How do you interpret a high positive RNP in the setting of a negative ANA and negative sm/RNP?

This is a challenging scenario that we often see in clinical practice with our current multiplex assays. A great reference is the following ACR abstract: Clinical Significance of RNP Antibodies in Diagnosis of Systemic Autoimmune Rheumatic Disease When Detected By Multiplex Immunoassay.

As demonstra...