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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Thrombotic Microangiopathies ... In Systemic Lupus ... Lupusreference #TMAs #Thrombotic ... Erythematosus #SLE #hematology ... differential #diagnosis
Thrombotic Microangiopathies - Primary Thrombotic Microangiopathy (TMA) - Differential Diagnosis Table

 • Thrombotic Thrombocytopenic Purpura (TTP)
Thrombotic Microangiopathies ... - Primary Thrombotic ... Diagnosis Table ... • Thrombotic ... Microangiopathy #TMA #hematology
Differential diagnosis of schistocytes / fragmentation hemolysis:
 • Thrombotic microangiopathies (TMA)
    - TTP
Differential diagnosis ... hemolysis: • Thrombotic ... - Drug-induced thrombotic ... macroangiopathic hemolytic anemia ... #diagnosis #hematology
Thrombotic Microangiopathy - TTP VS HUS

Big picture points : Often hard to differentiate the two entities,
Thrombotic Microangiopathy ... Often hard to differentiate ... testing for TTP #Thrombotic ... Comparison #Diagnosis #Table ... #Hematology
Red Blood Cell (RBC) Morphology Atlas
 • Microcytic - Iron-deficiency anemia, Thalassemia, Sideroblastic anemia, Lead poisoning
Iron-deficiency anemia ... Sideroblastic anemia ... uremic syndrome, Thrombotic ... key #diagnosis #differential ... #hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
syndrome - Thrombotic ... microangiopathy: Thrombotic ... Extravascular #Causes #differential ... #diagnosis #hematology ... #anemia
Paraproteinemias

Entities That Can Feature A Monoclonal Protein/M Component:
• MM
• WM
• MGUS
• MGCS
• MGRS
• Splenic Marginal Zone
Organomegaly+↑RBC/plt+, ↑thrombosis ... (-) hemolytic anemia ... Hyperviscosity (Thrombosis ... Paraproteinemias #Hematology ... #Monoclonal #Differential
TTP - Laboratory Evaluation for Thrombotic Thrombocytopenic Purpura

Activity of von Willebrand factor-cleaving protease activity - A
Evaluation for Thrombotic ... result in severe anemia ... immune hemolytic anemia ... WBC count and differential ... Diagnosis #Workup #Hematology
Endocarditis Summary

Who?
Infectious:
• Pre-existing valvular disease
• Prosthetic valve
• Congenital heart disease
• IV substance use
• IV catheter
• Recent
Vascular: • Systemic ... Marantic (NTBE) Differential ... • Nonbacterial thrombotic ... Leukocytosis, anemia ... underlying cause + Systemic
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
SLE (Systemic Lupus ... permanent alopecia Differential ... Neuropsychiatric systemic ... Hematologic: ... lymphopenia, low PLT • Anemia