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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 ... Erythematosus #SLE #hematology ... #rheumatology # ... differential #diagnosis #causes
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Causes Intravascular ... hemoglobinuria (PNH ... usually IgG) (e.g. lupus ... #Causes #differential ... #diagnosis #hematology
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
Causes of Extravascular ... and Intravascular ... • PCH • PNH ... Diagnosis #Algorithm #Causes ... #Hematology
Causes of Arterial and Venous Thrombosis - Differential Diagnosis Framework

STRUCTURAL:
 - PFO: paradoxical emboli
 - Popliteal
Causes of Arterial ... artery aneurysm: Causes ... - Disseminated intravascular ... neoplasms - PNH ... Diagnosis #clots #hematology
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
CNS Manifestations ... autoantibodies that will cause ... Erythematosus #SLE #CNS ... #neurology #rheumatology ... cerebritis #diagnosis #management
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
Systemic Lupus Erythematosus ... Diagnosis and Management ... , oral ulcers, Lupus ... Positive in 60-80% of cases ... #Summary #rheumatology
Causes of Bleeding / Bruising - Differential Diagnosis Algorithm
Thrombocytopenia - Quantitative Defect
 • Decreased Production
 •
Causes of Bleeding ... • Disseminated Intravascular ... Diagnosis #Algorithm #Causes ... #Hematology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
Causes of Splenomegaly ... Inflammatory • Systemic Lupus ... Spherocytosis • Acquired causes ... Diagnosis #Algorithm #Causes ... #Hematology
Differential Diagnosis for Hemolytic Anemia
Intrinsic Causes:
 • Enzyme deficiencies ex. G6PD, pyruvate kinase 
 • Hemoglobinopathies
Anemia Intrinsic Causes ... elliptocytosis Extrinsic Causes ... IVIG infusion Intravascular ... Causes: • MAHA ... classification #hematology
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