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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Lupusreference #TMAs ... Erythematosus #SLE ... #hematology #rheumatology ... #differential #diagnosis
Thrombotic Microangiopathy - TMAs
1. Not all MAHAs are due to TMAs but (almost) all TMAs cause
Microangiopathy - TMAs ... MAHAs are due to TMAs ... triad of MAHA + thrombocytopenia ... catastrophic APS, SRC, SLE ... #hematology #diagnosis
Thrombotic Microangiopathy - TTP VS HUS

Big picture points : Often hard to differentiate the two entities,
Microangiopathy #thrombocytopenic ... HemolyticUremicSyndrome #HUS #thrombocytopenia ... #Comparison #Diagnosis ... #Table #Hematology
Causes of Thrombocytopenia - Differential Diagnosis Algorithm
 
Decreased Megakaryopoiesis
 • Aplastic Anemia
 • Toxic Damage (e.g.
Causes of Thrombocytopenia ... - Differential Diagnosis ... Autoimmune • ITP • SLE ... #Differential #Diagnosis ... Algorithm #Causes #Hematology
Causes of Thrombocytopenia - Differential Diagnosis Framework
Decreased Production:
 - Drugs (chemo, yang, sulfa, acetaminophen, NSAIDs, quinine,
Causes of Thrombocytopenia ... - Differential Diagnosis ... - Autoimmune: SLE ... #Differential #Diagnosis ... #Framework #hematology
Thrombotic Microangiopathies - Primary Thrombotic Microangiopathy (TMA) - Differential Diagnosis Table

 • Thrombotic Thrombocytopenic Purpura (TTP)
- Differential Diagnosis ... Table • Thrombotic ... Thrombocytopenic ... Microangiopathy #TMA #hematology ... #differential #diagnosis
EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus
Clinical Domains:
 • Constitutional domain: Fever
 • Cutaneous domain: Non-scarring
EULAR/ACR Classification ... domain: Leukopenia, Thrombocytopenia ... #Criteria #SLE ... Erythematosus #diagnosis ... #rheumatology
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
- Differential Diagnosis ... Splenomegaly - CTD (SLE ... Associated - SLE ... #Differential #Diagnosis ... #hematology #rheumatology
Macrophage Activation Syndrome (MAS)
Classified among the secondary or acquired forms of haemophagocytic lymphohistiocytosis (sHLH)

What?
A subset of
erythematosus [SLE ... leukopenia, anemia, and thrombocytopenia ... Activation #Syndrome #Diagnosis ... #Management #Hematology ... #Rheumatology
Autoantibodies and their Disease Associations
ANA - Non-specific; common in SLE, autoimmune hepatitis
Anti-CCP, Rheumatoid factor - RA
Anti-dsDNA
Non-specific; common in SLE ... RA Anti-dsDNA - SLE ... - Drug-induced SLE ... Associations #diseases #diagnosis ... #table #rheumatology