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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
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Associated with Joint ... lesions • Discoid lupus ... #joint #pain #skin ... #rashes #differential ... #diagnosis #rheumatology
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
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 ... #differential # ... diagnosis #algorithm #rheumatology
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
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
Purpura - Differential ... Splenomegaly - CTD (SLE ... Associated - SLE ... #Diagnosis #hematology ... #rheumatology #
Causes of Thrombocytopenia - Differential Diagnosis Algorithm
 
Decreased Megakaryopoiesis
 • Aplastic Anemia
 • Toxic Damage (e.g.
Causes of Thrombocytopenia ... - Differential ... Autoimmune • ITP • SLE ... HUS • DIC • Vasculitis ... #Hematology
Approach to Joint Pain - Diagnostic Framework

1) Chronicity
2) Inflammatory vs Non-Inflammatory
3) Number of Joints Involved

1) Chronicity:
spondyloarthropathies, lupus ... Like in this case ... Chronic = RA, SLE ... #rheumatology # ... approach #workup #differential
Dermatological semiology of Cutaneous Vasculitis 

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