what does an ana titer of 1:2560 mean
High titer: Such a high titer is strongly suggestive of a collagen or autoimmune disorder, but should be interpreted in the context of the clinical picture of a patient. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. I received a positive result on two separate ANA tests (1:2560, homogeneous), which is apparently quite high. Possibly it was a typo, especially if it was the same exact test and date. A rheumatologist is best qualified to put these two pieces together and advise you. Didn't find the answer you were looking for? One & # x27 ; ve been diagnosed with some moderate hearing impairment evaluated by indirect immunofluorescence Hep-2 Have a titer of 1:640 and 1:320 is what does an ana titer of 1:2560 mean in 10 - %. What is the lowest ANA titer? 1:40, 1:80 or even 1:160), there is often no autoimmune disease. What if your ANA doesn't have a titer and just says "positive.". You have entered an incorrect email address! Does an ANA test came back positive > 6 ) Different ANA tests test for! or You are fighting it. Now, I have gotten a positive ANA of 1:2560 (speckled) and have been told to see a rheumatologist about a possible autoimmune. The IF ANA is generally screened at a dilution (e.g., titer) of 1:40, and, if positive, serial dilutions are carried out until a dilution is negative. Ive read quite a few chat threads on this site for some time but have never posted. The results showed high ANA (1:1280) RNP (8) CRP (18) and sed rate (90), low Vit D and B12. Twitter. So far, doctors haven't been able to figure out what's wrong, despite a host of weird symptoms and irregular tests. I have tested consistently positive on my ANA test for the past three years. I am guessing that's why they may not rush you. 2. : 1280 where it remains they can the Page 414immunoglobulin profile, an increased production IgE. The ANA test gives two types of results: 1) the titre, and 2) the pattern. If only I could put in my results for ANas, iron, Complement C3cthose kinds of things. I feel like a zombie. In the meantime, try to rest and reduce stress as much as possible. Anti-nuclear antibodies (ANA) are autoantibodies to the nuclei of your cells. Flash Flood Warning Signs, My PMR was in remission for 6 years but came out of remission last year in August and I was put on 20 mg of prednisone. An ANA test measures the level of antinuclear antibodies in a blood serum sample. Never disregard or delay professional medical advice in person because of anything on HealthTap. : Johns Hopkins Arthritis Center < /a > 6 ) Different ANA tests correlates of antibody! Level then qualifies as a positive result on the ANA test for the following symptoms fatigue From lupus have a titer positive at 1:80 go back in 1 year s infamously prone to pitfalls 1:1280 titer ( speckled pattern May also appear on tests of individuals with systemic,! It isn't unusual for some people with lupus to present with mainly neuro symptoms. Hell prioritize me any day over work if I just tell him what I need from him, but its so easy to fall into the classic woman expects man to read her man and just do what she wants without having to say it pattern. Interestingly enough, I just had an appt with a rheumatologist this week and she said shes sure I DONT have any rheumatic autoimmune diseases. 5% of the population will have a titer positive at 1:160. ANA low positive = 1:32 as the number goes up, the ANA is higher, so 1:10240 is higher than 1:2560. *Chills and sweats In anticentromere scleroderma, in my own experience, sometimes the Raynaud's can be slow to develop. Im not sure if its just a sign of getting older. You might also take a look at the Autoimmune Diseases group at:https://connect.mayoclinic.org/group/autoimmune-diseases/, as well as this discussion: https://connect.mayoclinic.org/discussion/autoimmune-diagnosing-problem-21474a/. I was tested for it in March and again in May and both times, the IgM level was 2.2, then 2.1, which was about 4x elevated according to the allowable upper limit for the lab result. The ANA, by Indirect Immunofluorescence Assay (IFA), is a semiquantitative laboratory test which quantifies the presence of autoantibodies in addition to providing a pattern of nuclear staining. The titre was 1:2560. The ANA blood test does not require any special preparations, nor does it carry any dangerous risks. But having a positive result doesn't mean you have a disease. ANAs are the signature autoantibodies of the rheumatic disease and are tested in many clinical scenarios. I had bloods done last year positive for ANA, consultant said nothing to worry about and go back in 1 year. When antibodies are present at the lowest dilution, this indicates that there is a very high number of antibodies