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ANA is approximately 95% sensitive in Lupus patients
That means 5% people can still have Lupus with negative ANA
In such cases if clinical suspicion is high more definitive tests like anti-dsDNA and anti-Smith antibodies should be done
Please do let me know if you have any other question
If all other investigations for lupus are negative so it is not lupus
Biopsy of the rash may help to make a diagnosis
It can be an undifferentiated connective tissue disorder in which the problem does not fit in to any specific single condition '
There are treatment options after confirming diagnosis