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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 ... Microangiopathies #Systemic #Lupus ... Erythematosus #SLE #hematology ... #rheumatology # ... differential #diagnosis #causes
Hydroxychloroquine Serum Measurement in SLE
 • Terminal elimination half-life = 40 days ([HCQI reflects long-term intake)
half-life = 40 days ([HCQI ... • Special cases ... Hydroxychloroquine #HCQ ... Measurement #SLE #rheumatology ... pharmacology #levels #lupus
Rapidly Progressive Glomerulonephritis (RPGN)
RPGN has three primary pathophysiologic causes differentiated by immunofluorescence

Immune Complex Mediated (granular staining):
pathophysiologic causes ... Complement: Post-strep GN ... , Lupus Nephritis ... diagnosis #algorithm #rheumatology
Common causes of Acute Kidney Injury AKI - Differential Diagnosis
HEMODYNAMIC
 • Cardiac failure: Impaired forward flow,
Common causes of ... Glomerulonephritides (GN ... Post-infectious GN ... , Lupus Acute Tubular ... NephroP #AKI #causes
Hypertension and Altered Mental Status (AMS) - Differential Diagnosis Framework

Hypertension:
 • Hypertensive emergency
 • Hypertensive encephalopathy
Renal: • Acute GN ... Vasculitis • Lupus ... Scleroderma renal crises ... Differential #Diagnosis #causes
Paraproteinemias

Entities That Can Feature A Monoclonal Protein/M Component:
• MM
• WM
• MGUS
• MGCS
• MGRS
• Splenic Marginal Zone
Zone Lymphoma (HCV ... Immunotactoid GN ... -C3 GN • Cast ... to cold IgG • Lupus ... Paraproteinemias #Hematology
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Vasculitis • GN ... Med, Contrast, Pigment ... Diagnosis #nephrology #causes
Hydroxychloroquine - Risks and Benefits in Lupus
Benefits:
↓ Disease activity, ↓ Flare, ↓ Damage, ↓ Corticosteroid dose,
and Benefits in Lupus ... rare with ~100 cases ... Hydroxychloroquine #hcq ... Risks #Benefits #Lupus ... #sideeffects #rheumatology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
Causes of Splenomegaly ... Inflammatory • Systemic Lupus ... Spherocytosis • Acquired causes ... Diagnosis #Algorithm #Causes ... #Hematology
Causes of Thrombocytopenia and Platelet Disorders - Differential Diagnosis and Workup
History:
 - Prior platelet count, family
factor for HIV, HCV ... blood smear, HIV/HCV ... patients if the cause ... Differential #Diagnosis #Causes ... #Workup #hematology