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Should I see a Rheumatologist or Immunoligist for positive ANA results?

I currently have cirrhosis due to fatty liver disease. I have tested positive two times on the ANA test. (Lyme disease has been ruled out.) My most recent test came back Positive, 1:320, Homogeneous, Speckled. I saw a Rheumatologist  who spent approximately two minutes with me tapping my neck and shoulders and thus stating I didn't have Lupus.No further blood tests or possibilities of diagnosis. I'm at my wit's end. The joint pain can be relentless and I wake crying at times during the night from shoulder pain. Should I try another Rheum doctor or an Immunologist? Any help is greatly appreciated. Thank you
1 Responses
1530171 tn?1448129593
Your Rheumie was probably right.
The prevalence of  positive ANAs is significantly higher in patients with NAFLD compared to the general population.
According to studies around 25% of NAFLD  sufferers have elevated ANAs. and may be associated with more severe liver damage.
Perhaps you should look into further testing  (biopsy?)to rule out autoimmune hepatitis.
Best wishes.
Niko
2 Comments
Thank you, Niko. Unfortunately, hep was ruled out long ago., but I truly appreciate the suggestion.
Kind Regards,
MMG
That is actually good as long as your NAFLD is  under control.
Should your symptoms seem to be worsening, it might be wise to see your hepatologist( if haven't consulted with him/her recently)
The elevated ANA titer as I mentioned before may be indicative
of  further liver damage.
Just my educated opinion.
Best wishes
Niko
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