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However, without clinical evidence of diabetes, occult malignancy, arthritis, multiple sclerosis, or other systemic illness, serologic studies, such as rheumatoid factor, antinuclear anti- bodies, Borrelia burgdorferi, muscle enzymes, and serum complement, are generally not necessary.47 According to Hench, 32 Goldenberg, 47 and others, 10% to 15% of patients with FMS have isolated abnormal serologic test results with- out evidence of underlying connective tissue disease, which can often be misleading