Many things: I'd ignore the normal ESR / sed rate. The ANA at this titer is concerning, but means nothing apart from its clinical context. Many women even of your age have positive ana's like this without evidence of illness. If it was ordered as part of a rheumatology workup, it suggests something in the autoimmune / lupus family. Despite the many labs, diagnosis and treatment rest mostly on clinical picture.
Answered 9/11/2015
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