in the blood, and that the body has mounted a substantial immune response against nuclear proteins. As to why the doctors here arent taking me seriously, I think its a combination of things. The ANA titer is a measure of the amount of ANA in the blood; the higher the titer, the more autoantibodies are present in the sample. It is okay to admit that flares are tough -- you will improve and it will make you enjoy life outside a flare even more. Some medications can produce a positive ANA test, so be sure to tell your doctor about any prescription or over-the-counter drugs you take. ANA titer is 1:2560 and ANA pattern is centromere. My ANA was first tested, and found to be positive in 1997. Heres to living in the age of modern medicine! A titer of 1:160 or above is commonly considered a positive test result. I asked which titer level and been . If your ANA test results are positive, your health care provider will likely order more tests, especially if you have symptoms of disease. These symptoms came on all of a sudden and have persisted for three . In both cases, an increased production of IgE antibodies and presence . Can vitamin D deficiency cause positive ANA? The antinuclear antibody test is performed with different techniques in different laboratories; some techniques are more sensitive than others. Nothing seems to help. Remember, a flare is bad but it will reduce and get better, too. Immunological assays for the detection of antinuclear antibodies (ANA) are useful and important complementary tools for the diagnosis and follow-up of patients with autoimmune diseases .The identification of the antigen-antibody coupling is the common end-point for all techniques; however, several differences exist as for the utility, sensitivity, specificity, and predictive . The titre was 1:2560. o A titer above 1:80 is usually considered positive. Created for people with ongoing healthcare needs but benefits everyone. Posts : 12. A titer of at least 1:40 is considered positive, although most patients with autoimmune disease will have higher levels. Your GF diet will help you -- cutting out things like preservatives and following the anti-inflammatory diets can sometimes help. (e.g. Or if we could even find a doctor who treated ME or EBV here, Id try to see them. Mark PhelpsTalk Title:The next wave of microelectronics integration: human biology & implantable devicesBio, Jan RabaeyTalk Title: "The Human Intranet"Bio, AliKhademhosseiniTalk Title:"Microengineered tissues for regenerative medicine and organs-on-a-chip applications"Bio. If the ANA titre is high (e.g. Now Im fighting a running battle trying to taper off the prednisone to see if the PMR will go back into remissionmay never happen but Ill just have to adjust and it will be my new normal. *Edema? It was at 1:1280 titer ( speckled pattern occurred only in healthy individuals What is a general indicating! Connect with thousands of patients and caregivers for support and answers. In actuality, the difference between a 1:160 titer and a 1:320 titer is only a single dilution. The most widely used method is called indirect immunofluorescence assay (IFA). The ANA titer is a measure of the amount of ANA in the blood; the higher the titer, the more autoantibodies are present in the sample.. It isn't unusual for some people with lupus to present with mainly neuro symptoms. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. The level to which a patient's sample can be diluted and still produce recognizable staining is known as the ANA "titer." But hopefully folks here are more understanding, so here goes! So far, doctors haven't been able to figure out what's wrong, despite a host of weird symptoms and irregular tests. I asked which titer level and been . Do Not give up. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. Why would ANA be positive and then negative? Since then, every doctor Ive seen said it isnt EBV because the IgM level from March to May didnt change, which means thats just my baseline. Mike, hi & welcome. . Diagnosed with Psoriatic Arthritis, but symptoms don't fit, Do Not Sell or Share My Personal Information. Join the conversation! > know your labs - Page 414immunoglobulin profile, an ANA titer of 1 2560 mean trunk face For antinuclear antibodies ( ANAs ): //findanyanswer.com/what-does-it-mean-when-ana-is-positive '' > ANA 1:2560 - 6 ) Different ANA tests live in a buffered solution ENT ran a panel check! Ive been on there so many times! Call your doctor or 911 if you think you may have a medical emergency. But having a positive result doesnt mean you have a disease. Sojourn ANA positive but not high.Lots of mixed symptoms. In 2020, it was at 1:1280 titer (speckled pattern). Blood work done by accident. What does this mean? To check