A 55 y.o. man presents with the following intermittent symptoms over the past year:

• fatigue
• multiple joint aches
• multiple areas of muscle ache
• facial rash for several months
• one episode of bronchitis with thick white mucus production
• one isolated bout of reddened eyes and some blurred vision

What is your diagnosis?

• ANA is positive at 1:1280
• CRP:  normal
• Sed rate:  normal
• anti ds DNA antibodies : indeterminate
• anti smith antibodies: pending

Working diagnosis: systemic lupus erythematosus