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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
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
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 ... HIV, hepatitis, herpes ... Chronic = RA, SLE ... #rheumatology #
Vesiculobullous Skin Rash - Differential Diagnosis Algorithm
Vesicles Fragile/EasiIy Ruptured - Intraepidermal blisters, possibly crusts/erosions
 - Inflammatory
chickenpox) • Herpes ... shingles) • Herpes ... Bullous systemic lupus ... Vesiculobullous #SkinRash ... #dermatology #Differential
Myositis and Myopathies
Polymyositis 
 • Progressive, symmetric muscle weakness 
 • Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis
temporal arteritis Inclusion ... Anti-retrovirals, Gemcitabine Lupus ... uncommon 5-15% of lupus ... myopathy) VA Joint ... diagnosis #comparison #rheumatology
EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus
Clinical Domains:
 • Constitutional domain: Fever
 • Cutaneous domain: Non-scarring
Criteria for Systemic Lupus ... in at least 2 joints ... pericarditis • Hematologic ... Classification #Criteria #SLE ... Erythematosus #diagnosis #rheumatology
SLICC SLE Diagnostic Criteria - Systemic Lupus Erythematosus
Clinical and Immunologic Criteria

CLINICAL CRITERIA
 - ACUTE CUTANEOUS LUPUS
SLICC SLE Diagnostic ... Criteria - Systemic Lupus ... INVOLVING 2 OR MORE JOINTS ... #Diagnosis #Rheumatology ... #SLE #Lupus #Erythematosus
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: ... phenomenon (20%) Joints ... #SLE #systemic ... symptoms #diagnosis #rheumatology
Causes of Bone/Joint Pain in Sickle Cell Disease
Vaso-occlusive pain:
 • Mechanism: ischemic pain
 • Can present
Causes of Bone/Joint ... Disease Vaso-occlusive ... dz difficult to see ... BrighamChiefs #Bone #Joint ... diagnosis #causes #hematology
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
: • Vascular occlusion ... Associated - SLE ... Differential #Diagnosis #hematology ... #rheumatology # ... #nonpalpable #dermatology