Hi Coreo and welcome to the board!
First off, the "normal" ANA titer is below 1:40. 1:40 is considered mildly positive. You are quite high with an ANA of 1:640!! An ANA can be specific to a whole range of autoimmune diseases, one being Lupus. What the important thing here is the stain pattern. Yours is homogenous, which is the most specific antibody for Lupus activity. The other one that goes with Lupus is "speckled". There are other stains also, which can indicate other immune problems. Your ANA would be considered medium high range. I have seen people with ANA's of 1:1260 and above!! The ANA goes up when active disease is present. Now you just need to really look back at your history and see if Lupus is the culprit or not. Please check out the symptoms of Lupus in this forum- they do not have to occur right now- but moreso in the past too! It's EVERYTHING up to this point. I will ask you some questions:
Do you get mouth sores?
Do you have a rash on your face or other places? It doesn't have to be a raging rash, it can be scaly too!
Do you get joint pain upon arising from bed in the morning or at night?
Have you ever had kidney inflammation (pyelonephritis) or other kidney problems?
Have you had other organ problems in the past?
Have you ever had hair loss?
Do you have fluctuations in your weight?
Do you get intermittant fevers? (not HIGH fevers, but low grade). If you don't know if you do.. check your temperature a few times a day for awhile. I know that my temperature goes up in the evening.
Have you ever had anything abnormal in yoru blood work or urine work? (protein in the urine, or abnormalities in blood that were unexplainable?)
Do you have thyroid problems, diabetes (type 1) or any other autoimmune problems?
Do you get migraines, headaches, or have a history of Stroke, TIA (mini stroke), DVT (leg clots) or miscarraige?
Thanks, I am being a royal pain here!! This will give me a better understanding of what is going on with you. I will be able to help you prepare for your upcoming Rheumy appointment too! I hope this answers your question for now.. Hope to hear from you soon!