A 25-year-old woman with a history of systemic lupus erythematosus presents with diffuse petechiae and fatigue. Physical examination demonstrates lymphadenopathy and splenomegaly Laboratory findings include normocytic anemia (hemoglobin =6.1 g/dL) and thrombocytopenia (30,000/mL). Which of the following is the most likely underlying mechanism in the development of thrombocytopenia in this patient?
In common with idiopathic thrombocytopenic purpura and certain drug-induced thrombocytopenias, systemic lupus erythematosus is associated with increased platelet destruction due to immune-mediated damage and removal of circulating platelets (antibody-mediated platelet destruction). The other choices do not represent immune destruction of platelets.Diagnosis: Idiopathic thrombocytopenic purpura, systemiclupus erythematosus
Antibody-mediated platelet destruction
Clonal plasma cell circulating paraprotein
Decreased susceptibility to complement-mediated lysis
Defect in the platelet cytoskeleton
Blood