Systemic lupus erythematosus (SLE) Quiz: Ace Your Exams

A 32-year-old woman comes to the clinic because of a three month history of pain and swelling in both wrists. She states that the pain is worse in the morning and is characterized by stiffness that takes approximately one hour to improve. Upon questioning, the patient notes that she had one episode last month where red patches over her cheeks and nose appeared after spending a day at the park with her nephew. She is sexually active with one partner and takes oral contraceptive pills. She drinks approximately four alcoholic beverages per week and does not smoke cigarettes. The patient’s temperature is 38.0°C (100.4°F), pulse is 77/min, respirations are 18/min, and blood pressure is 118/78 mmHg. Physical examination shows flat, fixed erythema over the malar eminences, with sparing of the nasolabial folds. The wrists are visibly swollen bilaterally and are tender on palpation. Laboratory studies show the following:  

Laboratory value	Result	Reference Range
Hemoglobin	14.0 g/dL	12-16 g/dL
Leukocyte count	3,800/mm3	4,500-11,000/mm3
Platelet count	160,000/mm3	150,000-400,000/mm3

Which of the following laboratory findings is most consistent with this patient’s diagnosis?