So you are in the diagnosis process and your doctor just ordered lots of blood work. What are they looking for? As you may know, there is lots of MS mimics out there and they have to be eliminated before you can get the proper diagnosis. Here is a list of common blood panels that are ordered and what they are looking for.
ANA-
An antinuclear antibody (ANA) test measures the amount and pattern of antibodies in your blood that work against your own body (autoimmune). These abnormal antibodies, called auto-antibodies, bind to components of the person’s own cells calls “antigens,” causing the immune system to attack the body in an effort to combat disease. This test can also be referred to as FANA. If positive, it can point to an autoimmune response such a SLE, Sjogrens Syndrome,
RA, etc.
Rheumatoid Factor-
High levels of rheumatoid factor can indicate if you have RA or can point to several autoimmune diseases.
Sed Rate-
Also known as ESR, the sedimentation rate blood test measures how quickly red blood cells (erythrocytes) settle in a test tube in one hour. The more red cells that fall to the bottom of the test tube in one hour, the higher the sed rate. A high sed rate will indicate inflammation in the body caused by an autoimmune, infection, or cancer.
CBC-
A complete blood count (CBC) gives important information about the kinds and numbers of cells in the blood, especially red blood cells, white blood cells, and platelets. A CBC helps your doctor check any symptoms, such as weakness, fatigue, or bruising, you may have. A CBC also helps them diagnose conditions, such as anemia, infection, and many other disorders. Your doctor might order just a WBC differential (white blood cell types) if they want information on your immune system.
CRP-
A C-reactive protein (CRP) test is a blood test that measures the amount of a protein called C-reactive protein in your blood. C-reactive protein measures general levels of inflammation in your body.
ACE-
ACE is primarily ordered to help diagnose and monitor Sarcoidosis. Concentrations of ACE tend to rise and fall with disease activity. Sarcoidosis is a MS mimic.
Vitamin B12-
This test measures how much vitamin B12 is in your blood. Your body needs vitamin B12 to maintain a healthy nervous system and to make blood cells.
RPR-
Rapid plasma reagin test will detect syphilis antibodies. It can mimic MS. A reactive or positive test result does not always mean that you have syphilis. Other conditions can cause positive screening test results, including injecting illegal drugs, recent vaccinations, pregnancy, endocarditis, autoimmune dieseases (such as systemic lupus erythematosus), tuberculosis, mononucleosis, leprosy, malaria, hepatitis, Lyme disease, and rheumatoid arthritis.
Lyme Disease Test-
There are 3 test that check for the antibodies that are caused from Lyme Disease. They are the ELISA, IFA, and the Western Blot. The Western Blot can confirm results from the ELISA and IFA and is most often done to detect chronic Lyme Disease. This disease can mimic MS.
TSH T3, T4-
This test checks on your thyroid hormone levels. If they are too low or too high, it can point to problems with the thyroid gland. Some symptoms of hypothyroidism can mimic MS.
Anti-SS-A / -SS-B-
This test is for Sjogrens Syndrome, although it does come up positive sometimes in Lupus patients. Sjogrens Syndrome is a very good mimic of MS.
Anti-dsDNA-
The Anti-dsDNA Antibodies is a specific test for Lupus. This test will only be positive for Lupus. This disease mimics MS.
C3, C4-
The complement system is made up of a network of proteins that involve the immune system and inflammation. If C3 or C4 is decrease, which is part of the complement, it could mean Lupus. Vasculitis also can have decrease levels.
Anti-histone-
This test can check for a autoimmune process. People with SLE or drug-induced lupus may make antibodies to certain histones.
Acetylcholine receptor antibody-
Acetylcholine receptor antibody is an antibody found in the blood of some people with myasthenia gravis. Myasthenia Gravis can mimic MS. 10-15% of people who have Myasthenia Gravis will not have the antibody in their blood.
I would like to add that like MS, Lupus, is difficult to diagnose. The ANA levels to detect Lupus can fluctuate with the disease process. The levels can be normal one week and be abnormal the next.
Sarcoidosis ACE levels will fluctuate with the disease as well and in Sjogrens Syndrome, not everyone that has it, come up positive in the blood test. If you have a node in your lung and they suspect Sarcoidosis, the only confirmed result is a biopsy as to if you have the disease or not. Not a blood test. A biopsy of the salivary gland will 100% confirm Sjogrens Syndrome as well.
