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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 #
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Antiphospholipid-antibody syndrome ... lesions • Discoid lupus ... Sarcoidosis #dermatology ... #rashes #differential ... #diagnosis #rheumatology
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Features of Systemic Lupus ... (SLE) General: ... Photosensitivity, Butterfly rash ... Demyelinating syndromes ... symptoms #diagnosis #rheumatology
ANA Patterns and Associated Rheumatic Diseases:
 • Homogeneous: Systemic lupus erythematosus (SLE), Mixed connective tissue disease
erythematosus (SLE ... erythematosus (SLE ... ), Sjogren's Syndrome ... ANA #patterns #rheumatology ... #diagnosis #differential
Joint Disorders - Differential Diagnosis Algorithm
Monoarthritis
 • Septic
 • Crystalline
     - Gout
- Differential Diagnosis ... arthritis - (Reiter’s syndrome ... with Systemic Lupus ... Erythematosus (SLE ... like “butterfly rash
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
SLE (Systemic Lupus ... permanent alopecia Differential ... Arthritis: • Joint ... arthropathy • 90% joints ... Erythematosus #Diagnosis #Rheumatology
Myositis and Myopathies
Polymyositis 
 • Progressive, symmetric muscle weakness 
 • Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis
muscle weakness, rash ... Anti-retrovirals, Gemcitabine Lupus ... uncommon 5-15% of lupus ... Myopathies #myopathy #differential ... diagnosis #comparison #rheumatology
Top 10 situations when to think about lupus
1) Inflammatory joint pain (especially in the wrists and
) Inflammatory joint ... everywhere) 2) A rash ... the face (many differential ... #diagnosis #sle ... erythematosus #rheumatology
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

Inflammatory
Pancytopenia - Differential ... Wiskott-Aldrich syndrome ... Diseases: • Systemic lupus ... #Pancytopenia #Differential ... #Diagnosis #Hematology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
69% - Malar rash ... involvement 3% SLE-Related ... (aPL) 30-45% Differential ... Lupusreference #SLE ... #rheumatology