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    What do all the blood test mean that they ordered on me?

    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.
    -----------------------------------------------------------------


    Here are some of the mimics,

    ADEM differs from MS in that it is often clearly triggered by an immunization, or viral infection. The most common cause is prior measles infection, usually in children. ADEM runs a monophasic course, which means that there is one episode.

    Systemic Lupus Erythematosus (SLE), is a chronic, inflammatory disease that may affect the skin, joints, blood and kidneys. Symptoms include achy, swollen joints, extreme fatigue, anemia, skin rash, sun or light sensitivity, hair loss, seizure, and Raynaud's phenomenon, where fingers turn white or blue in the cold.

    Sometimes called the great imitator, lupus commonly displays symptoms associated with another disease, such as MS. Lupus and MS can be diagnosed simultaneously, although that is less common than being diagnosed with one disease, and then later, diagnosed with the other.

    An antinuclear antibody (ANA) test can help to confirm a lupus diagnosis, but other diseases, including MS, can also produce positive ANA results. In addition, even a person who has lupus will not always produce positive results on this test. A urinalysis or kidney biopsy may be performed to check for signs of possible kidney problems. MRI, CT scan, echocardiography, x-rays, and other diagnostic criteria are also used. Sometimes, MS lesions on the spinal cord can be a distinguishing factor, or first-trimester miscarriages, which are quite common in women with lupus, but not women with MS.

    Sjögren's Syndrome is a chronic disease in which white blood cells attack the moisture-producing glands. It is a systemic disease, which means that it affects the entire body. Symptoms include dry eyes and mouth, difficulty swallowing and speaking, fatigue, joint pain, decreased sensation, and numbness. Sjögren's can plateau, worsen, or go into remission, and some people will experience mild symptoms, while others will be greatly debilitated.

    Nerve conduction velocity (NCV) tests can be helpful in differentiating between MS and Sjogren's because nerve damage in MS is central, but nerve damage in Sjögren's is peripheral. However, this is not always the case. Occasionally, Sjögren's affects the central nervous system, causing cognitive impairment and spinal cord involvement.

    "Some researchers believe that Sjögren's syndrome is somehow linked to MS," Burks says. "But this opinion remains highly controversial."

    Myasthenia Gravis (MG) is a disease in which weakness occurs when the nerve impulse responsible for initiating movement fails to reach the muscle cells. Individuals with MG have an increased risk of developing other autoimmune diseases.

    MG symptoms tend to fluctuate throughout the day, often worsening at night. Droopy eyelids, facial weakness, impaired eye coordination, weakness of the limbs, neck, shoulders, hips and trunk muscles are all typical. Muscle fatigue is common, and heat, overexertion, or increased stress can aggravate this symptom. MG can occur at any age, although young women and older men are the most commonly affected. Those with MG experience no loss or change in sensation and they don't normally experience generalized fatigue. Instead, they experience localized fatigue in overtired muscles.

    "A very specific test for MG is a blood test for serum antibodies to acetylcholine receptors," Burks explains. "Eighty percent of all patients with MG will have abnormally elevated serum levels of these antibodies."

    Sarcoidosis typically appears between the ages of 20 and 40. Usually, the disease appears briefly and heals naturally. However, between 20 and 30 percent of sarcoidosis patients are left with some permanent lung damage, and in 10 to 15 percent of the patients, the disease can become chronic. Symptoms include dry mouth, excessive thirst and fatigue, skin rash, vision abnormalities, chronic arthritis, shortness of breath, enlarged lymph glands, cough and fever. A chest x-ray is one of the most helpful diagnostic tools

    INFECTIOUS DISEASES THAT MIMIC MS

    Lyme disease (LD) is an infection caused by Borrelia burgdorferi, a bacterium carried by deer ticks. Untreated, the bacterium travels through the bloodstream, causing severe fatigue, a stiff, aching neck, tingling or numbness in the extremities, and facial palsy. The primary symptom is usually a rash that radiates from the tick bite. Diagnosis should be made on the basis of symptoms and evidence of a tick bite, not blood tests, which can often give false results if performed in the first month after infection.

    Those who live or work in residential areas surrounded by tick-infested woods, or enjoy hiking, camping, fishing and hunting, or live in endemic areas are at increased risk for this disease.

    Human T-cell lymphotrophic virus-1 (HTLV-1) is associated with progressive spinal cord dysfunction. Symptoms include spasticity, partial paralysis of the lower limbs, bladder and bowel incontinence, and impotence. HTLV-1 can be ruled out with a titer, which is a type of elevated antibody test. "HTLV-1 affects the spinal cord and does appear similar to primary progressive MS," Burks explains. "But HTLV-1 primarily occurs in the Caribbean, so it is important to ask about travel to endemic areas. Besides the Caribbean, these areas include Southern Japan and less commonly, the Pacific Coast of South America, Equatorial Africa and the Southern United States. HTLV-1 is also common among intravenous drug users."

