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Renal Involvement in Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#Renal #diseases #SLE #Systemic #Lupus #Erythematosus #venn #nephrology
Renal Involvement ... in Systemic Lupus ... Lupusreference #Renal ... nephrology #nephritis #classification ... #types #rheumatology
Classification of Vasculitis 
Vasculitis of large vessels 
 - Arteritis temporalis (giant-cell arteritis) 
 - Takayasu
Classification of ... angiitis of the central ... nervous system ... disease - systemic ... Vessels #Diagnosis #Rheumatology
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
severe disease & renal ... block • Sjogren syndrome ... polymyositis overlap syndrome ... Summary #diagnosis #rheumatology ... #management
Pharmacological Treatment of Hepatorenal Syndrome (HRS)

Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure
of Hepatorenal Syndrome ... pressure incr renal ... Systemic vasoconstriction ... #HepatoRenal #Syndrome ... #Nephrology #Management
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Clinical Features of Systemic ... joints Nervous system ... Demyelinating syndromes ... Abdominal pain (20%) Renal ... symptoms #diagnosis #rheumatology
Behcet's Syndrome - Treatment
Ulcers:
 • Treatment: Topical steroids
 • Prevention: Colchicine
 • Azathioprine for refractory disease
Arthritis:
Behcet's Syndrome ... Neuro disease: • Systemic ... Behcets #disease #Syndrome ... #Treatment #management ... #pharmacology #rheumatology
Causes of Hypocomplementemia - CHAMPS Mnemonic
C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis
H - Heavy Chain deposition
antiphospholipid syndrome ... glomerulonephritis (>90%) S - Systemic ... Erythematosus (total 50, renal ... #differential #hematology
EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus
Clinical Domains:
 • Constitutional domain: Fever
 • Cutaneous domain: Non-scarring
EULAR/ACR Classification ... Criteria for Systemic ... hemolysis • Renal ... Criteria #SLE #Systemic ... Erythematosus #diagnosis #rheumatology
ANA (Antinuclear Antibody) and ANCA (Antineutrophil cytoplasmic antibodies)
 • Systemic lupus erythematosus
   1. Anti-dsDNA
antibodies) • Systemic ... cases • Sjögren syndrome ... polyangiitis without renal ... ANCA+ 30-60% • Renal-limited ... antibodies #diagnosis #rheumatology
Monoclonal Gammopathy of Clinical Significance (MGUS) - Differential Diagnosis

Neurologic-Centered:
 (+) Systemic Features: POEMS, AL amyloid, Cryoglobulinemia
Cryoglobulinemia (-) Systemic ... capillary leak syndrome ... • Schnitzler syndrome ... Cryoglobulinemia Renal-centered ... Differential #Diagnosis #hematology