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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
Etiology: • Vascular ... Disruptions in vascular ... Differential #Diagnosis #hematology ... #rheumatology # ... #nonpalpable #dermatology
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
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 #
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
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
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
Causes of Bleeding / Bruising - Differential Diagnosis Algorithm
Thrombocytopenia - Quantitative Defect
 • Decreased Production
 •
Causes of Bleeding ... Renal Disease Vascular ... TeIangiectasia Vascular ... Diagnosis #Algorithm #Causes ... #Hematology
Causes of Hypocomplementemia - CHAMPS Mnemonic
C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis
H - Heavy Chain deposition
Causes of Hypocomplementemia ... S - Systemic Lupus ... #differential #hematology
Vesiculobullous Skin Rash - Differential Diagnosis Algorithm
Vesicles Fragile/EasiIy Ruptured - Intraepidermal blisters, possibly crusts/erosions
 - Inflammatory
blisters, possibly crusts ... Bullous systemic lupus ... drug eruption #Vesicular ... Vesiculobullous #SkinRash #dermatology ... Diagnosis #Algorithm #causes