ANA 1:80 nucleolar pattern

A recent physical revealed positive ANA 1:80 nucleolar pattern. Next blood work was ENA 6 panel which was negative. 2006 blood work showed positive anti-smooth muscle antibody, which was repeated, results pending.

Dxs include fibromyalgia, osteoarthritis, and chronic Lyme. Problem sx: joint and muscle pain (chronic pain), recurrent bouts of illness with low grade fevers, nausea, terrible fatigue and weakness, headaches, frequeny hot flushes with sweating (also menopause), and postural hypotension.

The possibility of either Lupus or an undignosed autoimmune disease has been mentioned over the years (10+). Is 1:80 a low titre? And does the nucleolar pattern appear in Lupus? Another surprising finding from an EKG showed bradycardia at 54 bpm. My resting pulse has never been that low.

Any thoughts or ideas?

Would further cardiac testing be done based on the low heart rate?

Thank you, Joy.

I was a little shocked when my GP said the EKG had showed a heart rate of 54. I can't even remember what he said after I told him I've never had a low pulse rate before. Of course now I'm worried because I'm far from an athlete, and due to the extreme fatigue, etc. Some days I've fairly normal in terms of strength, then other days it's exhausting just trying to feed the cats or wipe the kitchen counters.

I'm such an idiot with doctors sometimes though, blurting out things instead of thinking first. He asked about my joint pain and I said "I have trouble spots." In retrospect, I should have said I have new joint pains in the past year: hand, foot, shoulder (not just back arthritis).

I've gone off antibiotic therapy for Lyme (4 years of no lasting improvement), including Plaquenil, which I stopped about 6 months ago or more. They use it for Lyme as a cyst-buster, in hopes of killing the Lyme spirochetes. I suspect I have some permanent damage from the late stage. I also stopped taking Prevacid, because it's useless for the nausea bouts I get repeatedly.

He said he will send me to either an internist or a rheumy. I haven't seen a rheumatologist since 2001 - the one who dx'd "fibromyalgia or soft tissue rheumatism." Most specialists in BC, Canada are anti-Lyme. I used to come on this forum back before I got the Lyme dx, and you guys were always very helpful and kind.

Thank you again for your help.

Hi Lynnwood, thank you for clearing that up for me. I was reading about the titres (but not comprehending) and I think I had it backwards - thinking 1:80 is high. So if it's low, that's better. My GP ordered the ENA 6 Panel, which was negative.