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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 ... Microangiopathies #Systemic ... Erythematosus #SLE ... #hematology #rheumatology ... #differential #
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
autoantibodies: positive ... • Blood smear: Differential ... → schizocytes, Positive ... FOR a cause → Systematic ... management #treatment #rheumatology
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Lupus (SLE) General ... normochromic nomocytic or haemolytic ... Coombs positive ... Thrombocytopenia #Lupus #SLE ... symptoms #diagnosis #rheumatology
Causes of Anemia with Normal Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Decreased WBCs
 - Decreased/NormaI
Volume (MCV) - Differential ... RA, SLE, PRV, Chronic ... Bleed • Hemolysis ... Microangiopathic Hemolytic ... Algorithm #Causes #Hematology
Causes of Diffuse Lymphadenopathy - Differential Diagnosis Algorithm
Reactive:
 - Systemic Inflammatory
     •
Lymphadenopathy - Differential ... Reactive: - Systemic ... Inflammatory • Systemic ... Algorithm #Causes #Hematology ... #Oncology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
Splenomegaly - Differential ... Inflammatory • Systemic ... Serum Sickness Hemolytic ... Spleen #Enlarged #Differential ... Algorithm #Causes #Hematology
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

Inflammatory
Pancytopenia - Differential ... Autoimmune Diseases: • Systemic ... Antibody-mediated hemolysis ... #Pancytopenia #Differential ... #Diagnosis #Hematology
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
Purpura - Differential ... DIC/TTP/HUS - Hemolytic ... #Diagnosis #hematology ... #rheumatology # ... #nonpalpable #dermatology
SLICC SLE Diagnostic Criteria - Systemic Lupus Erythematosus
Clinical and Immunologic Criteria

CLINICAL CRITERIA
 - ACUTE CUTANEOUS LUPUS
SLICC SLE Diagnostic ... Criteria - Systemic ... NEUROLOGIC - HEMOLYTIC ... determined by Positive ... #Diagnosis #Rheumatology
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... - Differential ... genotypes): SS, SC, SE ... #Anemia #Differential ... Algorithm #workup #hematology