<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 14-year-old Asian girl is brought to the physician because of a 6-week history of fatigue. During this period, she has had a 3-kg 6.6-lb weight loss and intermittent low-grade fevers. She also reports recurrent episodes of pain in her left wrist and right knee. She has no personal history of serious illness. Her aunt has rheumatoid arthritis. The patient appears pale. Her temperature is 38C 100.4F. Examination shows diffuse lymphadenopathy. Oral examination shows several painless oral ulcers. The left wrist and the right knee are swollen and tender to touch. The remainder of the examination shows no abnormalities. Laboratory studies show a hemoglobin concentration of 10 gdL, a leukocyte count of 3,000mm3, and a platelet count of 80,000mm3. Urinalysis shows excessive protein. Further evaluation of this patient is most likely to show which of the following findings?? A: Anti-citrullinated peptide antibodies, B: Positive monospot test, C: Anti-dsDNA antibodies, D: Excessive lymphoblasts, E: Elevated serum IgA levels,  <response>: This is a clinical vignette describing a 14-year-old Asian girl with a 6-week history of fatigue, weight loss, low-grade fevers, joint pain, oral ulcers, lymphadenopathy, anemia, leukopenia, thrombocytopenia, and proteinuria. The key findings are:- Young female patient - Constitutional symptoms fatigue, weight loss, fevers- Joint pain and swelling - Oral ulcers- Lymphadenopathy- Anemia, leukopenia, thrombocytopenia pancytopenia- Proteinuria- Family history of autoimmune disease aunt with rheumatoid arthritisThis presentation is most consistent with an autoimmune process or connective tissue disease. The differential diagnosis includes:- Systemic lupus erythematosus SLE- Juvenile idiopathic arthritis JIA- Hematologic malignancy like leukemiaSLE is the most likely diagnosis given the combination of constitutional symptoms, arthritis, oral ulcers, hematologic abnormalities, and proteinuria. Anti-dsDNA antibodies are highly specific for SLE.The other answer choices would not be expected:- Anti-CCP: associated with rheumatoid arthritis, not SLE- Monospot: would indicate infectious mononucleosis - Lymphoblasts: seen in hematologic malignancies like leukemia- Elevated IgA: not a feature of SLEC: Anti-dsDNA antibodies 