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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Erythematosus #SLE #hematology ... #rheumatology #
Treatment of Thrombotic Thrombocytopenic Purpura (TTP)
Diagnosis of TTP:
 • Rare and severe, ADAMTS13 deficiency
 • Autoimmune
(scheduled on day ... supplementation (5-10 mg/day ... management #treatment #rheumatology ... #hematology
Systemic Sclerosis (Scleroderma)
Limited - CREST:
 • Calcinosis
 • Raynaud phenomenon
 • Esophageal dysmotility
 • Sclerodactyly
 •
65%, Can involve DIP ... signs #symptoms #rheumatology
Thrombocytosis - Differential Diagnosis
Platelet Count > 450
Reactive:
 • Anemia/blood loss (Fe deficiency)
 • Infection/Sepsis
 • Non-infectious
Non-infectious (malignancy, rheumatologic ... causes #Platelets #hematology
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
marrow disease - DIC ... Coagulation Defects: • DIC ... Purpura Fulminans (DIC ... Differential #Diagnosis #hematology ... #rheumatology #
Causes of Arterial and Venous Thrombosis - Differential Diagnosis Framework

STRUCTURAL:
 - PFO: paradoxical emboli
 - Popliteal
intravascular coagulation (DIC ... MAHA: TTP, HUS, DIC ... Diagnosis #clots #hematology
Rheumatoid Arthritis Summary
MCP and PIP Involvement, Spares DIP, Carpal Tunnel, Sicca Syndrome, Epi/Scleritis, Heart Disease, Rheumatoid
Involvement, Spares DIP ... RA #diagnosis #rheumatology
Peripheral Blood Smear Analysis
Hypochromia
Megaloblastic Anemia
Schistocytes: Microangiopathic hemolytic anemia (e.g. DIC, TTP, HUS)
Microspherocytes: Autoimmune hemolytic anemia
Sickled red
DIC, TTP, HUS) ... Smear #Analysis #hematology
Renal involvement in 35% of mixed cryoglobulinemia vasculitis 
Associated with : 
 • Absence of skin
proteinuria - 3.5 g/day ... (%) • > 3g / day ... Vasculitis #Management #Rheumatology
Gout Management Algorithm

DOI: 10.1016/j.semarthrit.2020.04.010

#Gout #Management #Algorithm #rheumatology #uricacid
Management #Algorithm #rheumatology