单项选择题

女性，60岁。反复低热1年余，伴双手腕关节及掌指关节肿痛，晨起关节有胶黏着样感觉，症状加重时脚踝部可见大小不一、无压痛的皮下结节，伴口干，查血白细胞9.3×10/L，血红蛋白83g/L，血沉90mm／h，ANA（-），RF（+）。应首先考虑的诊断是（）

A. 系统性红斑狼疮
B. 风湿关节炎
C. 干燥综合征
D. 痛风性关节炎
E. 类风湿关节炎

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