A 28-Year-Old Man Comes to the Physician Because of a Swollen

A 28-year-old man comes to the physician because of a swollen, tender left knee for the past 4 days. During this period, the patient has had pain with urination. He has no history of serious illness and takes no medications. He is sexually active with two male partners and they use condoms inconsistently. His older sister has systemic lupus erythematosus. He is 180 cm (5 ft 11 in) tall and weighs 98 kg (216 lb) ; BMI is 30 kg/m2. His temperature is 37°C (98.6°F) , pulse is 83/min, and blood pressure is 140/75 mm Hg. Examination shows conjunctivitis bilaterally. The left knee is warm, erythematous, and tender to touch; range of motion is limited. Laboratory studies show an erythrocyte sedimentation rate of 62 mm/h. Urinalysis shows WBCs. Which of the following is most likely associated with this patient's joint symptoms?

A) C1 inhibitor deficiency
B) High titers of antistreptolysin O antibodies
C) Histocompatibility antigen HLA-B27
D) Positive serum antinuclear antibodies
E) Positive serum rheumatoid factor