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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 Hemolytic Anemia - Differential Diagnosis
Inherited
 • Membrane
 • Internal
    - Hemoglobin
Causes of Hemolytic ... Anemia - Differential ... #Anemia #Differential ... #Diagnosis #Causes ... #hematology
Hemolysis - Diagnostic Algorithm and Causes

Increased red cell production: 
 • Increased Reticulocytosis/polychromasia 
 • Erythroid
Hemolysis - Diagnostic ... Algorithm and Causes ... #Algorithm #Differential ... #Causes #Workup ... #Hematology #Diagnosis
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Extravascular Causes ... usually IgG) (e.g. lupus ... Extravascular #Causes ... #differential # ... diagnosis #hematology
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
autoantibodies: positive ... • Blood smear: Differential ... → schizocytes, Positive ... 2) LOOK FOR a cause ... management #treatment #rheumatology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
- Differential ... Inflammatory • Systemic Lupus ... Serum Sickness Hemolytic ... Spleen #Enlarged #Differential ... #Hematology
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Malar rash • SLE ... lesions • Discoid lupus ... Sarcoidosis #dermatology ... #rashes #differential ... #diagnosis #rheumatology
Causes of Anemia with Normal Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Decreased WBCs
 - Decreased/NormaI
Causes of Anemia ... Volume (MCV) - Differential ... RA, SLE, PRV, Chronic ... Bleed • Hemolysis ... #Hematology
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
Causes of Extravascular ... - Differential ... Extravascular #Differential ... Diagnosis #Algorithm #Causes ... #Hematology
SLICC SLE Diagnostic Criteria - Systemic Lupus Erythematosus
Clinical and Immunologic Criteria

CLINICAL CRITERIA
 - ACUTE CUTANEOUS LUPUS
SLICC SLE Diagnostic ... NEUROLOGIC - HEMOLYTIC ... determined by Positive ... #Diagnosis #Rheumatology ... #SLE #Lupus #Erythematosus