Ms. R., 24-year-old university student:

• Has been well in the past except for Raynaud's phenomenon in her hands over the past two years
  
• Visited her physician a few times in the past three months for non-specific complaints of fatigue and aches and pains in her hands
  
• Fatigue and aches attributed to school stress and hours of sitting at the computer working on term papers
• No symptoms of fever, night sweats or weight loss
• Not sexually active.