A 10-year-old girl presents to the emergency department with 4 days of fever, headache, and malaise. Her fevers (up to IO2℉ 38.9℃ at home) are responsive to antipyretics, and her headache is described as a left temporal throbbing sensation. She denies vomiting, diarrhea, skin rashes, or joint pain. Her immediate medical history includes an 8.2-lb (3.7-kg) weight loss and a normocytic anemia noted during the past 6 months. She is currently undergoing an outpatient evaluation by gastroenterology, nutrition, and hematology without a definitive diagnosis. She takes no medications, has no pets, and has no history of recent travel. Her family history is negative for rheumatologic diseases and malignancies.
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