I have had a positive ANA on 4 different occasions now and the ANA titer is 1:160. ANA Pattern is Homogeneous. The cascade reflex all came back Negative. ESR of 2 mm per hour. Severe fatigue and continuous pain, rashes on my face and I am never sick and now I always feel ill and extremely tired. Please help or suggest what I can do next. No definitive diagnosis and it seems to be becoming worse as time goes on.