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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
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
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
Causes of Splenomegaly ... - Differential ... Inflammatory • Systemic Lupus ... Spleen #Enlarged #Differential ... #Hematology
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 Fever of Unknown Origin (FUO) - Differential Diagnosis
 • Infection: Extrapulmonary tuberculosis, Abscess, Endocarditis,
Origin (FUO) - Differential ... Lemierre's syndrome), Malaria ... Malignancy: - Hematologic ... . 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
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
Purpura - Differential ... vasculitis/HSP • Cryoglobulinemia ... Vasculopathy #Purpura #Differential ... #Diagnosis #hematology ... #rheumatology #
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
Causes of Diffuse Lymphadenopathy - Differential Diagnosis Algorithm
Reactive:
 - Systemic Inflammatory
     •
Causes of Diffuse ... Lymphadenopathy - Differential ... • Systemic Lupus ... Diagnosis #Algorithm #Causes ... #Hematology #Oncology