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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
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Erythematosus (SLE ... Demyelinating Syndrome ... autoantibodies that will cause ... Erythematosus #SLE ... #rheumatology #
Myelodysplastic Syndrome (MD) - Diagnosis and Management Summary
myelo (marrow) -dys- (abnormal) -plastic (shape) = funny-shaped cells
Myelodysplastic Syndrome ... old, ~10,000 new cases ... cytopenias (usually anemia ... • Risks: infection ... #hematology #oncology
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
- Hemolytic anemia ... Associated - SLE ... Differential #Diagnosis #hematology ... #rheumatology # ... #nonpalpable #dermatology
Causes of Thrombocytopenia - Differential Diagnosis Algorithm
 
Decreased Megakaryopoiesis
 • Aplastic Anemia
 • Toxic Damage (e.g.
Causes of Thrombocytopenia ... Megakaryopoiesis • Aplastic Anemia ... Autoimmune • ITP • SLE ... Non-lmmune: • HELLP Syndrome ... #Hematology
Causes of Thrombocytosis - Differential Diagnosis Algorithm
Spurious:
 • Artifact (redo CBC)
Autonomous:
 • Essential thrombocytosis
 • Polycythemia
Causes of Thrombocytosis ... effect following treatment ... Iron deficiency anemia ... Diagnosis #Algorithm #Causes ... #Hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Extravascular Causes ... hemoglobinuria (PNH ... usually IgG) (e.g. lupus ... differential #diagnosis #hematology ... #anemia
Causes of Anemia with Normal Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Decreased WBCs
 - Decreased/NormaI
Causes of Anemia ... RA, SLE, PRV, Chronic ... #Normocytic #Anemia ... Diagnosis #Algorithm #Causes ... #Hematology
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

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

Cardiovascular Causes of Dyspnea:
 • Myocardium:
	- Heart failure
	- CAD/ACS
	- Valvulopathy
 • Electrical:
	-
Cardiovascular Causes ... - Water - Pus ... Hepatopulmonary syndrome ... Transverse myelitis • Hematology ... : - Anemia