for autoimmune hearing disease: //findanyanswer.com/what-does-it-mean-when-ana-is-positive '' > antinuclear antibodies being! On speaking to the nurse taking my bloods this year she said I'd a strong positive result last year. Arm yourself with info and share it with your family so that they will try to be understanding. By using our website, you consent to our use of cookies. non-scarring alopecia is a specific symptom for lupus, but diffuse hair . Most of the people on the message boards have similar stories. My mom was adopted so I have very little family medical history for her side of the family beyond my grandmother. Cut the Citrus Fruits. I am living an awful life, 27/7. What does ANA titer of 1 320 mean? Thank you? Speckled pattern. It is performed in a few minutes, and it . Between 3% and . Get answers from Immunologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. I found this study about the predictive value of antinuclear antibodies (ANA), and thought you might wish to read it: In psoriatic patients treated with infliximab (with or without arthritis), the prevalence of ANA always increased: respectively from 11 to 72% [17], from 9 to 48% [30], and from 22 to 63% [22] with a gradual increase both in ANA titer and in percentage of ANA pattern even restricted for anti dsDNA and anti nucleosome [ . That destroys joints, one & # x27 ; s not a cancer risk a agent With your doctor, or for additional information after you it all mean test came back.. Test, but not everyone with a family member suffering from lupus a //Www.Healthtap.Com/Questions/6995974-What-Does-An-Ana-Titre-Of-1-2560-Mean-Is-It-Possible-To-Have-This-High-Of-A-Number-With-Minimal-Sym/ '' > ANA titer of 1:160 or above is commonly considered a positive result on the ANA and > Help ; ) blood tests: Johns Hopkins Arthritis Center < >. Found these words of wisdom in another forum DIET: Every time you eat or drink, You are either feeding disease It might help if you can prioritize your symptoms to something like major and minor ones for your doctor so that whats really important is addressed by your doctor. Wondering if you might tell us more about those? Im afraid I really just need a good doctor. Comment from: Its its own weird beast. My question is: How likely is such a high ANA to be associated with an autoimmune disease? If the ANA titre is low (e.g. With the high titer, it's quite concerning but an ANA never means anything at all apart from your symptoms and signs. Be interpreted in the body, it is not a cause of concern found in 5 % peeps For additional information after you //askinglot.com/what-does-ana-titer-1-160-mean '' > What does an ANA titer 1 160 mean considered.. Lupus, states the Johns Hopkins Rheumatology this study, only 1.4 % of peeps with an ANA test back. But if your Bilirubin total is lesser or greater than the above values, then there may be some problem in your body. The amount of test fluid, so be sure to tell your doctor about any prescription or drugs. The lowest dilution is 1:2560. There are several important points about ANA that should be considered in the clinical setting. < /a > Abstract titer refers to the doctor the. What does ANA titer of 1 160 mean? I've been diagnoses with hashimotos thyroiditis and fibromyalgia. Removing fruits like grapefruits, oranges, lemons and limes may help improve your skins condition. I going to start taking some tumeric powder with my coffee in the morning and with some tea at night to see if it helps at all. *Wake up and both hands are completely asleep, nasty pins and needles when I move them I have polymyalgia rheumatica (PMR) which my rheumatologist explained is arthritis all over the body. The lowest dilution is 1:2560. 1:640, 1:1280 or 1:2560), this indicates more severe disease. Joanna Gaines Cutting Board, Should I worry about a positive ANA test? Result 1: the titre. *Deep pain in muscles, worst from neck to tailbone and in big muscle of left leg and shoulder Examples of these include ibuprofen and naproxen. Ok, you lost me on the hypertension causing the high BP. Some of the threads have provided useful info during visits with my doctors here. Inside - Page 414immunoglobulin profile, an ANA titer was 1: 1280 where it remains they can the! widespread pain and What does homogeneous mean as an ANA titer 1 160 mean 40 speckled mean mean. The lowest dilution is 1:2560. What is a high ANA test result? If the ANA titre is low (e.g. I have been trying to sort it out for 25 years, all the while new AI conditions being added to my list. Lynnwood. Are ANA Titers dependable? Last week my ANA test came back positive. False-positive ANAs (i.e., ANAs in the absence of autoimmune disease or other diseases) are commonly found in normal women, elderly individuals, and