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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
ANA Patterns and Associated Rheumatic Diseases:
 • Homogeneous: Systemic lupus erythematosus (SLE), Mixed connective tissue disease
Associated Rheumatic Diseases ... connective tissue disease ... ), Sjogren's Syndrome ... ANA #patterns #rheumatology ... #diagnosis #differential
I’M DAMN SHARP - Lupus Diagnosis Mnemonic
I  	 Immunoglobulins (Anti-dsDNA, Anti-Sm, Anti-phospholipid)
M 	 Malar Rash
D
M DAMN SHARP - Lupus ... Pleuritis) H Hematologic ... Arthritis R Renal Disease ... #IMDAMNSHARP #sle ... erythematosus #rheumatology
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
Systemic Lupus Erythematosus ... block • Sjogren syndrome ... #Systemic #Lupus ... #Summary #diagnosis ... #rheumatology #
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

Inflammatory
- Differential Diagnosis ... deficiency • Fanconi’s anemia ... Wiskott-Aldrich syndrome ... : • Systemic lupus ... #Hematology
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
- Differential Diagnosis ... - Hemolytic anemia ... Kasabach-Merritt syndrome ... Associated - SLE ... #hematology #rheumatology
Connective tissue disease-associated interstitial lung diseases

LIP: lymphoid interstitial pneumonia. NSIP: nonspecific interstitial pneumonia. OP: organizing pneumonia.
PSS: Sjogren syndrome ... rheumatoid arthritis SLE ... : systemic lupus ... LungDisease #CTILD #Diagnosis ... Table #Pulmonary #Rheumatology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Diagnostic Framework ... Extravascular Causes ... ) - HELLP syndrome ... usually IgG) (e.g. lupus ... #hematology #anemia
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
- Hemolytic anemia ... involvement 3% SLE-Related ... sclerosis, Still's disease ... Lupusreference #SLE ... #differential #rheumatology
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Demyelinating syndromes ... pain (20%) Renal disease ... ) Blood (75%): Anemia ... signs #symptoms #diagnosis ... #rheumatology