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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Erythematosus #SLE ... #hematology #rheumatology ... differential #diagnosis #causes
Rapid Ultrasound in SHock Evaluation
RUSH Protocol:
 • PUMP: LV contractility, RV strain, tamponade
 • TANK: IVC
SHock Evaluation RUSH ... - IVC • M - Morrison's ... Pneumothorax, PLE ... jackcfchong #RUSH
I’M DAMN SHARP - Lupus Diagnosis Mnemonic
I  	 Immunoglobulins (Anti-dsDNA, Anti-Sm, Anti-phospholipid)
M 	 Malar Rash
D
Anti-phospholipid) M Malar Rash ... D Discoid Rash ... #IMDAMNSHARP #sle ... erythematosus #rheumatology
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
Erythematosus (SLE ... Manifestations: Malar rash ... are evocative of SLE ... Positive in 60-80% of cases ... Management #Summary #rheumatology
Drug Induced Lupus vs SLE
Drug Induced Lupus (DIL):
 • Epidemiology: -10% of all lupus cases, drug-dependent,
Induced Lupus vs SLE ... NPSLE rare, Malar rash ... Discontinuation of causal ... Manifestations: Malar rash ... comparison #table #rheumatology
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Joint Pain Rash ... infection Malar rash ... • SLE • Human ... IBD • RA • SLE ... differential #diagnosis #rheumatology
Top 10 situations when to think about lupus
1) Inflammatory joint pain (especially in the wrists and
everywhere) 2) A rash ... 6) An annular rash ... children (pediatric SLE ... lupus #diagnosis #sle ... erythematosus #rheumatology
Hydroxychloroquine Serum Measurement in SLE
 • Terminal elimination half-life = 40 days ([HCQI reflects long-term intake)
Measurement in SLE ... suspected) • In case ... • Special cases ... #Measurement #SLE ... #rheumatology #
Causes of Thrombocytopenia - Differential Diagnosis Algorithm
 
Decreased Megakaryopoiesis
 • Aplastic Anemia
 • Toxic Damage (e.g.
Causes of Thrombocytopenia ... Autoimmune • ITP • SLE ... Diagnosis #Algorithm #Causes ... #Hematology
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
• Secondary Causes ... Splenomegaly - CTD (SLE ... Associated - SLE ... Differential #Diagnosis #hematology ... #rheumatology #