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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 Erythematosus ... #SLE #hematology ... #rheumatology # ... differential #diagnosis #causes
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Extravascular Causes ... uremic syndrome ... hemoglobinuria (PNH ... usually IgG) (e.g. lupus ... differential #diagnosis #hematology
Hemolysis - Diagnostic Algorithm and Causes

Increased red cell production: 
 • Increased Reticulocytosis/polychromasia 
 • Erythroid
Hemolysis - Diagnostic ... Algorithm and Causes ... #Hemolytic #Anemia ... #Differential #Causes ... #Workup #Hematology
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

Inflammatory
Wiskott-Aldrich syndrome ... Autoimmune Diseases: • Systemic ... lupus erythematosus ... Antibody-mediated hemolysis ... Differential #Diagnosis #Hematology
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
Causes of Extravascular ... Intravascular Hemolysis ... • PCH • PNH ... Diagnosis #Algorithm #Causes ... #Hematology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
Causes of Splenomegaly ... Inflammatory • Systemic ... Lupus Erythematosus ... Serum Sickness Hemolytic ... #Hematology
Algorithm for workup of thrombocytopenia based on observation of the peripheral blood film. 
TTP/HUS indicates thrombotic
Algorithm for workup ... thrombocytopenic purpura/hemolytic ... uremic syndrome ... thrombocytopenia, Hematology
Approach to Thrombocytosis - Elevated Platelet Count - Differential Diagnosis Algorithm

Peripheral Smear concerning for malignancy?
→ Refer to hematology ... for workup, including ... blood loss, Acute hemolysis ... Kawasaki, Nephrotic syndrome ... Diagnosis #Algorithm #hematology
Dyspnea - Differential Diagnosis Framework

Cardiovascular Causes of Dyspnea:
 • Myocardium:
	- Heart failure
	- CAD/ACS
	- Valvulopathy
 • Electrical:
	-
Cardiovascular Causes ... - Water - Pus ... Hepatopulmonary syndrome ... Barre - ALS - Transverse ... myelitis • Hematology
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
of Systemic Lupus ... Demyelinating Syndrome ... autoantibodies that will cause ... RheumOnePagers) #Systemic ... #rheumatology #