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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
Hypertension and Altered Mental Status (AMS) - Differential Diagnosis Framework

Hypertension:
 • Hypertensive emergency
 • Hypertensive encephalopathy
• Cushing’s syndrome ... Renal: • Acute GN ... Vasculitis • Lupus ... • Serotonin syndrome ... Differential #Diagnosis #causes
Common causes of Acute Kidney Injury AKI - Differential Diagnosis
HEMODYNAMIC
 • Cardiac failure: Impaired forward flow,
Common causes of ... inhibitors, hepatorenal syndrome ... Glomerulonephritides (GN ... Post-infectious GN ... , Lupus Acute Tubular
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
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
disease - Alport syndrome ... Mesangioproliferative GN ... Post-infectious GN ... pain hematuria syndrome ... Diagnostic of GN
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Abdominal Compartment Syndrome ... Vasculitis • GN ... Med, Contrast, Pigment ... Diagnosis #nephrology #causes
Paraproteinemias

Entities That Can Feature A Monoclonal Protein/M Component:
• MM
• WM
• MGUS
• MGCS
• MGRS
• Splenic Marginal Zone
Immunotactoid GN ... Cryoglobulinemic GN ... -C3 GN • Cast ... to cold IgG • Lupus ... Paraproteinemias #Hematology
Causes of Proteinuria - Differential Diagnosis Algorithm
Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Causes of Proteinuria ... • Fanconi's syndrome ... Membranoproliferative GN ... Post-infectious GN ... Diagnosis #Algorithm #Causes
ANA Patterns and Associated Rheumatic Diseases:
 • Homogeneous: Systemic lupus erythematosus (SLE), Mixed connective tissue disease
Homogeneous: Systemic lupus ... , Drug-induced Lupus ... Speckled: Systemic lupus ... SLE), Sjogren's Syndrome ... ANA #patterns #rheumatology
Autoantibodies in Rheumatology
 • Lupus (SLE): ANA (anti-nuclear antibody), dsDNA (double-stranded DNA), Anti-Smith, Anti-Ro (SSA) and
Autoantibodies in Rheumatology ... • Lupus (SLE): ... Antiphospholipid Antibody Syndrome ... glycoprotein I (ß2GP), Lupus ... LAC) • Sjogren Syndrome