Some of these tests may be run on your CSF fluid when you get your LP done, otherwise it will be done on just regular blood.
ANA-
An antinuclear antibody (ANA) test measures the amount and pattern of antibodies in your blood that work against your own body (autoimmune). These abnormal antibodies, called auto-antibodies, bind to components of the person’s own cells calls “antigens,” causing the immune system to attack the body in an effort to combat disease. This test can also be referred to as FANA. If positive, it can point to an autoimmune response such a SLE, Sjogrens Syndrome,
RA, etc.
Rheumatoid Factor-
High levels of rheumatoid factor can indicate if you have RA or can point to several autoimmune diseases.
Sed Rate-
Also known as ESR, the sedimentation rate blood test measures how quickly red blood cells (erythrocytes) settle in a test tube in one hour. The more red cells that fall to the bottom of the test tube in one hour, the higher the sed rate. A high sed rate will indicate inflammation in the body caused by an autoimmune, infection, or cancer.
CBC-
A complete blood count (CBC) gives important information about the kinds and numbers of cells in the blood, especially red blood cells, white blood cells, and platelets. A CBC helps your doctor check any symptoms, such as weakness, fatigue, or bruising, you may have. A CBC also helps them diagnose conditions, such as anemia, infection, and many other disorders. Your doctor might order just a WBC differential (white blood cell types) if they want information on your immune system.
CRP-
A C-reactive protein (CRP) test is a blood test that measures the amount of a protein called C-reactive protein in your blood. C-reactive protein measures general levels of inflammation in your body.
ACE-
ACE is primarily ordered to help diagnose and monitor Sarcoidosis. Concentrations of ACE tend to rise and fall with disease activity. Sarcoidosis is a MS mimic.
Vitamin B12-
This test measures how much vitamin B12 is in your blood. Your body needs vitamin B12 to maintain a healthy nervous system and to make blood cells.
RPR-
Rapid plasma reagin test will detect syphilis antibodies. It can mimic MS. A reactive or positive test result does not always mean that you have syphilis. Other conditions can cause positive screening test results, including injecting illegal drugs, recent vaccinations, pregnancy, endocarditis, autoimmune dieseases (such as systemic lupus erythematosus), tuberculosis, mononucleosis, leprosy, malaria, hepatitis, Lyme disease, and rheumatoid arthritis.
Lyme Disease Test-
There are 3 test that check for the antibodies that are caused from Lyme Disease. They are the ELISA, IFA, and the Western Blot. The Western Blot can confirm results from the ELISA and IFA and is most often done to detect chronic Lyme Disease. This disease can mimic MS.
TSH T3, T4-
This test checks on your thyroid hormone levels. If they are too low or too high, it can point to problems with the thyroid gland. Some symptoms of hypothyroidism can mimic MS.
Anti-SS-A / -SS-B-
This test is for Sjogrens Syndrome, although it does come up positive sometimes in Lupus patients. Sjogrens Syndrome is a very good mimic of MS.
Anti-dsDNA-
The Anti-dsDNA Antibodies is a specific test for Lupus. This test will only be positive for Lupus. This disease mimics MS.
C3, C4-
The complement system is made up of a network of proteins that involve the immune system and inflammation. If C3 or C4 is decrease, which is part of the complement, it could mean Lupus. Vasculitis also can have decrease levels.
Anti-histone-
This test can check for a autoimmune process. People with SLE or drug-induced lupus may make antibodies to certain histones.
Acetylcholine receptor antibody-
Acetylcholine receptor antibody is an antibody found in the blood of some people with myasthenia gravis. Myasthenia Gravis can mimic MS. 10-15% of people who have Myasthenia Gravis will not have the antibody in their blood.
I would like to add that like MS, Lupus, is difficult to diagnose. The ANA levels to detect Lupus can fluctuate with the disease process. The levels can be normal one week and be abnormal the next.
Sarcoidosis ACE levels will fluctuate with the disease as well and in Sjogrens Syndrome, not everyone that has it, come up positive in the blood test. If you have a node in your lung and they suspect Sarcoidosis, the only confirmed result is a biopsy as to if you have the disease or not. Not a blood test. A biopsy of the salivary gland will 100% confirm Sjogrens Syndrome as well.
Some of these tests may be run on your CSF fluid when you get your LP done, otherwise it will be done on just regular blood.
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