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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Microangiopathies In Systemic ... Lupus Erythematosus ... #rheumatology # ... differential #diagnosis ... #causes
Hemolysis - Diagnostic Algorithm and Causes

Increased red cell production: 
 • Increased Reticulocytosis/polychromasia 
 • Erythroid
Hemolysis - Diagnostic ... Algorithm and Causes ... #Algorithm #Differential ... #Causes #Workup ... #Hematology #Diagnosis
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
- Differential ... Inflammatory • Systemic ... Lupus Erythematosus ... Serum Sickness Hemolytic ... #Causes #Hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Diagnostic Framework ... Extravascular Causes ... usually IgG) (e.g. lupus ... #differential # ... diagnosis #hematology
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Anemia 1) DIAGNOSE ... • Blood smear: Differential ... 2) LOOK FOR a cause ... → Systematic screening ... management #treatment #rheumatology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Systemic Lupus Erythematosus ... Lymphadenopathies 7% - Hemolytic ... Diagnosis and Lupus ... #signs #symptoms ... #rheumatology
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Lupus (SLE) General ... normochromic nomocytic or haemolytic ... Thrombocytopenia #Lupus ... erythematosus #signs #symptoms ... #diagnosis #rheumatology
Common causes of Acute Kidney Injury AKI - Differential Diagnosis
HEMODYNAMIC
 • Cardiac failure: Impaired forward flow,
Common causes of ... Diagnosis HEMODYNAMIC ... Secondary GNs: Due to systemic ... Post-infectious GN ... , Lupus Acute Tubular
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

Inflammatory
Diagnosis Congenital ... Autoimmune Diseases: • Systemic ... lupus erythematosus ... Antibody-mediated hemolysis ... #Diagnosis #Hematology
Causes of Diffuse Lymphadenopathy - Differential Diagnosis Algorithm
Reactive:
 - Systemic Inflammatory
     •
Causes of Diffuse ... Diagnosis Algorithm ... Reactive: - Systemic ... Lupus Erythematosus ... #Causes #Hematology