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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 #SLE ... #hematology #rheumatology ... #differential # ... diagnosis #causes
Aortitis - Differential Diagnosis Framework
Non-Infectious Aortitis:
 • Vasculitides: Giant Cell Arteritis (GCA), Takayasu's arteritis, Cogan's Syndrome,
Aortitis - Differential ... ANCA associated vasculitis ... (RA), Systemic lupus ... erythematosus (SLE ... #Diagnosis #rheumatology
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 ... Glomerulonephritis #Vasculitis ... #differential #
Hypertension and Altered Mental Status (AMS) - Differential Diagnosis Framework

Hypertension:
 • Hypertensive emergency
 • Hypertensive encephalopathy
Status (AMS) - Differential ... Renal: • Acute GN ... Autoimmune: • Vasculitis ... • Lupus • Polyarteritis ... #Diagnosis #causes
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Features of Systemic Lupus ... (SLE) General: ... Butterfly rash, Vasculitis ... erythematosus #signs ... symptoms #diagnosis #rheumatology
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Malar rash • SLE ... Hypersensitivity vasculitis ... lesions • Discoid lupus ... #skin #rashes #differential ... #diagnosis #rheumatology
Vasculitis and Vasculitides - Differential Diagnosis Framework

When to Consider Vasculitis:
 • Purpura, ischemic skin lesions
 •
rapidly progressing GN ... tract, and often causes ... purpura: strong sign ... , and SLE) • Urinalysis ... #rheumatology #
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
Purpura - Differential ... Splenomegaly - CTD (SLE ... Associated - SLE ... Vasculopathy #Purpura #Differential ... #rheumatology #
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
involvement 3% SLE-Related ... (aPL) 30-45% Differential ... Lupusreference #SLE ... autoantibodies #signs ... #rheumatology
Dermatological semiology of Cutaneous Vasculitis 

Clinicopathologic correlations
 • Purpura, papules, pustules, necrosis: involvement of small vessels
semiology of Cutaneous Vasculitis ... Identification of causes ... disease (10%) : SLE ... dermatology #semiology #signs ... pathology #lesions #differential