Chronic pericardial effusion stable 26 yrs +ana 3xs then negative low lymphocyts nrml white count sed rate low no other symptoms ena all neg lupus?

Autoimmune: The symptoms you are describing certainly sound to be autoimmune in nature. I assume the pericardial fluid has been analyzed for infection (including TB) and there are no other unusual cells in the fluid. Patients can have autoimmune symptoms without a specific diagnosis being made. Treatment would still be needed. In the future other labs may become positive