The remaining immunologic labs, including anti-double-stranded antibodies (DS-DNA) for lupus, anti-Smith antibody (SM/RNP), anti-Sjögren’s antibodies (SS-A/SS-B), anti-scleroderma antibodies (Scl-70), hepatitis panel, HLA-B27 antigen, and Lyme disease antibodies (IgG and IgM), were negative, and the creatine kinase (CK) levels were within normal limits at 195 U/L (Reference: 22 to 198 U/L). Here, CD40LG is linked to Lyme disease.