June 02, 2010

"Borderline Positive for Lupus" – What Does That Mean?

During a recent interview on Larry King Live on CNN, singer Lady Gaga stated that she tested borderline positive for lupus but that, as of right now, she does not have lupus. But some have asked us, just what does “borderline positive” mean?

No single laboratory test can determine whether a person has lupus.

The anti-nuclear antibody (ANA) test is used as a screening test for lupus. We know that 95 percent of people with lupus have a positive ANA. Therefore, if a person has symptoms of systemic lupus but their ANA test is negative, that's generally regarded as pretty good evidence against lupus being the explanation for the symptoms they are having.

On the other hand, if the ANA test comes back positive, that IS NOT proof of lupus. The positive ANA is only an indicator; it is not diagnostic. A positive ANA can be found in a number of illnesses and conditions. In fact, many people may have positive lupus tests-particularly the anti-nuclear antibody test-and yet they do NOT have the disease.

All lab tests have normal values. If a test result comes back and the value is at the upper limit of normal, this is often referred to as being on the border or borderline. These results are often very difficult to interpret; and the assessment of its importance is dependent on meeting other criterion.

A variety of laboratory tests are used to detect physical changes or conditions in the body that can occur with lupus. Each test result adds more information to the body of evidence that a doctor uses to determine if a person has lupus. However, lupus cannot be diagnosed solely on lab work. A lupus diagnosis is made by a careful review of:

• a person’s current symptoms,
• laboratory test results,
• medical history, and
• the medical history of close family members (grandparents, parents, brothers and sisters, aunts, uncles, cousins).

For more information about lupus, visit the LFA website at http://www.lupus.org/

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