How do you approach follow up of young patients with isolated +ANA, but no current clinical signs or symptoms of SLE?

An old study showed that ANA can be positive in patients who develop lupus up to 9 years (average 3 years) before the onset of clinical disease but it was not necessarily isolated ANA as Ro and La antibodies could also be detected long before the onset of the disease (Arbuckle et al., PMID 14561795)...

One of the first things to do is find out what the patient and family know about the ANA and lupus. Calming them down by educating them may be the first thing to do.

If after a detailed history and physical examination, with special and detailed attention to family history of auto-immune disorders, ...

The best predictor of ANA is why was it checked in the first place. If for pain/OA, I am not worried at all. ANA is meaningless in the absence of inflam arthritis or S/Sx of CTD, SLE. Unfortunately, it is used now as a screening test and not as confirmatory. PCPs seem to use ANA as a screening tool ...

We see referrals for isolated positive ANAs in the absence of clinical signs and symptoms every day. The vast majority of these patients do not have a bona fide connective tissue disease. Items to keep in mind are, as above-mentioned: a positive family history, autoimmune thyroid disease, the use of...

I just found this thread on a lazy Sunday and glad I did. All excellent discussions above.

Personally, I do NOT think that ANAs are over-ordered. There is too long a delay in SLE dxs than there should be, resulting in more severe disease and damage in affected individuals. They certainly can be orde...

@Dr. First Last, I can understand our getting "tired" of too many ANA referrals. However, it ensures that systemic autoimmune disorders are not overlooked; for example, neurologic dz is common in Sjogren's disease (SjD) and SjD patients often present with non-sicca manifestations (Brito-Zerón et al....