Hi Deb. To answer your question....YES, you can have Lupus without having a positive ANA, and also, about 15% of the population can have a positive ANA but not have Lupus. it is a tricky disease to diagnose and a Rheumatologist usually won't diagnose Lupus on a positive ANA only, but will wait until other bloodwork comes out positive. I have just posted a long response about my case and you can read it and see the similarities between MS and Lupus that I have, which is why I love this board.(You will find it in the "Micheal" posts) I never had a LP or an MRI in 23 years. My Rheumatologist seems sure it is Lupus. MY Neurologist thought about doing a LP until he saw my results in the ANA, then he just referred me to the Rheumy. Only other tests I had done were EEG which showed I had a seizure disorder. I have never had a seizure but I did ask the Neurologist "If I were to have one, what form would it be?" and he said it would be a Grand Mal..................hope I NEVER have one!!!!!