A 25-Year-Old Woman with End-Stage Renal Disease, Low Platelet Count, and Skin Rash

A 25-year-old Caucasian woman with a past medical history of hypertension, systemic lupus erythematosus (SLE), s/p three spontaneous abortions, severe aortic stenosis, and mild pulmonary hypertension was transferred to our dialysis clinic from another outpatient dialysis center. She had been on dialysis for four years and undergone aortic valve replacement surgery two years previously.

On admission, she complained of severe weakness ...