The laboratory studies for systemic and infectious diseases, including antinuclear antibody (ANA), rheumatoid factor (RF), C-reactive protein (CRP), angiotensin-converting enzyme (ACE), antineutrophil cytoplasmic antibodies (ANCA), immunoglobulin G4 (IgG4), and Bartonella antibody, as well as tests for HIV, herpes simplex virus type 2 (HSV 2) IgG, rapid plasma reagin (RPR), QuantiFERON tuberculosis (TB), and purified protein derivative, were all normal or negative. Here, ACE is linked to tuberculosis.