If i have a high positive ana (1:640) speckled, nucleolar and low positive sma (1:40), what further tests do i need to do? (negative ss-a, ss-b, smith, rnp, scl-70, anti jo abs)

? anti dsDNA: You've probably already had these more basic tests: complete blood count, sedimentation rate, C-reactive protein, urinalysis & rheumatoid factor. It appears to me that the ANA results with slight positive anti-Smith may suggest lupus; you need an antibody to double-stranded DNA (anti dsDNA) which is very specific & somewhat sensitive for lupus.All this needs to be correlated by your doc/specialist