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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Erythematosus #SLE ... #hematology #rheumatology ... differential #diagnosis #causes
Drug Induced Lupus vs SLE
Drug Induced Lupus (DIL):
 • Epidemiology: -10% of all lupus cases, drug-dependent,
constitutional symptoms • Treatment ... Discontinuation of causal ... life-threatening • Treatment ... #comparison #table ... #rheumatology #
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
Erythematosus (SLE ... are evocative of SLE ... Positive in 60-80% of cases ... life-threatening • Treatment ... Management #Summary #rheumatology
Monoarthritis - Differential Diagnosis
Infection (Acute):
 - S. aureus (most common)
 - S. pneumonia
 - Salmonella (in
Gout- usually LE ... involve the b/l wrists ... arthritis - SLE ... Differential #Diagnosis #Causes
Autoantibodies and their Disease Associations
ANA - Non-specific; common in SLE, autoimmune hepatitis
Anti-CCP, Rheumatoid factor - RA
Anti-dsDNA
Non-specific; common in SLE ... RA Anti-dsDNA - SLE ... - Drug-induced SLE ... diseases #diagnosis #table ... #rheumatology #
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
dysmotility • MCTD (SLE ... • Specific for SLE ... severe disease Treatment ... Erythematosus #SLE ... Summary #diagnosis #rheumatology
Hydroxychloroquine Serum Measurement in SLE
 • Terminal elimination half-life = 40 days ([HCQI reflects long-term intake)
Measurement in SLE ... suspected) • In case ... • Special cases ... #Measurement #SLE ... #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
Causes of Thrombocytopenia - Differential Diagnosis Algorithm
 
Decreased Megakaryopoiesis
 • Aplastic Anemia
 • Toxic Damage (e.g.
Causes of Thrombocytopenia ... Autoimmune • ITP • SLE ... Diagnosis #Algorithm #Causes ... #Hematology
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
• Secondary Causes ... Splenomegaly - CTD (SLE ... Associated - SLE ... Differential #Diagnosis #hematology ... #rheumatology #