    Neurosyphilis, the advanced form of syphilis, can cause visual problems, cognitive changes, and sensory or motor tract dysfunction. As with HTLV-1, testing the production of antibodies can eliminate syphilis and neurosyphilis from the list of possible diagnoses. "Neurosyphilis is not as common as it once was," Dr. Burks explains. "This is because syphilis, the forerunner of neurosyphilis, is so readily treatable today."

    VASCULAR DISEASES THAT MIMIC MS

    Stroke symptoms include sudden trouble with vision in one or both eyes, sudden trouble walking, dizziness, loss of coordination, sudden severe headache, confusion, trouble speaking or understanding, sudden nausea, fever, vomiting or loss of consciousness.

    "Strokes can be caused by bleeding in the brain or by blood clots that cut off the blood supply to an area of the brain," Burks explains. "The result is that neurons in the brain die. Major strokes cause very obvious losses in function and are unlikely to be confused with MS. However, smaller strokes can produce changes or loss in function that can look similar to a MS attack. Many people with MS have first been misdiagnosed with stroke."

    Central nervous system (CNS) Angitis, an inflammation of the blood vessels of the brain, can produce headache, confusion, and other neurologic deficits that slowly progress.

    Dural Arteriovenous Fistulas are abnormal structures of blood vessels along the spinal cord that deprive the spinal cord of blood, resulting in weakness, bladder and bowel changes, and sensory symptoms, all of which appear in a relapsing or progressive manner. MRI of the spinal cord or spinal angiography may be required to confirm diagnosis.

    Binswanger's is a cerebrovascular disease usually seen in older patients with high blood pressure. Demyelination of the white matter surrounding the brain, similar to white matter lesions seen in MS, can appear with this disease.

    OTHER MIMICS

    Other diseases are occasionally confused with MS. These include fibromyalgia and vitamin B12 deficiency, muscular dystrophy (MD), amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), migraine, hypo-thyroidism, hypertension, Beçhets, Arnold-Chiari deformity, and mitochondrial disorders, although your neurologist can usually rule them out quite easily.

    Fibromyalgia involves pain and fatigue of the muscles, ligaments and tendons. Muscular pain can be shooting or throbbing. Burning, stiffness, fatigue, face and head pain, cognitive impairment, numbness, tingling, dizziness and impaired coordination are common. Changes in weather, hormonal fluctuations, stress or depression can all contribute to symptom flare-ups.

    "Although fibromyalgia does mimic MS, it will not show up on an MRI or even be observable at an exam," Burks says. "Fibromyalgia is very non-specific."

    Vitamin B12 deficiency may cause demyelination, numbness and tingling of the hands and feet, fatigue, weakness, and in extreme cases, change in mental status. "There is a theory that vitamin B12 can actually produce more myelin, so people with MS may assume that they need more of it," Burks says. "But B12 is only beneficial if you have a deficit to begin with."

    * courtesy of MSAA*
    Disabled RN with MS for 14 years
    SPMS EDSS 7.5 Wheelchair (but a racing one)
    Tysabri

    #2
    Great explanation

    I didn't ask the original question, but your explanation was so helpful. I'm going to print it. Thanks, Diane
    You cannot dream yourself into a character; you must hammer and forge yourself one.

    Comment


      #3
      blood works

      Hi I also did not ask the question but found this to be so educational as when blood work is taken I never know what it is for..Thank you so much for your detailed explanation..I find it very helpful indeed..I to shall print it off .xx Mary

      Comment


        #4
        Love!!

        Thank you!

        Comment


          #5
          Great Info

          Hi i didnt write the post but i was recently diagnosed. And ur explanation was so very helpful and i understood it lol. Thank u and the post. Live Laugh Love

          Comment


            #6
            Blood Tests

            Thank you so much for all the time and trouble you have spent to make the blood tests more understandable.

            It is so useful and I'm sure many people will be so thankful for this information.

            Many thanks once again.

            Min

            Comment


              #7
              Blood test

              Thank you so very much for your research, time and knowledge to explain the blood tests and what they mean and the data they provide!

              I was trying to research each one by one and your post was amazingly helpful!

