Q. A 34-year-old female presents to your clinic with a chief complaint of fatigue, joint pain, and a rash on her face. She reports that the symptoms have been ongoing for several months and have progressively worsened. She denies any fever, weight loss, or other significant medical history. She also reports a family history of autoimmune disease, including lupus. On physical examination, the patient is found to have a butterfly-shaped rash on her cheeks and nose. She also has swelling and tenderness in multiple joints, including her hands and wrists. Blood tests reveal anemia and elevated levels of anti-nuclear antibodies and anti-double-stranded DNA antibodies. You refer her to a rheumatologist for further evaluation and management. You also start her on hydroxychloroquine and nonsteroidal anti-inflammatory drugs for pain relief. Which of the following would NOT be a common/characteristic feature of this patient's diagnosis?