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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Erythematosus ... #Erythematosus ... #rheumatology # ... differential #diagnosis ... #causes
Approach to managing Glomerulonephritis (GN) in children. 

ANCA, antineutrophil cytoplasmic antibodies; c-ANCA, cytoplasmic antineutrophil cytoplasmic antibodies;
Glomerulonephritis (GN ... antineutrophil cytoplasmic antibodies ... antineutrophil cytoplasmic antibodies ... SLE, systemic lupus ... erythematosus.
ANA Patterns and Associated Rheumatic Diseases:
 • Homogeneous: Systemic lupus erythematosus (SLE), Mixed connective tissue disease
erythematosus ( ... erythematosus ( ... #Antinuclear #Antibodies ... ANA #patterns #rheumatology ... #diagnosis #differential
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 ... Purpura Anti-GBM antibodies ... diagnosis #algorithm #rheumatology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Systemic Lupus Erythematosus ... SLE-Related Auto-Antibodies ... (aPL) 30-45% Differential ... #Erythematosus ... #rheumatology
Antinuclear Antibodies (ANA)
ANA or Anti-NucIear Antibody refers to antibodies against antigens in the nucleus → like
Antinuclear Antibodies ... erythematosus ( ... erythematosus ( ... ANA #patterns #rheumatology ... #diagnosis #differential
EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus
Clinical Domains:
 • Constitutional domain: Fever
 • Cutaneous domain: Non-scarring
Criteria for Systemic Lupus ... Erythematosus ... Highly specific antibodies ... #Erythematosus ... #diagnosis #rheumatology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
- Differential ... Inflammatory • Systemic Lupus ... Erythematosus ... Spleen #Enlarged #Differential ... #Hematology
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
permanent alopecia Differential ... Non-autoimmune rheumatologic ... 1, SCL-70, RNP antibodies ... anticardiolipin antibodies ... #Diagnosis #Rheumatology
Causes of Proteinuria - Differential Diagnosis Algorithm
Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
- Differential ... Membranoproliferative GN ... • Anti-GBM antibodies ... Post-infectious GN ... Diagnosis #Algorithm #Causes