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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology
Thrombotic Microangiopathies ... In Systemic Lupus ... Erythematosus #SLE ... #hematology #rheumatology ... differential #diagnosis #causes
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Erythematosus (SLE ... autoantibodies that will cause ... vasculopathy, thrombosis ... Induction Rx: high-dose ... #CNS #neurology
Lupus Nephritis Primer
Class I - Minimal Mesangial
Class II - Mesangial Proliferative
Class Ill - Focal Proliferative
Class IV
Lupus Nephritis ... DrFlashHeart #Lupus ... #Nephritis #SLE ... Classification #Classes ... diagnosis #management #nephrology
Vesiculobullous Skin Rash - Differential Diagnosis Algorithm
Vesicles Fragile/EasiIy Ruptured - Intraepidermal blisters, possibly crusts/erosions
 - Inflammatory
blisters, possibly crusts ... Bullous systemic lupus ... tarda • Diabetic ... Vesiculobullous #SkinRash #dermatology ... Diagnosis #Algorithm #causes
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... diuresis • Central diabetes ... • Nephrogenic diabetes ... #nephrology #sodium ... #high
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
SLE (Systemic Lupus ... complements and a high ... artery or vein thrombosis ... • Mesenteric thrombosis ... • Pelvic vein thrombosis
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... Sodium >145 mmol/L High ... Osmotic diuresis (see ... 300 mmol/kg • Diabetes ... Hypernatremia #Nephrology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Extravascular Causes ... syndrome - Thrombotic ... microangiopathy: Thrombotic ... usually IgG) (e.g. lupus ... Extravascular #Causes
Thrombotic Microangiopathy - TMAs
1. Not all MAHAs are due to TMAs but (almost) all TMAs cause
Thrombotic Microangiopathy ... almost) all TMAs cause ... catastrophic APS, SRC, SLE ... There is a high ... @AnnKumfer #Thrombotic
The Diagnostic Approach to Hyperkalemia
Drugs
 - Amiloride
 - Spironolactone
 - Triamterene
 - Trimethoprim
 - Pentamidine
 -
inhibitors Other causes ... transplant - SLE ... High Renin - ... Low Renin - Diabetes ... #differential #causes