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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 ... Microangiopathies #Systemic #Lupus ... #rheumatology # ... differential #diagnosis ... #causes
Thrombocytosis - Differential Diagnosis
Platelet Count > 450
Reactive:
 • Anemia/blood loss (Fe deficiency)
 • Infection/Sepsis
 • Non-infectious
- Differential Diagnosis ... Non-infectious (malignancy, rheumatologic ... , trauma) • Post-splenectomy ... #Differential #Diagnosis ... #causes #Platelets
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
(SLE) - Diagnosis ... and Management ... Positive in 60-80% of cases ... Erythematosus #Diagnosis ... #rheumatology
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
autoantibodies that will cause ... permeability Diagnosis ... CNS #neurology #rheumatology ... #cerebritis #diagnosis ... #management #treatment
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
Causes of Splenomegaly ... - Differential Diagnosis ... Inflammatory • Systemic Lupus ... #Differential #Diagnosis ... #Hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Diagnostic Framework ... Extravascular Causes ... • Mechanical Trauma ... usually IgG) (e.g. lupus ... #hematology #anemia
Drug Induced Lupus vs SLE
Drug Induced Lupus (DIL):
 • Epidemiology: -10% of all lupus cases, drug-dependent,
cases, drug-dependent ... Discontinuation of causal ... Usual therapeutic management ... comparison #table #rheumatology ... #diagnosis #management
Causes of Hematuria - Differential Diagnosis Algorithm
Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... - Differential Diagnosis ... below) • Trauma ... IgA, post-strep, lupus ... #Algorithm #Causes
Hydroxychloroquine Serum Measurement in SLE
 • Terminal elimination half-life = 40 days ([HCQI reflects long-term intake)
suspected) • In case ... • Special cases ... Measurement #SLE #rheumatology ... pharmacology #levels #lupus ... #management
Shock - Differential Diagnosis by Classification

Hypovolemic (Intravascular volume depletion)
 - Hemorrhagic 
   • Trauma
- Differential Diagnosis ... Hemorrhagic • Trauma ... - Spinal cord trauma ... exacerbation (any cause ... Classification #Table #CriticalCare