Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
We normally have antibodies in our blood that repel invaders into our body,
such as virus and bacteria microbes. Antinuclear antibodies (ANAs) are unusual
antibodies, detectable in the blood, that have the capability of binding to
certain structures within the nucleus of the cells. The nucleus is the innermost
core within the body's cells and contains the DNA, the primary genetic material. ANAs
are found in patients whose immune system may be predisposed to cause
inflammation against their own body tissues. Antibodies that are directed
against one's own tissues are referred to as auto-antibodies. The propensity for
the immune system to work against its own body is referred to as autoimmunity.
ANAs indicate the possible presence of autoimmunity and provide, therefore, an
indication for doctors to consider the possibility of autoimmune illness.
How is the ANA test designed? What is it for?
The ANA test was designed by Dr. George Friou in 1957. The ANA test is
performed using a blood sample. The antibodies in the serum of the
blood are exposed in the laboratory to cells. It is then determined
whether or not antibodies are present that react to various parts of
the nucleus of cells. Thus, the term anti-"nuclear" antibody. Fluorescence techniques are frequently used to
actually detect the antibodies in the cells, thus ANA testing is
sometimes referred to as fluorescent
antinuclear antibody test (FANA). The ANA test is a sensitive screening test
used to detect autoimmune diseases.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Sjögren's syndrome is an autoimmune disease involving the abnormal production of extra antibodies that attack the glands and connective tissue. Sjögren's syndrome with gland inflammation (resulting dry eyes and mouth, etc.) that is not associated with another connective tissue disease is referred to as primary Sjögren's syndrome. Sjögren's syndrome that is also associated with a connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, or scleroderma, is referred to as secondary Sjögren's syndrome. Though there is no cure for Sjögren's syndrome, the symptoms may be treated by using lubricating eye ointments, drinking plenty of water, humidifying the air, and using glycerin swabs. Medications are also available to treat dry eye and dry mouth.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Fibromyalgia, formerly
known as fibrositis, causes chronic pain, stiffness, and
tenderness of muscles, tendons, and joints without detectable inflammation. Fibromyalgia patients have an unusually low pain threshold. Symptoms of fibromyalgia include fatigue, abnormal sleep, mental/emotional disturbances, abdominal pain, migraine and tension headaches, and irritable bladder. Treatment of fibromyalgia involves patient education, medication, exercise, and stress reduction.
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by
blood transfusion, hemodialysis, and needle sticks, especially with intravenous
drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
Raynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold. Occurring as a result of spasm of blood vessels, the cause is unknown. Symptoms of Raynaud's phenomenon depend on the severity, frequency, and duration of the blood vessel spasm. Treatments include protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.
A miscarriage is any pregnancy that ends spontaneously before the fetus can survive. Miscarriage usually occurs before the 13th week of pregnancy. The cause of a miscarriage cannot always be determined. The most common causes of a miscarriage in the first trimester are collagen vascular disease (lupus), hormonal problems, diabetes, chromosomal abnormalities, and congenital abnormalities of the uterus.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
Primary Biliary Cirrhosis is a chronic disease characterized by progressive inflammation and destruction of small bile ducts within the liver. The bile ducts transport bile from the liver to the intestine for the absorption of fat and elimination of waste products. The causes of Primary Biliary Cirrhosis may involve autoimmunity, infection, or genetic predisposition, acting alone or in combination. There are many medications and treatment options available for those with this and other associated diseases of Primary Biliary Cirrhosis.
Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Primary biliary cirrhosis (PBC) is a chronic (long duration) disease
characterized by progressive inflammation and destruction of the small bile
ducts within the liver. What are the bile ducts and what do they do? Lined with
cells named biliary epithelial cells, the bile ducts are tubules that make up a
plumbing system for the liver. The bile ducts along with the gallbladder are
part of what is called the biliary tract.
The plumbing system begins in the liver with very small caliber ducts that
connect to increasingly larger caliber ducts, like a tree in which twigs connect
to small branches that connect to larger branches. In fact, this system is often
referred to as the biliary tree. The large right and left bile ducts, still
within the liver, connect to an even larger common bile duct that runs outside
the liver to the small intestine just beyond the stomach. The common bile duct
connects by the cystic duct to the gallbladder....
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