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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
Approach to Joint Pain - Diagnostic Framework

1) Chronicity
2) Inflammatory vs Non-Inflammatory
3) Number of Joints Involved

1) Chronicity:
spondyloarthropathies, lupus ... Like in this case ... #rheumatology # ... approach #workup ... #differential #
Myositis and Myopathies
Polymyositis 
 • Progressive, symmetric muscle weakness 
 • Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis
Anti-retrovirals, Gemcitabine Lupus ... uncommon 5-15% of lupus ... myopathy) VA Joint ... Myopathies #myopathy #differential ... diagnosis #comparison #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
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Associated with Joint ... lesions • Discoid lupus ... #joint #pain #skin ... #rashes #differential ... #diagnosis #rheumatology
Hemolysis - Diagnostic Algorithm and Causes

Increased red cell production: 
 • Increased Reticulocytosis/polychromasia 
 • Erythroid
Algorithm and Causes ... Anemia #Algorithm #Differential ... #Causes #Workup ... #Hematology #Diagnosis
Dyspnea - Differential Diagnosis Framework

Cardiovascular Causes of Dyspnea:
 • Myocardium:
	- Heart failure
	- CAD/ACS
	- Valvulopathy
 • Electrical:
	-
Dyspnea - Differential ... - Tamponade Pulmonary ... Transverse myelitis • Hematology ... #dyspnea #sob #differential ... #pulmonary
Causes of Thrombocytopenia and Platelet Disorders - Differential Diagnosis and Workup
History:
 - Prior platelet count, family
Platelet Disorders - Differential ... Diagnosis and Workup ... or if a primary hematologic ... Platelet #Disorders #Differential ... #Workup #hematology
Causes of Diffuse Lymphadenopathy - Differential Diagnosis Algorithm
Reactive:
 - Systemic Inflammatory
     •
Causes of Diffuse ... Lymphadenopathy - Differential ... • Systemic Lupus ... Diagnosis #Algorithm #Causes ... #Hematology #Oncology
Rapidly Progressive Glomerulonephritis (RPGN)
RPGN has three primary pathophysiologic causes differentiated by immunofluorescence

Immune Complex Mediated (granular staining):
pathophysiologic causes ... Post-strep GN, Lupus ... With associated pulmonary ... Glomerulonephritis #Vasculitis #differential ... diagnosis #algorithm #rheumatology