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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #114

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Have a patient with non-specific signs and symptoms? Are you suspecting a possible autoimmune condition? Are you considering ordering an ANA? Think again…

Approximately 90% of ANA tests are false positive. It is better to order a CBC, CMP, ESR, and CRP first to determine if there are any systemic signs that would correlate with an autoimmune condition. If the CRP or ESR are elevated, for example, then order the ANA in addition to various other lab markers that are consistent with autoimmune disease.

False positive ANAs account for large numbers of unnecessary rheumatology referrals and added patient expense. Therefore, you can skip the ANA during the initial workup. Check inflammatory markers first.

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