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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
Pancytopenia - Differential Diagnosis

Congenital Diseases:
• GATA2 deficiency
• Fanconi’s anemia
• Wiskott-Aldrich syndrome
• Ribosomopathy or telomeropathy

Cancer:
• Leukemia
• Lymphoma

Inflammatory
deficiency • Fanconi’s anemia ... Wiskott-Aldrich syndrome ... Autoimmune Diseases: • Systemic ... lupus erythematosus ... #Diagnosis #Hematology
ANA Patterns and Associated Rheumatic Diseases:
 • Homogeneous: Systemic lupus erythematosus (SLE), Mixed connective tissue disease
lupus erythematosus ... , Drug-induced Lupus ... SLE), Sjogren's Syndrome ... ANA #patterns #rheumatology ... #diagnosis #differential
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Lupus (SLE) General ... Demyelinating syndromes ... ) Blood (75%): Anemia ... Thrombocytopenia #Lupus ... symptoms #diagnosis #rheumatology
Seronegative Inflammatory Arthritis - Differential Diagnosis
 • Seronegative Rheumatoid Arthritis 
 • Infectious Arthritis: Viral, Bacterial,
Inflammatory Arthritis - Differential ... Lupus Erythematous ... , Systemic Sclerosis ... #arthritides #Differential ... #Diagnosis #rheumatology
Macrophage Activation Syndrome (MAS)
Classified among the secondary or acquired forms of haemophagocytic lymphohistiocytosis (sHLH)

What?
A subset of
lupus erythematosus ... with leukopenia, anemia ... Treatment: • Corticosteroids ... Diagnosis #Management #Hematology ... #Rheumatology
Approach to Thrombocytosis - Elevated Platelet Count - Differential Diagnosis Algorithm

Peripheral Smear concerning for malignancy?
→ Refer to hematology ... hemolysis, deficiency anemia ... Rebound effect from treatment ... Kawasaki, Nephrotic syndrome ... Diagnosis #Algorithm #hematology
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
Systemic Lupus Erythematosus ... block • Sjogren syndrome ... severe disease Treatment ... #Lupus #Erythematosus ... Summary #diagnosis #rheumatology
Red Blood Cell (RBC) Morphology Atlas
 • Microcytic - Iron-deficiency anemia, Thalassemia, Sideroblastic anemia, Lead poisoning
Myelodysplastic syndrome ... • Sickle cells ... Hemolytic uremic syndrome ... key #diagnosis #differential ... #hematology
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Manifestations of Systemic ... Demyelinating Syndrome ... Puncture, EEG Treatment ... RheumOnePagers) #Systemic ... CNS #neurology #rheumatology