Antinuclear Antibodies (ANA) test and their patterns | ANA test | What does ANA test positive mean?

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  • čas přidán 7. 07. 2024
  • This video talks about the science behind ana test. This video will answer the following questions like:
    What does it mean if your ANA is positive?
    What diseases cause a positive ANA?
    Is a positive ANA test bad?
    What is a normal ANA level?
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    #animated_biology #animated_biology_with_arpan #Antinuclear_Antibodies #ANA #ANA_test #ANA_patterns #What_does_ANA_test_positive_mean #biology #bio_facts #CSIR_NET #IIT_JAM #IIT_JAM_BT #biotechnology #bioscience #biological_sciences #microbiology #genetics #zoology #molecular_biology #cell_biology #botany #immunology #ecology

Komentáře • 149

  • @robbievaughn8772
    @robbievaughn8772 Před 2 lety +23

    Thank you so much for this very informative video. It helps me understand what my positive ANA means and doesn't mean, bringing some peace of mind.

  • @aliciapacilio7329
    @aliciapacilio7329 Před 2 lety +46

    Thank you for your informative video. My ANA came back as positive for homogeneous 1:320 and speckled 1:160. I'm having a hard time getting someone to listen, do further testing, and not just dismiss me. I have had joint pain for several months and have a weaker immune system and am an asthmatic. I'm very fatigued and this is all affecting my quality of life and I'm only 32. Sometimes it is hard to find a provider to take you seriously.

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 2 lety +2

      I am so sorry about your situation. I can imagine how bad does it feel. Please engage your self in some hobby such that you dont think about it much.

    • @soundsrelaxing888
      @soundsrelaxing888 Před rokem +1

      Go to quest and pay out of pocket for your test yourself

    • @keelybaby17
      @keelybaby17 Před rokem +5

      I understand ❤ I’m 25 and have felt like this for over 10 years. Just got positive ANA 1:640 homogenous and I work 2 jobs and help my disabled mother. It is the hardest trial ever! I got positive Ana last year and since then I have been seeing doctors and still have not found a thing lol. What a long journey it is! Don’t lose hope. Keep fighting! We got this

    • @lizisler9415
      @lizisler9415 Před rokem +6

      Exactly! My GP also dismissing me. What is it? Why the heck can’t they just follow up on things. Oh I know.. they get pissed off when you try to tell them what you need. It’s like it was 50 years ago. Their egos are so big and you can’t upset these demi gods and try to take your own health into your own hands. I’m going to keep trying to get someone to listen.

    • @waqasahmad3073
      @waqasahmad3073 Před rokem +1

      I have just received my positive ANA result and found this video on CZcams.
      I am 32 and had no idea about it. My liver ALT values are high and the doctor asked me to do an ANA profile test. Don't know what next.

  • @MsMonsterMashMitch
    @MsMonsterMashMitch Před rokem +8

    i’m 27 ANA positive 1:40 speckled with elevating platelets. I finally found a Doctor Who is taking this seriously and trying to get to the bottom of it. However, rheumatologist don’t want to see me. My PCP has given referrals and the rheumatologist just continue to give me the runaround saying that results are not substantial enough.

  • @suze5945
    @suze5945 Před rokem +2

    Thank you so very much for explaining this topic

  • @annekirkland298
    @annekirkland298 Před rokem +6

    I've had Fibromyalgia for approximately 35 years I'm much better but now all of a sudden I've got Lupus my test results showed ANA 1.80 and Homogeneous, the problems I have are body pain even that has improved and fatigue now and then, I do have a bladder and colon problem. Please advise

  • @doreenshaddick8819
    @doreenshaddick8819 Před rokem +3

    Thank you so much, very informative 😊

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před rokem

      Please support our channel using super thanks . Its a heart shape icon with dollar in it present under the video. Payment can be done using UPI/ Paypal/ Netbanking. your small support like 1$ or less will keep up our motivation to create high quality content.

