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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
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Extravascular Causes ... usually IgG) (e.g. lupus ... lymphoproliferative disorders ... #differential # ... diagnosis #hematology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
- Differential ... Myeloproliferative disorders ... Inflammatory • Systemic Lupus ... Serum Sickness Hemolytic ... #Hematology
Warm vs Cold Autoimmune Hemolytic Anemia
Warm Autoimmune Hemolytic Anemia:
 • Mechanism: IgG and Complement-mediated
 • Etiology:
Lymphoproliferative disorder ... , Autoimmune disorder ... Spherocytes • Treatment ... • Treatment: Warm ... #Anemia #hematology
Causes of Hemolytic Anemia - Differential Diagnosis
Inherited
 • Membrane
 • Internal
    - Hemoglobin
Causes of Hemolytic ... Anemia - Differential ... #Anemia #Differential ... #Diagnosis #Causes ... #hematology
Hemolysis - Diagnostic Algorithm and Causes

Increased red cell production: 
 • Increased Reticulocytosis/polychromasia 
 • Erythroid
Hemolysis - Diagnostic ... Algorithm and Causes ... #Algorithm #Differential ... #Causes #Workup ... #Hematology #Diagnosis
Causes of Neutrophilia - Increased Neutrophils - Differential Diagnosis Algorithm
Infection
 • Bacterial
 • Abscess
 • Viral
Medications
Causes of Neutrophilia ... Neutrophils - Differential ... • Metabolic disorders ... pancytopenia, blast cells ... #Hematology
Causes of Thrombocytosis - Differential Diagnosis Algorithm
Spurious:
 • Artifact (redo CBC)
Autonomous:
 • Essential thrombocytosis
 • Polycythemia
Causes of Thrombocytosis ... - Differential ... • Rheumatic disorders ... effect following treatment ... #Hematology
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
Purpura - Differential ... DIC/TTP/HUS - Hemolytic ... #Diagnosis #hematology ... #rheumatology # ... #nonpalpable #dermatology
Causes of Anemia with Normal Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Decreased WBCs
 - Decreased/NormaI
Causes of Anemia ... Volume (MCV) - Differential ... Bleed • Hemolysis ... Microangiopathic Hemolytic ... #Hematology