MSFinals-5964

MSFinals-5964

A 32-year-old woman comes to the clinic for evaluation. She has been experiencing a red rash on her face for 6-12 months and is now having joint pain in multiple areas. She also reports having chest pain that feels like it’s coming from the lining of her lungs. During the examination, her blood pressure is measured at 155/92 mmHg, and she has a butterfly-shaped rash on her face.

The following tests were conducted:

– Haemoglobin: 119 g/l (normal range: 115-155 g/l)
– White cell count (WCC): 4.2 × 109/l (normal range: 4-11 × 109/l)
– Platelets: 192 × 109/l (normal range: 150-400 × 109/l)
– Sodium (Na+): 140 mmol/l (normal range: 135-145 mmol/l)
– Potassium (K+): 4.9 mmol/l (normal range: 3.5-5.0 mmol/l)
– Creatinine: 160 μmol/l (normal range: 50-120 µmol/l)
– Erythrocyte sedimentation rate (ESR): 66 mm/hr (normal range: 0-10mm in the 1st hour)
– Anti-nuclear antibody (ANA): positive
– Urine: blood and protein present

What is the most likely diagnosis?