, and other non-life-threatening forms of disease that have not responded to medications such as hydroxychloroquine or low doses of prednisone.
  • Benlysta (belimumab). This drug weakens the immune system by targeting a protein that may reduce the abnormal B cells thought to contribute to lupus. People with active, autoantibody-positive lupus may benefit from Benlysta when given in addition to standard drug therapy.  
  • CellCept (mycophenolate mofetil). A drug that suppresses the immune system and is also used to prevent rejection of transplanted organs. It is being used increasingly to treat serious features of lupus, especially those previously treated by Cytoxan.
  • Rituxan (rituximab). A biologic agent used to treat lymphoma and rheumatoid arthritis. It is used to treat the most serious features of lupus when other therapies are not effective.

 

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