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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
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
Rapidly Progressive Glomerulonephritis (RPGN)
RPGN has three primary pathophysiologic causes differentiated by immunofluorescence

Immune Complex Mediated (granular staining):
Complement: Post-strep GN ... , Lupus Nephritis ... diagnosis #algorithm #rheumatology
Common causes of Acute Kidney Injury AKI - Differential Diagnosis
HEMODYNAMIC
 • Cardiac failure: Impaired forward flow,
inhibitors, hepatorenal syndrome ... Glomerulonephritides (GN ... Post-infectious GN ... , Lupus Acute Tubular
Monoclonal Gammopathy of Clinical Significance (MGUS) - Differential Diagnosis

Neurologic-Centered:
 (+) Systemic Features: POEMS, AL amyloid, Cryoglobulinemia
capillary leak syndrome ... • Schnitzler syndrome ... immunotactoid GN ... , Type I cryo GN ... Differential #Diagnosis #hematology
Hypertension and Altered Mental Status (AMS) - Differential Diagnosis Framework

Hypertension:
 • Hypertensive emergency
 • Hypertensive encephalopathy
• Cushing’s syndrome ... Renal: • Acute GN ... Vasculitis • Lupus ... • Serotonin syndrome
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
Systemic Lupus Erythematosus ... block • Sjogren syndrome ... polymyositis overlap syndrome ... #Systemic #Lupus ... Summary #diagnosis #rheumatology
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Manifestations of Systemic Lupus ... Demyelinating Syndrome ... Diagnosis of Lupus ... #Systemic #Lupus ... CNS #neurology #rheumatology
Connective tissue disease-associated interstitial lung diseases

LIP: lymphoid interstitial pneumonia. NSIP: nonspecific interstitial pneumonia. OP: organizing pneumonia.
PSS: Sjogren syndrome ... SLE : systemic lupus ... Table #Pulmonary #Rheumatology