ANA-Positive, Questions Please

Hi, I'm a 39 year old female, who for the last year and a half have been experiencing health problems.  I have petechia, loss of hair, tiredness, dry skin, eyes, and mouth, have had numerous surgeries for nerve problems ulnar nerve, carpal tunnel, etc...
The last 6 months all of my blood results are going nuts.  My white counts go low and then they normalize, in July my WBC was 3.6, and now it's back up to 4.1
My ANA is positive, with a speckled pattern, and a titer of 1:80, Smooth Muscle AB is positive, with the titer of 1:20, albumin is 62.3, the Centromere AB Titer was normal at 1:40 but the reading underneath it says that fluorescence was observed which is indicative of other Antinuclear antibodies.
I'm so lost, my physician says to do nothing right now, I don't quite agree, I've been researching but it's all so confusing.
My symptoms come and go, some days I feel like I have my normal energy and then a couple of days I'm completely exhausted. I do catch colds very quickly, and when I do get a cold I always run a slight fever 99.8 or 100.0, have swollen lymph glands in my neck, and it takes me at least three weeks to get over it.
I also have one swollen lymph gland in my neck that has been there for 3 years and no-one seems to know what to do with it.
I'm very concerned, as I don't quite feel like myself, I just want to get to the bottom of things, if this is lupus or what.
Thanks!.

[Kevin Pho, MD]

The titer of ANA is on the low side - there are a variety of disorders that can present with a low-level ANA.  

Anti Smooth Muscle Ab (ASMA) is found in correlation with autoimmune hepatitis as well as hepatitis C.  The concentration if ASMA is higher in autoimmune hepatitis than with hepatitis C.  

I would suggest baseline liver function tests, as well as tests for hepatitis as a basic screen.  

If negative, I would suggest a referral to a rheumatologist to further evaluate if your symptoms are consistent with lupus or not.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[Nerak15]

I forgot to mention that I also suffer from Raynauds, fingers and toes get extremely cold, and turn blue.