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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
Glomerulonephritis - Differential Diagnosis Framework
ANCA:
 • C-ANCA: GPA (Wegener's)
 • P-ANCA: Microscopic Polyangiitis, Eosinophilic GPA (Churg
Glomerulonephritis - Differential ... Membranoproliferative • ↓C4: Lupus ... , Cryoglobulinemia ... Glomerulonephritis #differential ... diagnosis #nephrology #causes
Causes of Hypocomplementemia - CHAMPS Mnemonic
C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis
H - Heavy Chain deposition
Causes of Hypocomplementemia ... Mnemonic C - Cryoglobulinemia ... S - Systemic Lupus ... Mnemonic #diagnosis #differential ... #hematology
Rapidly Progressive Glomerulonephritis (RPGN)
RPGN has three primary pathophysiologic causes differentiated by immunofluorescence

Immune Complex Mediated (granular staining):
pathophysiologic causes ... Post-strep GN, Lupus ... Nephritis, Cryoglobulinemia ... Glomerulonephritis #Vasculitis #differential ... diagnosis #algorithm #rheumatology
Cryoglobulinemia Summary

Cryoglobulins:
 • Cryoglobulins are Igs in the serum that precipitate in vitro at temperatures below
causing endothelial injury ... • They can cause ... Cryoglobulins Cause ... (e.g. systemic lupus ... classification #rheumatology
Causes of Hematuria - Differential Diagnosis Algorithm
Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... - Differential ... IgA, post-strep, lupus ... #Hematuria #Differential ... Diagnosis #Algorithm #Causes
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... Kidney Injury (AKI ... ) - Differential ... Acute Kidney Injury ... IgA, post-strep, lupus
Causes of Fever of Unknown Origin (FUO) - Differential Diagnosis
 • Infection: Extrapulmonary tuberculosis, Abscess, Endocarditis,
Causes of Fever ... Origin (FUO) - Differential ... Lemierre's syndrome), Malaria ... . autoimmune): Lupus ... #Origin #FUO #Differential
Differential Diagnosis for Hemolytic Anemia
Intrinsic Causes:
 • Enzyme deficiencies ex. G6PD, pyruvate kinase 
 • Hemoglobinopathies
Differential Diagnosis ... Anemia Intrinsic Causes ... Bartonella, Babesia, Malaria ... Hemolytic #Anemia #Differential ... classification #hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Extravascular Causes ... usually IgG) (e.g. lupus ... • Infections: Malaria ... #differential # ... diagnosis #hematology