              Well wishes, Krista

              Comment


                #8
                I had all those same blood tests ran - thank God we maxed the deducable already b/c dear lord that was pricey.
                Mine all came back normal....I don't know if I should be happy or sad....
                Waiting on the results of the latest MRI just to see if I have any new lesions....I have 5 small ones and the won't confirm my diagnosis until they see more. Grrr.

                Comment


                  #9
                  lab tests

                  Hi there,
                  I had blood work done in October 2013. In January 2015, I asked my GP if we could redo the lab tests to see if there were any changes. He flatly refused stating there was no point since the results would likely be the same. Seriously? Couldn't the results be different?

                  I've been off work since Oct 2013 and have absolutely no idea when, or if, I will be going back to work either. My GP has no idea what is happening in my body and yet he refuses to send me for additional tests or see another neuro. I have seen three neuros and now says that's enough.

                  The first and second neuros dx me with Cervical Dystonia, which only explained the head tremors. However, the third neuro was for my cognitive issues (he was doozy that neuro). He would not listen to anything my husband and I had to say plus he insisted I was depressed...which I was not. I am now, six months later. Mind you, he did confirm my memory problems.

                  I have major cognitive issues: finding the words, concentration, memory, relaying/repeating information read or heard, slurring, balance/coordination, blurry vision, etc.

                  How do I get a correct diagnosis for the above if I cannot get my GP to investigate or refer me to a competent doctor that can?

                  Grrrr!!!

                  Comment


                    #10
                    I understand your frustration. I would walk away from your GP and find one that will be your advocate. If you have seen several neurologists and feel that you have not got to the bottom of your illness, you need to go to a neurologist at a teaching/research hospital. There is no reason that you need to live with a health problem that can't be diagnosed. Good luck

                    Comment


                      #11
                      Something to consider... Chiari Malformation

                      I recently have been diagnosed with Chiari 1 Malformation (CM). All the symptoms you describe is included in CM. A lot of neuros are not educated in this, neither are radiologists it often overlooked by one or the other or both. It can be diagnosed via an brain MRI - you can even diagnose it yourself ... it is very easy.

                      I ran into this info on CM before I was diagnosed and I thought if I had that they would definately see it in the mri so I ignored it thinking it was unlikely ... I was wrong. So please do not overlook this info and the possibility of having it until you look at your mri (based on video below will help you distinguish if you have it) or post it to the fb group below for review.

                      You can view the video here about how to see if you have it: https://www.youtube.com/watch?v=I0f9e3pU6to

                      If you are unsure about doing it yourself you can join a Facebook chiari group I'm in and post the brain MRI and others are more than happy to help you with saying yeah or nah. The group is:


                      Here is a video on some of the symptoms: https://www.youtube.com/watch?v=YyF3HVgHpCs Also, with CM you can have a Positive Romberg sign and you can have tremors as stated in 1st video above.

                      My neuros keep going over all the same conditions such as listed in the above (main) post but nothing until they confirmed CM. Seriously check it out. When I looked back at old MRIs dating back to over 15 years ago I had CM at that time but was never diagnosed.

                      **URL removed by Moderator in compliance with MSWorld Guidelines. This may be put in your Profile for all registered, logged-in members to see. Go to your Username on black bar running across top of page > My Settings > Edit Profile**


                      Originally posted by artfan View Post
                      Hi there,
                      I had blood work done in October 2013. In January 2015, I asked my GP if we could redo the lab tests to see if there were any changes. He flatly refused stating there was no point since the results would likely be the same. Seriously? Couldn't the results be different?

                      I've been off work since Oct 2013 and have absolutely no idea when, or if, I will be going back to work either. My GP has no idea what is happening in my body and yet he refuses to send me for additional tests or see another neuro. I have seen three neuros and now says that's enough.

                      The first and second neuros dx me with Cervical Dystonia, which only explained the head tremors. However, the third neuro was for my cognitive issues (he was doozy that neuro). He would not listen to anything my husband and I had to say plus he insisted I was depressed...which I was not. I am now, six months later. Mind you, he did confirm my memory problems.

                      I have major cognitive issues: finding the words, concentration, memory, relaying/repeating information read or heard, slurring, balance/coordination, blurry vision, etc.

                      How do I get a correct diagnosis for the above if I cannot get my GP to investigate or refer me to a competent doctor that can?

                      Grrrr!!!
                      ~Brittan~ Over 15 years w/ symptoms & Recently diagnosed w/ Chiari 1 Malformation - it has a lot of similar symptoms to MS. Easy to dx by MRI. See videos CM info - how to dx via MRI: https://youtu.be/I0f9e3pU6to CM symptoms: https://youtu.be/YyF3HVgHpCs FB group: Chiari Is For Real

                      Comment

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