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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
Hemolysis - Diagnostic Algorithm and Causes

Increased red cell production: 
 • Increased Reticulocytosis/polychromasia 
 • Erythroid
Hemolysis - Diagnostic ... Algorithm and Causes ... #Algorithm #Differential ... #Causes #Workup ... #Hematology #Diagnosis
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Extravascular Causes ... usually IgG) (e.g. lupus ... Extravascular #Causes ... #differential # ... diagnosis #hematology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
- Differential ... Inflammatory • Systemic Lupus ... Serum Sickness Hemolytic ... Spleen #Enlarged #Differential ... #Hematology
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
- Differential ... ): SS, SC, SE, Sβ ... bartonella (oroya fever ... Diagnosis #Algorithm #workup ... #hematology #testing
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Malar rash 40% - Fever ... Lymphadenopathies 7% - Hemolytic ... involvement 3% SLE-Related ... Lupusreference #SLE ... #rheumatology
ANA Patterns and Associated Rheumatic Diseases:
 • Homogeneous: Systemic lupus erythematosus (SLE), Mixed connective tissue disease
Associated Rheumatic Diseases ... erythematosus (SLE ... connective tissue disease ... ANA #patterns #rheumatology ... #diagnosis #differential
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
Purpura - Differential ... DIC/TTP/HUS - Hemolytic ... Associated - SLE ... #Diagnosis #hematology ... #rheumatology #
SLICC SLE Diagnostic Criteria - Systemic Lupus Erythematosus
Clinical and Immunologic Criteria

CLINICAL CRITERIA
 - ACUTE CUTANEOUS LUPUS
SLICC SLE Diagnostic ... NEUROLOGIC - HEMOLYTIC ... CRITERIA - ANA level ... #Diagnosis #Rheumatology ... #SLE #Lupus #Erythematosus
Causes of Thrombocytopenia and Platelet Disorders - Differential Diagnosis and Workup
History:
 - Prior platelet count, family
Diagnosis and Workup ... disease, decrease ... test, ANA (e.g., SLE ... disease), HBsAg ... #Workup #hematology