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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
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
Approach to Joint ... spondyloarthropathies, lupus ... Non-bloody: OA, avascular ... Like in this case ... #rheumatology #
Myositis and Myopathies
Polymyositis 
 • Progressive, symmetric muscle weakness 
 • Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis
stiffness in proximal joints ... Anti-retrovirals, Gemcitabine Lupus ... uncommon 5-15% of lupus ... myopathy) VA Joint ... diagnosis #comparison #rheumatology
EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus
Clinical Domains:
 • Constitutional domain: Fever
 • Cutaneous domain: Non-scarring
Criteria for Systemic Lupus ... Acute cutaneous lupus ... in at least 2 joints ... pericarditis • Hematologic ... Erythematosus #diagnosis #rheumatology
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
platelet disorders, vascular ... Etiology: • Vascular ... Disruptions in vascular ... Differential #Diagnosis #hematology ... #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
Rheumatoid Arthritis Summary
Overview: chronic, inflammatory symmetric polyarthritis involving small joints of hands/feet, knees, shoulders
Signs & Symptoms:
involving small joints ... • synovitis; joint ... narrowing) • Ultrasound ... exam and imaging Treatment ... diagnosis #management #rheumatology
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Associated with Joint ... lesions • Discoid lupus ... Sarcoidosis #dermatology ... #joint #pain #skin ... differential #diagnosis #rheumatology
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Manifestations of Systemic Lupus ... autoantibodies that will cause ... Puncture, EEG Treatment ... CNS #neurology #rheumatology ... diagnosis #management #treatment
Causes of Bone/Joint Pain in Sickle Cell Disease
Vaso-occlusive pain:
 • Mechanism: ischemic pain
 • Can present
Causes of Bone/Joint ... Avascular necrosis ... BrighamChiefs #Bone #Joint ... differential #diagnosis #causes ... #hematology