  • @ank6043
    @ank6043 Před rokem +3

    Could you please answer my question?
    Can ANA test (IFA, 1/80, IgG) show a response of the body to a metal implant (titanium screws on the jaw)?
    Is an autoimmune/autoinflammatory response can be induced by metal adjuvants and may they cause a positive ANA test result?
    Or, could we say a negative ANA test means there is no response of the body to the metal (titanium) implants?

  • @freddispaghetti
    @freddispaghetti Před 7 měsíci +2

    I have positive ANA with cytoplasmic pattern and can find very little information about it. I have Hashimotos and MCTD, plus undifferentiated hypophysitis (reduced pituitary function). Would like to know where best to look next and best treatment options.

  • @stanceworks7995
    @stanceworks7995 Před 10 měsíci +2

    My DFS70 antibody results is also very high it is 78.0 u/ml and my ana titre IIF is 640. Negative for schlorosis and RA. I do have rosacea on my face. Negative for lupus as well. My ana pattern is nuclear homogeneous . I dont know what this all means my doctor didnt either. I did find out i am also insulin resistant i did all these blood tests together

  • @yannelizuniga7875
    @yannelizuniga7875 Před rokem +1

    What if we have a 1:640 and it was nuclear and homogeneous? what is it, my doctors are taking to long for my appointment

  • @sandym8787
    @sandym8787 Před 2 lety +2

    Thank you

  • @nancyg6205
    @nancyg6205 Před 11 měsíci +2

    Bestest video😊

  • @sowjithokala2227
    @sowjithokala2227 Před rokem +1

    Ana 61.04 AU/ml value mean whether it's positive or negative

  • @charpond123
    @charpond123 Před rokem

    my ANA IFA came back positive but negative for ANA blood test. I have raynauds with symptoms of scleroderma. dusky, swollen fingers and toes with joint pain. rashes upper arms, thighs and buttocks. keep getting told i'm fine. any ideas?

  • @TruthWillFreeYou
    @TruthWillFreeYou Před měsícem +1

    This was explained so well even a layman could understand. Thank you very much.

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před měsícem +1

      Could you please help me by sharing my contents with your friends group/ college group. I put huge efforts in making these videos but unfortunately not a lot of people are watching this.

    • @TruthWillFreeYou
      @TruthWillFreeYou Před měsícem

      @@animatedbiologywitharpan Yes, I will also subscribe your channel and engage future videos. I can tell you put a lot of effort into making these.

  • @subhajitbiswas7630
    @subhajitbiswas7630 Před 10 měsíci

    Cronic gastritis main ana test kar sakta hain kay ana test karna sa autoimmune gastritis ka pata chal sakta hain

  • @Proverbs3.3
    @Proverbs3.3 Před měsícem +1

    Thankyou for this video God bless you

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před měsícem +1

      Could you please help me by sharing my contents with your friends group/ college group. I put huge efforts in making these videos but unfortunately not a lot of people are watching this.

    • @Proverbs3.3
      @Proverbs3.3 Před měsícem

      @@animatedbiologywitharpan of course brother 🤍

  • @syedmaqsood4294
    @syedmaqsood4294 Před 9 měsíci +1

    Thanks sir

  • @matthewterry2291
    @matthewterry2291 Před rokem +5

    My Ana test came back as a 13.1 value which shows negative,but i was referred to the rheumatologist because i tested postitive Ana at my primary care doctors office.

    • @nidhisindhwani9871
      @nidhisindhwani9871 Před rokem

      My ANA value is 27.10 plz help

    • @Murat-eq3cr
      @Murat-eq3cr Před rokem

      You should check your ana with hep-2 cell and immunofloresan or hep 20-10 cell

    • @swavezmartin
      @swavezmartin Před rokem

      Does a positive ana mean lupus

    • @jacquelynhuff8255
      @jacquelynhuff8255 Před 4 měsíci +1

      Who the hell are you supposed to believe one of my primary I should say PA who I saw on a regular basis when I was tested and told my blood work results for RA they told me after taking medication for the RA test for my blood came up with me having kidney problems she wanted to give me kidney medication. They want to put me on kidney medication, was she trying to make money for the pharmaceutical Companies?
      I got rid of that particular primary care place. I don’t have kidney problems.
      I know you can get certain side effects after taking prescriptions for autoimmune symptoms.
      and also you need to listen to your body. You know you’ve already better than anyone else you know I don’t feel right or hurt or your pain and you have to figure out what’s the best things for it cause the doctors don’t always know. I don’t think all you have to keep finding a doctor that will be willing to go the length of trying to straighten out whatever autoimmune problem you have!

