A 19-year-old college student was evaluated for a red rash on her face after a day at the beach ...

A 19-year-old college student was evaluated for a red rash on her face after a day at the beach

The student stated that the rash looked different from sunburn and that since she had been
feeling generally unwell lately that she decided to have it checked out. Laboratory results were
as follows. What is the most reasonable diagnosis and what follow-up testing is most
appropriate?
Complete blood count (CBC)slightly low red blood cells, platelets, and white blood cells
Urinalysis2+ protein
Renal function tests (BUN and creatinine)elevated
Liver function testswithin normal limits
Electrolytes and glucosewithin normal limits
Antinuclear antibody (ANA)positive, homogeneous pattern, titer 1:256
Total complementdecreased
Complement C3decreased
Complement C4decreased
A) Systemic lupus erythematosus/anti-DS DNA
B) Goodpasture's syndrome/rheumatoid factor
C) Goodpasture's syndrome/antiglomerular basement membrane antibody
D) Autoimmune hepatitis/antismooth muscle antibody
E) Systemic lupus erythematosus/antiglomerular basement membrane antibody

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A 19-year-old college student was evaluated for a red rash on her face after a day at the beach ...

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