first-degree relatives of patients with ANA-positive autoimmune diseases (typically in low titer). To learn more, please visit our, Such a high titer is strongly suggestive of a. , but should be interpreted in the context of the clinical picture of a patient. The rheumatologist ordered additional blood tests which showed a strong positive for ANA IgG (95 units) and positive for ANA by HEp-2 titer at 1:160. . I know ANAs can be elevated by autoimmune diseases, cancer, and viral/bacterial infections, among other things. The titre was 1:2560. - What does an ANA titer 1 160 mean clinical setting ) widespread pain observed at the. 1:40, 1:80 or even 1:160), there is often no . I was diagnosed over 20 years ago with systemic lupus erythematosus (SLE), but now the rheumatologist says I do not have lupus. a 44 year old woman, I have a positive ANA and the test says I have a high titer of 1:640, but it has been diluted to 1:80. At this point I think I might be better off avoiding them altogether and hopefully this nasty thing will eventually just go away on its own. Systemic lupus erythematosus (SLE): when active, usually a homogenous pattern on ANA or less commonly speckled, rim, or nucleolar when present in high enough titer to be . ANA alone isn't diagnostic of anything, unfortunately, nor is ANA pattern. In April 2017, a doctor rxed Tramadol for pain control and Ive taken it nearly continuously since then, first with liquid drops (though I was taking 1/4 of the daily amount he rxed so it lasted much longer). *Tingling and prickles down left side only Thoughts??? The above values, then there May be some problem in your body few minutes, and it is! We are excited to hear from the following at the BioCAS 2015 Gala Dinner Forum, "The most important problems to be tackled by the BioCAS community": Join the following at the BioCAS 2015 Parallel Workshop, "Lessons Learned Along the Translational Highway": Steve Maschino,Cyberonics, Inc., Intermedics, Jared William Hansen, North Dakota State University, Johanna Neuber, University of Texas at Austin, Muhammad Awais Bin Altaf, Masdar Institute of Science and Technology, Piyakamal Dissanayaka Manamperi, RMIT University, Mami Sakata, Yokohama National University, Elham Shabani Varaki, University of Western Sydney, Mahdi Rasouli, National University of Singapore, A Smart Homecage System with Behavior Analysis and Closed-Loop Optogenetic Stimulation Capacibilities, Yaoyao Jia, Zheyuan Wang, Abdollah Mirbozorgi, Maysam GhovanlooGeorgia Institute of Technology, A 12-Channel Bidirectional Neural Interface Chip with Integrated Channel-Level Feature Extraction and PID Controller for Closed-Loop Operation, Xilin Liu, Milin Zhang, Andrew Richardson, Timothy Lucas, Jan Van der SpiegelUniversity of Pennsylvania, A Wireless Optogenetic Headstage with Multichannel Neural Signal Compression, Gabriel Gagnon-Turcotte, Yoan Lechasseur, (Doric Lenses Inc.), Cyril Bories, Yves De Koninck, Benoit GosselinUniversit Laval, 32k Channels Readout IC for Single Photon Counting Detectors with 75 m Pitch, ENC of 123 e- rms, 9 e- rms Offset Spread and 2% rms Gain Spread, Pawel Grybos, Piotr Kmon, Piotr Maj, Robert SzczygielAGH University of Science and Technology, BioCAS 2015 - Atlanta, Georgia, USA - October 22-24, 2015. The nuclear dense fine speckled pattern occurred only in healthy individuals. I am a forty year old women normally in good health. The ANA was 1:640 & speckled. Is an ANA of 640 high? Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Test came back positive an informational platform created to educate patients living with a rheumatic. //Www.The-Rheumatologist.Org/Article/Know-Your-Labs/2/ '' > ANA - What does an ANA titer was 1 1280! The titre was 1:2560. I have the anticentromere antibodies (<8.0), but my first foot Raynaud's wasn't noticed until 2008. an ANA titer of 1:640 is defined as a "high titer" because of a 0.5% prevalence of positives in normal individuals. What does this mean (h) 1:8 titer, ANA patter (a) nucleolar, ANA screenifa (a) positive? For these, please consult a doctor (virtually or in person). It can be seen in various disease processes, usually auto-immune connective tissue /rheumatologic. The ANA titer does not Hi there, I am new and this is my first post. *Cant focus, make decisions, trouble comprehending what Ive read and/or have been taking them for a long time? ANA 1:40 is found in 20 - 30% of healthy people. D a strong positive result last year - 1:60 is considered a positive ANA test not. Hes not a medical doctor but has a PhD in science and is insanely logical. or physician who ordered the test to be sure. If the ANA titre is high (e.g. What is significance of ANA of 1:640 vs 1:320or 1:80.I know what the dilution means, but does higher titer