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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Erythematosus ... #SLE #hematology ... #rheumatology # ... differential #diagnosis ... #causes
I’M DAMN SHARP - Lupus Diagnosis Mnemonic
I  	 Immunoglobulins (Anti-dsDNA, Anti-Sm, Anti-phospholipid)
M 	 Malar Rash
D
M DAMN SHARP - Lupus ... Diagnosis Mnemonic ... Anti-phospholipid) M Malar ... #erythematosus ... #rheumatology #diagnosis
SLICC SLE Diagnostic Criteria - Systemic Lupus Erythematosus
Clinical and Immunologic Criteria

CLINICAL CRITERIA
 - ACUTE CUTANEOUS LUPUS
SLICC SLE Diagnostic ... Erythematosus Clinical ... NEUROLOGIC - HEMOLYTIC ANEMIA ... #Diagnosis #Rheumatology ... #SLE #Lupus #Erythematosus
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Systemic Lupus Erythematosus ... Arthritis 69% - Malar ... - Hemolytic anemia ... #Erythematosus ... #differential #rheumatology
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

Inflammatory
- Differential Diagnosis ... deficiency • Fanconi’s anemia ... Diseases: • Systemic lupus ... erythematosus ... #Hematology
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
Systemic Lupus Erythematosus ... (SLE) - Diagnosis ... Manifestations: Malar ... Positive in 60-80% of cases ... #Summary #rheumatology
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
B19 infection Malar ... lesions • Discoid lupus ... erythematosus ... #differential #diagnosis ... #rheumatology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
- Differential Diagnosis ... Inflammatory • Systemic Lupus ... Erythematosus ... #Differential #Diagnosis ... #Hematology
Differential Diagnosis for Hemolytic Anemia
Intrinsic Causes:
 • Enzyme deficiencies ex. G6PD, pyruvate kinase 
 • Hemoglobinopathies
Differential Diagnosis ... for Hemolytic Anemia ... Bartonella, Babesia, Malaria ... #Hemolytic #Anemia ... #hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Diagnostic Framework ... Extravascular Causes ... usually IgG) (e.g. lupus ... • Infections: Malaria ... #hematology #anemia