<prompt> 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 gdL and thrombocytopenia 30,000mL. Which of the following is the most likely underlying mechanism in the development of thrombocytopenia in this patient?Antibody-mediated platelet destructionClonal plasma cell circulating paraproteinDecreased susceptibility to complement-mediated lysisDefect in the platelet cytoskeleton  <response>: 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 