A member asked:

What would cause a high positive ana (1:640) speckled, nucleolar with a low positive smooth muscle antibody (1:40) but negative ss-a, ss-b, anti-smith, rnp, scl-70, anti jo antibodies? liver disease?

A doctor has provided 1 answer

Probably normal: Many people have a positive ANA without being sick. If you also have elevated liver enzymes, a workup for autoimmune hepatitis may be continued, but if there's nothing to suggest a liver problem biochemically, I'd not be in a hurry to diagnose despite anti-smooth-muscle. ANA means nothing apart from the clinical picture. Best wishes.

Answered 3/15/2019

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