Since the titre doubles each time it's tested, it goes from 1:640, 1:1280, 1:2560, which is the last dilution they usually bother making. At 1:1280 it is high enough to indicate an autoimmune connective tissue disease most likely lupus.
Of course other antibody tests will have been done which could provide further significant indicators for lupus but with the right sort of signs and symptoms the ANA would be enough.
People are diagnosed at all different titres and sometimes,though rarely, no ANA is detected at all. Diagnosis is as much clinical from history, examination and symptoms, as blood tests.
My highest was 1,280 which my specialist said was 'sky high'. So yours is very high. My doc had said at 1,280 I was at acute crisis. And said levels that high pretty much clinches a connective tissue disease diagnosis.
He had said undifferentiated diffuse ctd and other times said probable liver ctd. Haven't been diagnosed w/'Lupus', just the autoimmune family.
But last mth. after a biopsy & yrs. of on & off liver symptoms w/abnormal liver tests, was finally officially diagnosed by my Gastro. with AIH (Autoimmune Hepatitis). He said that with the other overall autoimmune stuff I have, that the liver is being attacked also.
BTW, my ANAs for the last 15 yrs. have fluctuated back & forth from normal to 1,280 and everything in between. Last one was normal.
My ANA has only scored positive 2 times in my life. One 25 years ago and one 2 weeks ago. I have multipe autimmune diseases. I have chrons (in remission) SLE, CNS, sjorgens chrons (in remission), and alot of other fun stuff. I was lucky to find a doctor who thought out side of the box when he DX'D me with SLE lupus a few years ago (ANA was normal). 95 to 97 percent of people with lupus will have a regular ANA. Most of them will show a postive reading after a while and have have a positive ANA.
A positive ANA is a great indicator of an autimmune disease for doctors. It does not mean that if you have a positive ANA that you have an active autimune disorder or that you will ever have one. This is just the first test that a doc will do.
Wishing you the best and hoping that you do not have lupus.
Since my diagnosis my ANA has always been positive. It fluctuates a little. Highest was 1:1280 and the lowest 1:604 (which was my last test) I always have a fine speckled pattern, although once they reported "nuclear dots". My ENA shows always a high positive titre of antibodies to U1-RnP (70 kD-ribonuclear protien) this finding in the absence of other ENA-antibodies (SSA, SSB, Jo-1) is a high diagnostic indicator for MCTD (Sharp's syndrome).
Oh sorry, I just noticed you where asking for those who don't yet have a diagnosis. However, in the beginning for me. I was given a diagnosis of MS based on MRI and nerve conduction tests. I think amoungst the hundreds of blood tests that were done at that time was at least once an ANA. It was positive but I don't how high. It was overlooked by everyone, because the MRI was just so much more interesting! When my problems became "more than just neurological" ANA was determined and the diagnosis was changed. Although my Rheumy stills thinks I have maybe MS as well, the Neuro says not likely that the MCTD and Vasculitis explains all of it.