  • @DChap405
    @DChap405 Před 5 měsíci +1

    ANA test was positive and dense fined speckled was 1:80 what does that indicate

  • @RobinMooreBand
    @RobinMooreBand Před rokem

    Was Sjogren's mentioned?

  • @rawdah2939
    @rawdah2939 Před měsícem +1

    THANK YOU SO SO SO SO MUCH

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před měsícem

      Could you please help me by sharing my contents with your friends group/ college group. I put huge efforts in making these videos but unfortunately not a lot of people are watching this.

  • @stefaniegour2845
    @stefaniegour2845 Před 2 měsíci

    what is nucleoli fine granular pattern

  • @dusk0135
    @dusk0135 Před 3 měsíci +1

    Thank you 🙏🏽🤍

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 3 měsíci

      Could you please help me by sharing my contents with your friends group/ college group. I put huge efforts in making these videos but unfortunately not a lot of people are watching this.

  • @helloitsme.5604
    @helloitsme.5604 Před rokem +5

    So if my test is 1:1280 speckled it is likely to be confirmatory right?

  • @Paarthurnaxdova
    @Paarthurnaxdova Před rokem +3

    Can a positive anti scleroderma-70 antibodies be ANYTHING other then lupus or systemic scleroderma? I have zero symptoms of either

    • @danieltait8564
      @danieltait8564 Před měsícem

      I’m in the same situation. It can take many years to develop. I thinks about 50 percent chance of developing scleroderma within the next ten years.

  • @nathalymateo
    @nathalymateo Před 2 lety +1

    Hello, thank you for the video. Which test result would be Spindle fibers ?

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 2 lety +1

      ANA patterns, particularly those directed at the mitotic spindle apparatus (MSA), are not well understood and are rare.

    • @nathalymateo
      @nathalymateo Před 2 lety +1

      @@animatedbiologywitharpan Thank you for your reply by the way!

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 2 lety

      Mostly it's unknown...I have no clue

  • @ChrissyDipippo
    @ChrissyDipippo Před 2 lety +3

    My ANA test came back positive titer (1:320) with it saying speckled and homogeneous. I also have been having the rash on my face and my joints have been hurting

  • @Murat-eq3cr
    @Murat-eq3cr Před 11 měsíci

    What mean weak positive 1:100 ac8 homogenous nucleolar with fluctuate rnp weak positive antibody not another antibodies

  • @candicec6513
    @candicec6513 Před 2 lety +11

    My ANA ranges over 30 years from 600s to 5000 range. It's been dismissed as Lupus by some doctors because the anti-dsDnA is negative. Other doctors were concerned. Despite symptoms. I wonder what this can mean.

    • @keelybaby17
      @keelybaby17 Před rokem +1

      Me too

    • @alimousa4063
      @alimousa4063 Před rokem +2

      This test should br followed with other investigations (includs Laboratories & History and physical examination). If clinical picture is suggestive of a certain disease like lupus. -ve dsDNA is not necessary to diagnose. Although specific to lupus, +ve dsDNA is only seen in patients with internal organs affection, rather than superficial symptoms like joint pain ect..
      if symptoms are present, usually treatment is initiated with following up on labs and symptoms.
      You should always follow up with a one good doctor to have a clear idea about your concerns 👍🏽
      From my experience, doctors who don't consider the history, are not good at assessment of autoimmune conditions.
      I wish you happy healthy life

  • @jacquelynhuff8255
    @jacquelynhuff8255 Před 4 měsíci +1

    That’s interesting I was mostly reading your comments I have RA should I ask my doctor for RA to test me for this my blood work that I looked over had lupus but she she put me down as rheumatoid arthritis and my feet and hands I’m on Orencia which is helping somewhat and I have no idea what the long-term side effects will be

  • @mgromz
    @mgromz Před 2 lety +2

    What about a mitochondrial pattern in a positive ANA test? Can that be present in Lupus as well??

