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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
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 ... #Hemolytic #Anemia ... #Algorithm #Differential ... #Hematology #Diagnosis
Causes of Hemolytic Anemia - Differential Diagnosis
Inherited
 • Membrane
 • Internal
    - Hemoglobin
Causes of Hemolytic ... Anemia - Differential ... #Anemia #Differential ... #Diagnosis #Causes ... #hematology
Causes of Anemia with Normal Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Decreased WBCs
 - Decreased/NormaI
Causes of Anemia ... Volume (MCV) - Differential ... Diagnosis Algorithm ... Hypersplenism • Secondary ... #Causes #Hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Diagnostic Framework ... anemia): ... usually IgG) (e.g. lupus ... #differential # ... diagnosis #hematology
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Anemia 1) DIAGNOSE ... 2) LOOK FOR a cause ... → Systematic screening ... #Anemia #diagnosis ... management #treatment #rheumatology
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

Inflammatory
deficiency • Fanconi’s anemia ... Autoimmune Diseases: • Systemic ... lupus erythematosus ... Antibody-mediated hemolysis ... #Diagnosis #Hematology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
- Differential ... Inflammatory • Systemic ... Lupus Erythematosus ... Serum Sickness Hemolytic ... #Causes #Hematology
Causes of Thrombocytosis - Differential Diagnosis
Secondary Thrombocytosis (a.k.a Reactive Thrombocytosis):
 • Acute infection
 • Solid organ
Diagnosis Secondary ... malignancies • Anemia ... iron deficiency, hemolysis ... #Diagnosis #Causes ... #hematology #secondary
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
Causes of Extravascular ... - Differential ... Diagnosis Algorithm ... anemia • ... #Causes #Hematology