Section: USMLE

41) A 57-year-old woman with a history of hypertension and arthritis is referred to a rheumatologist for evaluation. A complete blood count (CBC) is normal, and a mini-chem panel shows no electrolyte abnormalities. Her erythrocyte sedimentation rate (ESR) is elevated, and an antinuclear antibody test (ANA) is positive. Further antibody studies are performed, and the results are shown below.

Anti-histones	high titer
Anti-double stranded DNA	not detected
Anti-single stranded DNA	not detected
Anti-SSA	not detected
Anti-SSB	not detected
Anti-SCI-70	not detected
Anti-Smith	not detected
Anti-centromere	not detected
Anti-RNP	not detected

Which of the following diseases is suggested by these results?

CREST syndrome
Diffuse form of scleroderma
Drug-induced lupus
Sjögren syndrome
Systemic lupus erythematosus (SLE)