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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 ... Microangiopathies #Systemic #Lupus ... Erythematosus #SLE ... #hematology #rheumatology ... differential #diagnosis #causes
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
Splenomegaly - CTD (SLE ... Associated - SLE ... Differential #Diagnosis #hematology ... #rheumatology # ... #nonpalpable #dermatology
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
Systemic Lupus Erythematosus ... , oral ulcers, Lupus ... Positive in 60-80% of cases ... life-threatening • Treatment ... Management #Summary #rheumatology
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Erythematosus (SLE ... autoantibodies that will cause ... Puncture, EEG Treatment ... Erythematosus #SLE ... CNS #neurology #rheumatology
Drug Induced Lupus vs SLE
Drug Induced Lupus (DIL):
 • Epidemiology: -10% of all lupus cases, drug-dependent,
vs SLE Drug Induced ... constitutional symptoms • Treatment ... Discontinuation of causal ... life-threatening • Treatment ... #table #rheumatology
Causes of Thrombocytosis - Differential Diagnosis Algorithm
Spurious:
 • Artifact (redo CBC)
Autonomous:
 • Essential thrombocytosis
 • Polycythemia
Causes of Thrombocytosis ... Non malignant hematologic ... effect following treatment ... Diagnosis #Algorithm #Causes ... #Hematology
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Malar rash • SLE ... IBD • RA • SLE ... lesions • Discoid lupus ... Sarcoidosis #dermatology ... differential #diagnosis #rheumatology
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
Systemic Lupus Erythematosus ... • Specific for SLE ... severe disease Treatment ... #Systemic #Lupus ... Summary #diagnosis #rheumatology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
Causes of Splenomegaly ... Inflammatory • Systemic Lupus ... Spherocytosis • Acquired causes ... Diagnosis #Algorithm #Causes ... #Hematology
Hydroxychloroquine Serum Measurement in SLE
 • Terminal elimination half-life = 40 days ([HCQI reflects long-term intake)
Measurement in SLE ... • Special cases ... #Measurement #SLE ... #rheumatology # ... pharmacology #levels #lupus