A 27-year-old white woman sought medical attention because of persisting pain in her wrists and ankles and an unexplained skin irritation on her face.

Case 1

History and Physical

A 27-year-old white woman sought medical attention because of persisting pain in her wrists and ankles and an unexplained skin irritation on her face. On physical examination, swelling of the joints of the hands and ankles was evident, along with erythema of the skin over the bridge of the nose and the upper cheeks. The patient had a slightly elevated temperature.

Laboratory Data

Complete blood count, urinalysis (UA), and rheumatoid arthritis (RA) screening test were ordered, with the following results:

• Hemoglobin and hematocrit—normal

• Total leukocyte count—70 × 10 9/L

• Differential leukocyte count—normal

• Gross and microscopic UA—normal

• RA screening test—positive

Follow-Up

An ANA screening test was ordered. The results were positive.

Questions

1. What is the most probable diagnosis in this case?

2. Does this patient fit into the general characteristics of patients with this disease?

3. What is the principle of the ANA test?

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