A medical conundrum
A 36 year old school teacher, a mother of two, has come to the hospital with joint pain since 1 month, mainly in the hands and feet. She had previously complained of general fatigue, swelling of the legs, a rash on her face that worsened with sunlight, and hair loss. On enquiry, she said that she had very cold hands and feet during winter, and that they became very pale. Her vision had also been blurring since the past 3 months. Her lab reports showed low hemoglobin levels, leukocytopenia and thrombocytopenia.
What is the most probable diagnosis?