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Expert Q&A
Question:
I am 34 years old and 18 weeks into my first pregnancy. My mother has SLE (Systemic Lupus Erythematosus; a.k.a lupus) and therefore asked me to have some specific blood tests done. I have tested positive for ANA and Anti-cardiolipids. I am not getting much of a response on this matter from my GP in England who is supposed to be consulting a rheumatologist. Can you tell me what the results mean and where I can find out more information?
Answer:
SLE is a multisystem disease process and its diagnosis is based on the presence of symptom complexes together with laboratory abnormalities. The diagnosis is rarely based on abnormal lab values alone. The interpretation of ANA and Anti-cardioloipin results can be quite confusing. They are not just "positive" or "negative," rather fall within a range. A normal pregnant woman can have "positive" results but < 1% of these results will fall within a clinically significant range, i.e. the pregnancy will not be affected. It is for this reason that that testing for ANA and Anti-cardiolipids is only done in pregnancy for the following indications:

1. Personal history of SLE or other autoimmune disease
2. Unexplained or recurrent pregnancy losses
3. Presence or history of unexplained thrombocytopenia
4. History of unexplained thrombosis or embolis
5. History of unexplained stroke or myocardial infarction
6. False positive VDRL
7. Abnormal PTT or PT test
8. Severe or early onset preeclampsia

My recommendation: have a specialist in Maternal Fetal Medicine review your history and your lab results!

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