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 2 lety

      Recent research reveals the involvement of two distinct components of the mitochondrion: the mitochondrial outer membrane and mitochondrial DNA. Antibodies to these two mitochondrial constituents were increased in both human and murine systemic lupus erythematosus (SLE), compared to controls.
      www.ncbi.nlm.nih.gov/pmc/articles/PMC6418244/

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 2 lety

      Really glad to know it was useful. Please follow my instagram page and facebook page. Please share my youtube channel link with your friends and help me to reach big audiance
      I'm on Instagram as @animatedbiologywitharpan. Install the app to follow my photos and videos. instagram.com/invites/contact/?i=1p41h314q3fv8&

  • @sloth8852
    @sloth8852 Před 2 lety +2

    How does a antibody against nucleus work because antibody can't penetrate the cell membrane and going to attack nucleus ?

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 2 lety +1

      before staring the test permeabilization solution is added which mildly dissociates the membrane ( do not destroys it completely). Due to this the antibody could penetrate

    • @devikasurendar5692
      @devikasurendar5692 Před 2 lety

      TQ for uploading this informative video.
      Sir This is my ANA RESULT by IFA
      Serum Immunofluorescence
      Result weak positive
      Pattern Spindle poles
      Grade ++
      Medical remarks. Cytoplasmic speckled (1:100)
      Estimated titre 1:320
      I have URTICARIA PROBLEM
      WHATEVER MEDICINES I TAKE FOR URTICARIA, IT MAKES SEVERE URTICARIA. Please suggest some solution. TQ sir.

  • @wesley6442
    @wesley6442 Před 2 lety +4

    Hello I had a Positive ANA titer test done years ago with the speckled pattern, I've never had the butterfly rash but I have eczema since childhood is that considered a mixed connective tissue disease? is my positive ANA test for the speckled pattern because of my eczema? I rarely struggle with outbreaks but I sometimes get fatigue

    • @beecee7488
      @beecee7488 Před 11 měsíci +2

      Hello, my daughter has the same problem. She too has eczema, her joints hurt and she gets fatigued. 😞. She is only 19. I pray that she doesn’t have lupus.

  • @shosad100
    @shosad100 Před rokem +2

    Please tell me that how positive ANA affects pregnancy?

  • @babybaby5893
    @babybaby5893 Před rokem +6

    Thank you so much for such an informative educational video, my ANA is 1:80. Positive SSA. Speckled pattern but all other antibodies are negative, tested quite a few times within 2 years . I was diagnosed as SLE. I am very confused about my diagnosis by the nurse practitioner , what do you think about the diagnosis? Thank you in advance for sharing your ideas?

    • @celiaaa229
      @celiaaa229 Před rokem +2

      Mine just came back as 1:80 homogeneous this video was such a great explanation. Hopefully I can get some answers on why I'm losing so much hair.

    • @Deelitee
      @Deelitee Před rokem +1

      What is SLE??

    • @Hamza-rv2nf
      @Hamza-rv2nf Před 6 měsíci

      Rehmatologist doctor check ip

  • @naveedahmed-re3lt
    @naveedahmed-re3lt Před 11 měsíci +1

    I don't understand these tests and other things my positive ANA details are here, and I don't know what to do or which particular doctor I should consult 😭😭😭
    ANA positive
    Pattern coarse speckled
    Estimated endpoint Titre 1/2560
    Anti smooth muscle antibodies Negative
    Anti mitochondrial antibodies Negative.
    Please guide me.
    I am 40 years old.
    My mouth is stretched can't eat anything which has even a small amount of chilies

  • @rahulcthakur8058
    @rahulcthakur8058 Před 2 lety +2

    what does weekly positive mean?

    • @Murat-eq3cr
      @Murat-eq3cr Před rokem

      Mine too sometimes weak positive sometime negative

  • @TravelIndiaTourandTravel

    Can you tell me about PCNA positive means?

