A and A's in Lupus?

It's important to keep a broad differential diagnosis for a positive A and A because it's not always a rheumatologic condition. I've seen referrals in my clinic where a patient has been told that they have lupus because their A and A is positive. Matthew, what other things should we be thinking about? Well, some of the most interesting consults that I've seen in the hospital as a fellow presented as a mimic or of lupus with thepositive A and A turned out to be hematologic malignancies like lymphoma or even lymphropoleative disorders like castle mens.