Lupus blood test results, antibody question?

[CMilhous]

ssDNA of 1140?

[Jmiller623]

SsDNA is not typically used in the diagnosis or monitoring of lupus. It is nonspecific as it can be found in other autoimmune disorders and medication induced lupus. Some clinicians may use it to round out their clinical picture based on context. If you fulfill a lot of lupus criteria but don’t have a positive dsDNA, some may order ssDNA to help confirm a diagnosis of lupus. However, the utility in using these for monitoring and diagnosis is still unclear.

Ask your provider why they ordered ssDNA and what it means? See what they say.

[Ingrid1234]

hss.edu/conditions_understa...

[Jmiller623 in reply to Ingrid1234]

This is a great read. Very simplistic. Thanks for sharing Ingrid!

[Jmiller623]

I know what they are used for but they are not specific nor more sensitive than dsDNA so their utility is limited. It’s all about statistics. There are much better papers than the one you attached. The paper you attached has conflicted interests and is a lab advertisement. I only use primary literature.

[Jmiller623]

From UpToDate with references.

Anti-ssDNA antibodies — Anti-ssDNA antibodies are generally not useful in the diagnosis and management of systemic lupus erythematosus (SLE). Antibodies that identify ssDNA react primarily with the purine and pyrimidine bases that are buried within the beta helix of double-stranded deoxyribonucleic acid (dsDNA) [2]. Because these epitopes are "hidden" when DNA is in its native configuration, antibodies directed against ssDNA do not usually crossreact with dsDNA. Antibodies to ssDNA have the following general properties:

●They are much less specific for SLE than antibodies to dsDNA. As an example, anti-ssDNA antibodies have been reported in rheumatoid arthritis, in drug-related lupus, in healthy relatives of patients with SLE [3], and, less commonly, in other rheumatic diseases and healthy persons [2].

●Anti-ssDNA antibody testing is not useful for the management of patients with SLE because the presence and titer of anti-ssDNA antibodies do not correlate well with SLE disease activity.

2. pubmed.ncbi.nlm.nih.gov/957...

3. pubmed.ncbi.nlm.nih.gov/836...

[Jmiller623]

Lupus like is unfortunately not the same. Eg take my situation where I’ve had one positive ANA and never dsDNA positive. A positive ssDNA for me would make a rheumatologist more confident in their diagnosis of SLE. Lupus like is a bucket diagnosis and encompasses everything from Sjogrens to scleroderma so I’d never hang my hat on ssDNA unless other labs were indicative.

[Jmiller623]

You changed your response. I responded to your unedited post. Sorry. Is what it is. We can go back and forth all day but truth is the only person whose opinion matters most is CMilhous’s ordering physician.

I make a point not to correct people on here and just share my knowledge and experience. My knowledge of ssDNA is it shouldn’t be used to diagnose lupus or lupus like illnesses. And that is also based on my experience as a patient having asked my rheumatologist.

Appreciate your sharing literature but guidelines and data still stands that it is not appropriate to use it when making clinical decisions. ssDNA is just too sensitive and not specific enough to use as diagnostic criteria. When picking tests for diagnosis they must be highly specific but don’t have to be so sensitive. ANA is highly sensitive and not specific which is why we always start there. ssDNA abs may find the same fate.

[Jmiller623]

Also looked at your references and I can’t access the other two you added about lupus without payment. If you’d like to post links of a PDF or something accessible so I can read the rest, that’d be great! Thanks.