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Asymptomatic + ANAFrom: Hugo D. Ribot Jr. (hribot@mindspring.com)Sun Mar 15 21:54:09 1998
Dear listers: Got a couple of patients who have a + ANA and no symptoms whatsoever. One is a G2 P1 currently in 2nd trimester, with clinically chronic hypertension (numbers are 160-170 sys and 100-110 dia). There is no proteinuria/thrombocytopenia/CNS symptoms. For her, what if any further workup would you do? I planned on doing weekly NSTs starting at 28 weeks. Does anyone test for fetal heart block, rare antibodies, etc.? Her ANA titer is 1:80, diffuse pattern. Another patient is one of our office staff (permission given to post her case), a 22 year old nulligravida, on DepoProvera, who we found to have a 1:80 ANA last year. A repeat titer one year later is 1:320. The report said nucleolar pattern both times. What would be your next step? (please don't say "punt to the rheumatologist") Thanks for all feedback...
-- Hugo D. Ribot Jr., M.D., FACOG Cartersville, GA Private practice in a 2 MD (soon to be a 3 MD) and 2 CNM group
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