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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Lupus Erythematosus ... #SLE #hematology ... #rheumatology # ... differential #diagnosis ... #causes
SLICC SLE Diagnostic Criteria - Systemic Lupus Erythematosus
Clinical and Immunologic Criteria

CLINICAL CRITERIA
 - ACUTE CUTANEOUS LUPUS
SLICC SLE Diagnostic ... Criteria - Systemic ... NEUROLOGIC - HEMOLYTIC ... #Diagnosis #Rheumatology ... #SLE #Lupus #Erythematosus
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Warm Antibody Autoimmune ... • Blood smear: Differential ... 2) LOOK FOR a cause ... → Systematic screening ... management #treatment #rheumatology
EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus
Clinical Domains:
 • Constitutional domain: Fever
 • Cutaneous domain: Non-scarring
Classification Criteria for Systemic ... Thrombocytopenia, Autoimmune hemolysis ... Classification #Criteria #SLE ... #Systemic #Lupus ... Erythematosus #diagnosis #rheumatology
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

Inflammatory
Autoimmune Diseases: • Systemic ... lupus erythematosus ... hemoglobinuria • Antibody-mediated ... hemolysis Nutritional ... #Diagnosis #Hematology
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
Systemic Lupus Erythematosus ... • Immunologic Workup ... Positive in 60-80% of cases ... #lupus #Systemic ... Management #Summary #rheumatology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Systemic Lupus Erythematosus ... Lymphadenopathies 7% - Hemolytic ... Lupusreference #SLE ... #Systemic #Lupus ... #rheumatology
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
- Differential ... Inflammatory • Systemic ... Lupus Erythematosus ... Serum Sickness Hemolytic ... #Hematology
Antinuclear Antibodies (ANA)
ANA or Anti-NucIear Antibody refers to antibodies against antigens in the nucleus → like
or Anti-NucIear Antibody ... (SLE), Systemic ... (SLE), Systemic ... ANA #patterns #rheumatology ... #diagnosis #differential
ANA (Antinuclear Antibody) and ANCA (Antineutrophil cytoplasmic antibodies)
 • Systemic lupus erythematosus
   1. Anti-dsDNA
antibodies) • Systemic ... lupus erythematosus ... in drug-induced SLE ... ) • Systemic sclerosis ... antibodies #diagnosis #rheumatology