Does highly elevated antinuclear antibody result always mean systemic lupus erythematosus?

No: The presence of and anti nuclear antbody does not make a specific diagnosis no matter how high it is. You have to integrate it into the total clinical picture. It can be seen in non-lupus settings and other tests have to be done before the diagnosis is clear.

Not always: Unfortunately, there is no single laboratory test that absolutely rules in or out systemic lupus erythematosis (sle). Although a highly positive antinuclear antigen (ANA) is common in sle, diagnosis is based on a careful history, physical exam and laboratory evaluation.