BobbaBlu, hello & welcome! I'm only a (dumb) patient so please take what I write in that light, OK? I just read that increased alpha-1 globulins can indicate a chronic or acute inflammatory condition such as SLE or rheumatoid arthritis. There are chronic inflammatory BOWEL diseases, and I have *no idea* whether that test can go positive in those GI conditions. But sicne you have problems, I think it makes sense that you see a gastroenterologist either way...
As for whether ANA can fluctuate between positive & negative, in diseases that are prone to "flares", that may be possible, but honestly, I've never known for sure! You could ask every dr. you see upcoming for more insight into whether ANA can go up & down.
As for whether ANA can be negative in *systemic* lupus: YES, it definitely can, BUT it's rare. Something like 95%+ of patients who meet 4 or more ACR criteria for systemic lupus have positive ANA. (See the "sticky post" at the top of the thread list for the criteria). The main exceptions are believed to be those with the "subset" (variant) called Ro-lupus, in which *anti-Ro* autoantibody is the one that's positive, with ANA remaining negative in perhaps 1/3 of that subgroup.
I fit the ANA exception, and it took me a horribly long time to get a Dx. I had severe episodic GI problems for almost 25 years. I'd had shin & joint pain episodically from adolescence. Next came long, miserable episodes of GI malabsorption. Then urinary urgency and frequency. Migraines. Anemia. Elevated ESR. Fatigue. Neuro-like tingling. Last to arrive, in my late 30's, were episodic, nonscarring, nondepigmenting targetlike lesions on upper arms & back. Finally, after MANY dermies & deep-punch biopsies, rheumies, gastros, etc., I was Dx'ed by a teaching hospital rheumie and a dermatopathologist with "subacute cutaneous lupus erythematosus", abbreviated SCLE, positive for anti-Ro and negative for ANA. FYI, in terms of typical severity, SCLE is believed to *typically* fall somewhere between discoid & systemic lupus, although in some, it can be as severe as classic SLE, with major organ involvement.
So... can episodic GI problems be seen in lupus? My local drs. never seem to think it could, but my *metro rheumie* said ABSOLUTELY. Thing is, one needs to rule GI-only diseases/conditions in or out, to make sure it's not one of those.
Do you have anything ELSE going on that could help with a Dx? Rashes can be GREAT, if you know what I mean...! Deep-punch skin biopsy with additional immunofluorescent stain tests can very often (not always) determine if a rash is lupus-specific, which is VERY useful to know.
I hope something above is useful & that others chip in soon, too. I also hope you keep posting here: we're good company, if I do say so myself.
Let us know how you're doing, OK? Meanwhile, sending my best wishes, sincerely, Vee P.S. Hang in there!