A 25-year-old woman comes to the office due to arthralgias in her hands for the last several months. The pain frequently involves her wrists and proximal finger joints bilaterally, and alternates between being worse in the wrists versus in the hands. The patient has no other medical problems and takes no medications. Complete blood count results are as follows: Further evaluation reveals proteinuria and red blood cell casts. Which of the following is the most likely diagnosis?

Question

A 25-year-old woman comes to the office due to arthralgias in her hands for the last several months.  The pain frequently involves her wrists and proximal finger joints bilaterally, and alternates between being worse in the wrists versus in the hands.  The patient has no other medical problems and takes no medications.  Complete blood count results are as follows:  Further evaluation reveals proteinuria and red blood cell casts.  Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Systemic lupus erythematosus is an autoimmune disorder that occurs most commonly in women.  Hematologic abnormalities are common; autoantibodies against blood cell antigens (ie, type II hypersensitivity) can cause pancytopenia (ie, anemia, thrombocytopenia, leukopenia).  In contrast, lupus nephritis is caused by immune complex deposition (ie, type III hypersensitivity) in the glomeruli.

A 25-Year-Old Woman Comes to the Office Due to Arthralgias