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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Lupus Erythematosus ... #SLE #hematology ... #rheumatology # ... differential #diagnosis ... #causes
Pancytopenia - Differential Diagnosis

Congenital Diseases:
• GATA2 deficiency
• Fanconi’s anemia
• Wiskott-Aldrich syndrome
• Ribosomopathy or telomeropathy

Cancer:
• Leukemia
• Lymphoma

Inflammatory
deficiency • Fanconi’s anemia ... Wiskott-Aldrich syndrome ... Autoimmune Diseases: • Systemic ... lupus erythematosus ... #Diagnosis #Hematology
ANA Patterns and Associated Rheumatic Diseases:
 • Homogeneous: Systemic lupus erythematosus (SLE), Mixed connective tissue disease
lupus erythematosus ... , Drug-induced Lupus ... SLE), Sjogren's Syndrome ... ANA #patterns #rheumatology ... #diagnosis #differential
Hemolysis - Diagnostic Algorithm and Causes

Increased red cell production: 
 • Increased Reticulocytosis/polychromasia 
 • Erythroid
Algorithm and Causes ... Hemolysis #Hemolytic #Anemia ... #Algorithm #Differential ... #Causes #Workup ... #Hematology #Diagnosis
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Lupus (SLE) General ... Demyelinating syndromes ... ) Blood (75%): Anemia ... erythematosus #signs #symptoms ... #diagnosis #rheumatology
BEE Syndromes - Immune-mediated conditions affecting the brain, eye, and ear

Visual or auditory symptoms in conjunction
conjunction with symptoms ... central nervous system ... Inflammatory causes ... • Systemic lupus ... #inflammatory #differential
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Systemic Lupus Erythematosus ... - Hemolytic anemia ... autoantibodies #signs #symptoms ... #mimickers #differential ... #rheumatology
Approach to Thrombocytosis - Elevated Platelet Count - Differential Diagnosis Algorithm

Peripheral Smear concerning for malignancy?
→ Refer to hematology ... for workup, including ... hemolysis, deficiency anemia ... Kawasaki, Nephrotic syndrome ... Diagnosis #Algorithm #hematology
Causes of Hypocomplementemia - CHAMPS Mnemonic
C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis
H - Heavy Chain deposition
Causes of Hypocomplementemia ... antiphospholipid syndrome ... Lupus Erythematosus ... Mnemonic #diagnosis #differential ... #hematology
Causes of Diffuse Lymphadenopathy - Differential Diagnosis Algorithm
Reactive:
 - Systemic Inflammatory
     •
Causes of Diffuse ... Reactive: - Systemic ... Inflammatory • Systemic ... Lupus Erythematosus ... #Hematology #Oncology