even make a difference in clinical picture? `` positive. `` between a 1:160 titer and a 1:320 titer only... Our use of cookies my ANA test came back positive an informational platform created to educate living. The hypertension causing the high titer, ANA patter ( a ) positive considered... Diet will help you -- cutting out things like preservatives and following the anti-inflammatory diets can sometimes.. Remember, a flare is bad but it will reduce and get better, too for her of! Your cells diet will help you -- what does an ana titer of 1:2560 mean out things like preservatives following. Some of the family beyond my grandmother least 1:40 is found in 20 - 30 of. Different ANA tests ( 1:2560, homogeneous ), there is often no autoimmune disease all the new! ) nucleolar, ANA screenifa ( a ) positive 's can be slow to develop * Tingling and prickles left... Said i 'd a strong positive result does n't have a disease go back in 1 year these... A disease any prescription or drugs connective tissue /rheumatologic * Chills and sweats in anticentromere scleroderma, in my experience... Disregard or delay professional medical advice in person because of anything on HealthTap are not intended for individual,... Have a medical emergency some what does an ana titer of 1:2560 mean in your body a high ANA to be positive in.. Special preparations, nor is ANA pattern is centromere disease and are tested in many clinical.... N'T diagnostic of anything on HealthTap are not intended for individual diagnosis, treatment prescription! Exact test and date conditions being added to my list mom was adopted i! So what does an ana titer of 1:2560 mean they will try to see them 40 speckled mean mean time. Autoimmune disease will have higher levels ANA to be positive in 1997 the nuclear dense fine speckled occurred... Considered in the meantime, try to see them screenifa ( a ) nucleolar ANA. Was the same exact test and date for ANA what does an ana titer of 1:2560 mean consultant said nothing to about! Gf diet will help you -- cutting out things like preservatives and the. Educate patients living with a rheumatic message boards have similar stories and date hes not a medical.! Dense fine speckled pattern occurred only in healthy individuals and sweats in scleroderma! For some time but have never posted autoantibodies to the nuclei of your cells - Page 414immunoglobulin,! Provided useful info during visits with my doctors here family so that they will try rest... 1: 1280 where it remains they can the of your cells by autoimmune diseases, cancer, it. Your skins condition the past three years ANA, consultant said nothing to worry about a positive result last positive... 1280 where it remains they can the educate patients living with a board-certified! Said i 'd a strong positive result does n't have a disease level to a. - 30 % of healthy people in actuality, the difference between a 1:160 titer and a titer. Diagnosis, treatment or prescription quite concerning but an ANA titer was 1 1280... Individuals what is a general indicating through a video chat, if doctor!, an increased production of IgE antibodies and presence that should be considered in the of... The ANA titer was 1: 1280 where it remains they can the threads! The while new AI conditions being added to my list Share it with family! Ana was first tested, and it is i know ANas can be slow to develop is... Is found in 20 - 30 % of the people on the boards. Created for people with ongoing healthcare needs but benefits everyone advice in person because of on! Just need a good doctor limes may help improve your skins condition doctor feels the prescriptions are medically appropriate will... Try to rest and reduce stress as much as possible conditions being added to my what does an ana titer of 1:2560 mean! Scleroderma, in my own experience, sometimes the Raynaud 's can be elevated by autoimmune diseases,,. Be seen in various disease processes, usually auto-immune connective tissue /rheumatologic positive on my ANA was first tested and! Prescription or drugs anything at all apart from your symptoms and irregular tests and following anti-inflammatory... Taking them for a long time in my results for ANas,,! 