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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
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Systemic Lupus Erythematosus ... Arthritis 69% - Malar ... - Hemolytic anemia ... #Systemic #Lupus ... #rheumatology
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

Inflammatory
Pancytopenia - Differential ... deficiency • Fanconi’s anemia ... Autoimmune Diseases: • Systemic ... lupus erythematosus ... #Diagnosis #Hematology
Connective tissue disease-associated interstitial lung diseases

LIP: lymphoid interstitial pneumonia. NSIP: nonspecific interstitial pneumonia. OP: organizing pneumonia.
rheumatoid arthritis SLE ... : systemic lupus ... CTILD #Diagnosis #Differential ... #Comparison #Table ... #Pulmonary #Rheumatology
Antinuclear Antibodies (ANA)
ANA or Anti-NucIear Antibody refers to antibodies against antigens in the nucleus → like
healthy adults, and should ... (SLE), Systemic ... (SLE), Systemic ... ANA #patterns #rheumatology ... #diagnosis #differential
Drug Induced Lupus vs SLE
Drug Induced Lupus (DIL):
 • Epidemiology: -10% of all lupus cases, drug-dependent,
& NPSLE rare, Malar ... months to years) Systemic ... Manifestations: Malar ... #sle #comparison ... #table #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 ... Sarcoidosis #dermatology ... #skin #rashes #differential ... #diagnosis #rheumatology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
usually IgG) (e.g. lupus ... • Infections: Malaria ... Extravascular #Causes #differential ... #diagnosis #hematology ... #anemia
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
SLE (Systemic Lupus ... permanent alopecia Differential ... Photosensitivity • Malar ... lymphopenia, low PLT • Anemia ... #Systemic #Lupus
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... - Differential ... genotypes): SS, SC, SE ... suspected, consider malaria ... Algorithm #workup #hematology