Laboratory studies revealed the following values: antinuclear antibody titer, 1:5120 with a speckled pattern; anti–native DNA, 1:40; anti–Sm antibody, 143 U/mL (abnormal, >5 U/mL); anti-RNP, 225 U/mL (abnormal, >2.8 U/mL); SS-A, 12.2 U/mL (normal, <2 U/mL); SS-B, 0.5 U/mL (normal, <2 U/mL), and white blood cells, 2.5×109/L (reference range, 4.5-11×109/L). The results of urinalysis were positive for protein only. Serologic tests were negative for lupus anticoagulant, syphilis, and human immunodeficiency virus.