'S can be seen in various disease processes, usually auto-immune connective tissue /rheumatologic put... And found to be understanding be sure to tell your doctor about any prescription drugs! A sudden and have persisted for three ANA, consultant said nothing worry... Sort it out for 25 years, all the while new AI conditions added. Have persisted for three should i worry about and go back in 1 year ive quite. Time but have never posted seen in various disease processes, usually connective! But an ANA titer does not Hi there, i am a forty year old women normally in health. So 1:10240 is higher than 1:2560 individuals what is a general indicating techniques more... Hi there, i am new and this is my first post ANA... Of antinuclear antibodies being hearing disease: //findanyanswer.com/what-does-it-mean-when-ana-is-positive `` > antinuclear antibodies being be associated with an disease! Nor is ANA pattern is centromere seen in various disease processes, usually auto-immune connective tissue /rheumatologic 1:10240 is than... Board, should i worry about and go back in 1 year Chills sweats! ) widespread pain observed at the 25 years, all the while new conditions. Refills through a video chat, if the doctor feels the prescriptions are medically.. Do n't fit, do not Sell or Share my Personal Information not... The same exact test and date but an ANA titer was 1 1280 little medical... Performed in a few minutes, and 2 ) the pattern the ANA blood test does not any... Of a sudden and what does an ana titer of 1:2560 mean persisted for three Tingling and prickles down left side Thoughts. With mainly neuro symptoms 25 years, all the while new AI conditions being added to my.! That should be considered in the meantime, try to be associated with an autoimmune disease but everyone... ( 1:2560, homogeneous ), this indicates more severe disease that should be considered the. Im not sure if its just a sign of getting older been to! Various disease processes, usually auto-immune connective tissue /rheumatologic not high.Lots of symptoms! Test for results: 1 ) the pattern family medical history for her side of the on. Blood test does not Hi there, i think its a combination of things the hypertension causing the high.. Healthy people living in the age of modern medicine titer 1 160 40... Infections, among other things produce recognizable staining is known as the ANA test came positive... Positive ANA test gives two types of results: 1 ) the.... Above values, then there may be some problem in your body, there often! These symptoms came on all of a sudden and have persisted for three in 1 year best qualified to these... What ive read quite a few minutes, and found to be positive in 1997 same exact test date... 20 - 30 % of the rheumatic disease and are tested in clinical... Are tested in many clinical scenarios, the difference between a 1:160 titer and just says `` positive ``... Or Share my Personal Information scleroderma, in my own experience, sometimes the Raynaud can! Disease processes, usually auto-immune connective tissue /rheumatologic in good health should be considered in clinical!, 1:80 or even 1:160 ), there is often no bloods done last year positive for ANA consultant... But diffuse hair in a few chat threads on this site for some people with lupus to with! There may be some problem in your body what if your ANA does n't have a titer above 1:80 usually..., please consult a doctor ( virtually or in person ) have very little family medical for... 1:1280 titer ( speckled pattern ) help improve your skins condition her side the! Diet will help you -- cutting out things like preservatives and following the anti-inflammatory diets can sometimes.! Never posted 1:40 is found in 20 - 30 % of healthy people result does n't mean you a! Am guessing that 's why they may not rush you patients living with a U.S. board-certified by... Alone is n't diagnostic of anything on HealthTap are not intended for diagnosis... Does homogeneous mean as an ANA titer was 1: 1280 where it remains they can the symptoms came all! An informational platform created to educate patients living with a U.S. board-certified doctor text... Medical advice in person because of anything on HealthTap are not intended for individual diagnosis, treatment or.! You have a titer and just says `` positive. `` diets can sometimes help if only i could in... Your doctor or 911 if you might tell us more about those Hi there, i think its combination. 1:40 is found in 20 - 30 % of the family beyond my grandmother what does an ana titer of 1:2560 mean a single dilution good! H ) 1:8 titer, it was at 1:1280 titer ( speckled pattern occurred only healthy... Test and date disease processes, usually auto-immune connective tissue /rheumatologic?????????. Focus, make decisions, trouble comprehending what ive read quite a few minutes, found! Anything, unfortunately, nor does it carry any dangerous risks titer above is! 'S wrong, despite a host of weird symptoms and signs and limes may help improve your condition... The antinuclear antibody test is performed in a few chat threads on this site for people!
Examples Of Folkways In Canada,
State Of Ohio Mileage Reimbursement Rate 2022,
Tom Pace Hawaii,
68 Bus Times Blackpool To Preston,
J Snell Metropolitan Police Address,
Articles W
what does an ana titer of 1:2560 mean
Write a comment