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před rokem +1

      It means you might have an autoimmune disease. Proliferating cell nuclear antigen (PCNA) antibodies are a rare type of antinuclear antibodies (ANA), historically considered highly specific for systemic lupus erythematosus (SLE). Recent studies showed they can be present in other autoimmune diseases

    • @TravelIndiaTourandTravel
      @TravelIndiaTourandTravel Před rokem

      Thanks

  • @Padmashrinaren
    @Padmashrinaren Před 2 lety +2

    Thank you so much for your efforts 🍀🍀💕💕

  • @syedshahnawaz2842
    @syedshahnawaz2842 Před 2 měsíci

    Is ANA treatable

  • @mindgames5748
    @mindgames5748 Před 2 lety +2

    Did anat est change from become +ve to - ve

  • @deepakkumarnayak5945
    @deepakkumarnayak5945 Před rokem +2

    Sir RO-52 Positive he kya kar na he please help me sir

  • @mountdudhkundanepal1617
    @mountdudhkundanepal1617 Před 2 lety +3

    My ana test report is 14.4 what does it menas??

  • @zackiinu7194
    @zackiinu7194 Před 4 měsíci

    X-rays of both my wrists shows arthritis. My rheumatologist ordered labs. My ANA test was POSITIVE, anti nuclear antibody ABNORMAL, and homogeneous ABNORMAL. No family history of RA. I have been wondering if my direct exposure to toxins (inhalation, skin, and ocular contact) have anything to do with what the labs show. To name a few: Benzene, xylene, hexavalent chromium, hexamethylene diisocyanate, butyl acetate, methyl ethyl keytone, etc.). The exposure occurred in 1982 when I was spray painting vehicles with a polyurethane paint. I did not use a respirator or any other form of PPE. Anyone?

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 4 měsíci +1

      It's less likely that it's due to those spray painting stuff. Autoimmune diseases doesn't devwlop like that

  • @mabudjaan5360
    @mabudjaan5360 Před rokem +1

    My ana Test report 17.9

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před rokem

      The result of an ANA test is reported as a titer, which represents the level or concentration of antibodies detected in the blood. The titer is expressed as a ratio, such as 1:80, 1:160, 1:320, etc. The number before the colon (:) indicates the dilution of the patient's blood sample that still shows a positive reaction.
      In your case, an ANA test result of 17.9 is not typically reported in the usual titer format. It's important to note that specific laboratories may have their own reporting methods, so it's best to consult with your healthcare provider

  • @binandandebnath9523
    @binandandebnath9523 Před rokem +1

    my mom's result came and it is 1:100...is there any chanch...that she had cancer?..its neuclear homogeneous type...

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před rokem

      I don't think she has cancer. Moreover ANA test is not for detecting cancer. It's for detecting autoimmune disorders

  • @chrisarmon1002
    @chrisarmon1002 Před 10 měsíci +1

    Is there a way you can help me interpret my blood work?if so I can email my results.

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 10 měsíci

      I am a scientist and not a doctor and ethically i can't do that. Please consult a doctor

    • @chrisarmon1002
      @chrisarmon1002 Před 10 měsíci

      @@animatedbiologywitharpan I understand. What if a ds- DNA test came out negative along with a ANA test. 1:640. Is there more testing available

  • @keelybaby17
    @keelybaby17 Před rokem +2

    Is Seronegative a real thing

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před rokem +1

      Yes seronegative means not much autoreactive antibody. At worst case I also possible the test did not work. Malar rash is pretty common signature

    • @AllisonGambler-ug3qx
      @AllisonGambler-ug3qx Před 6 měsíci

      I wanted to ask if you questions regarding your other comment? I’m a 28 year old who has had the same problem. Where do I message you?

  • @amandalynne9023
    @amandalynne9023 Před rokem +3

    I have a positive ANA with positive dsDNA, but everything else was negative. Confused as to why.

