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If you have a positive ANA but no positive antigens (DsDna, SM, RNP, etc), and no symptoms, then likely there is no reason to worry. However, if you have a positive ANA at 1:320 and symptoms, but nothing else showing up in your blood work, an autoimmune issue could be developing. Personally, I don't think high titers should be ignored.

I had a positive 1:320 homogeneous when I first got sick. Now I have a positive ANA with a high RNP 13 years later. It must be speckled now but the test didn't say. However an RNP is of a speckled pattern.

There are other tests doctors do also that help in the diagnosis. Like ESR, CRP, CPK, RF. If nothing shows up here, I'd say your ANA test may be ignored unless you have a positive antigen, because without the antigen, they can just say, well maybe your ANA is a false positive. Or if the ANA becomes negative at any point and time (though that can mean disease is in remission also), it can be ignored. I have no idea what would show now with me with the CRP and such, but all that used to be normal for me and it did not help in as far as showing how sick I was, not at all.

Yes if your swelling, I'd ask my doctor for an ANA. It could be related to a connective tissue disease. I wouldn't ignore such a symptom.

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