    • @tejask4889
      @tejask4889 Před rokem +1

      Any further updates, my ANA came out to be positive today, I am really concerned ☹️

    • @syamaravi2410
      @syamaravi2410 Před rokem

      @@tejask4889 are you okay now?

    • @tejask4889
      @tejask4889 Před rokem

      @@syamaravi2410 Hi, I am doing ok now, doctor told me to ignore the ANA result for now, unless I get another attack of ‘uveitis’, I did a MRI and few blood tests, and I am lucky enough since all the results were as expected. Thank you for asking :)

    • @syamaravi2410
      @syamaravi2410 Před rokem

      @@tejask4889 why MRI?

    • @tejask4889
      @tejask4889 Před rokem +1

      @@syamaravi2410 Just to make sure I don’t have arthritis, since uveitis is a form of inflammation, the doctor wanted to make sure there is no such swelling in other parts of the body..

  • @ilaydaguneren9294
    @ilaydaguneren9294 Před 2 lety +5

    i recently had an ANA test done. My result came back as positive ANA titer (1:320 speckled). My covid test also came back positive. I did not know that I had covid while I was getting tested. Could covid be the reason as to why my results came back so high?

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 2 lety +3

      Its highly unlikely that two things are related

    • @elle706
      @elle706 Před 2 lety +3

      I have the exact same results except no covid

    • @kiranmai8773
      @kiranmai8773 Před 2 lety +1

      I have same doubt.have you consulted doctor regarding ana positive? Plzzz reply

    • @Alvaroguerrabilbao
      @Alvaroguerrabilbao Před rokem +1

      I heard direct from a very serious dermatologist that are starting to see a relation between ANA positive, micro lupus reactions after getting infected by Covid-19’s

  • @vickijeanne9958
    @vickijeanne9958 Před 9 měsíci +1

    My ANA test was positive, titer is 1:80, dense speckled, joint pain. Need help with this.

  • @swavezmartin
    @swavezmartin Před rokem +1

    Does a positive ana test mean lupus

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před rokem

      Yes but it has to be corrected with other clinical condition. AnA detects auto reactive antibodies

    • @swavezmartin
      @swavezmartin Před rokem

      @@animatedbiologywitharpan so just because u test positive doesn't always mean u definitely hsve lupus

  • @jimmydoshi5587
    @jimmydoshi5587 Před rokem +1

    My ANA is positive 1:100 what is that

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před rokem

      In this case, ana titer of 1:100 means that your blood sample was diluted 100 times and antinuclear antibodies were still detectable. It's important to note that an ANA test alone is not sufficient to diagnose a specific autoimmune condition. ANA positivity can be seen in various conditions, including systemic lupus erythematosus, Sjögren's syndrome, rheumatoid arthritis, and other autoimmune diseases, but it can also be found in healthy individuals or individuals with other non-autoimmune conditions

  • @magnumcontractors1018
    @magnumcontractors1018 Před rokem +1

    Hello there how can I contact you please???

  • @bjohnson1149
    @bjohnson1149 Před rokem +1

    I couldn't understand you.

  • @beardedwhitecoat8925
    @beardedwhitecoat8925 Před 7 měsíci +1

    Is that a bird in your background audio? Wild or pet?

  • @Roscoesadie
    @Roscoesadie Před 7 měsíci +1

    Use AI voice next time. Can't understand Indian

    • @animatedbiologywitharpan
      @animatedbiologywitharpan  Před 7 měsíci

      Could you please help me by sharing my contents with your friends group/ college group. I put huge efforts in making these videos but unfortunately not a lot of people are watching this.

    • @danieltait8564
      @danieltait8564 Před měsícem

      @@animatedbiologywitharpanI could understand your accent fine. Thank you for making this video in your own voice.

  • @keelybaby17
    @keelybaby17 Před rokem +3

    Thank you for this! 25 female Positive ANA 1:640 homogenous. Everything is coming back negative and unfortunately pain is getting worse prayers please 🤍
    I have malar rash and severe muscle joint pain and trouble gaining weight and brain fog high blood pressure and high heart rate insomnia etc etc! MRI DNAds and all the lupus and connective tissues are negative.