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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 Erythematosus ... #SLE #hematology ... #rheumatology #differential ... #diagnosis #causes
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
Systemic Lupus Erythematosus ... severe disease & renal ... block • Sjogren syndrome ... polymyositis overlap syndrome ... severe disease Treatment
BEE Syndromes - Immune-mediated conditions affecting the brain, eye, and ear

Visual or auditory symptoms in conjunction
BEE Syndromes - ... diagnosis and treatment ... Inflammatory causes ... • Systemic lupus ... #inflammatory #differential
ANA Patterns and Associated Rheumatic Diseases:
 • Homogeneous: Systemic lupus erythematosus (SLE), Mixed connective tissue disease
(SLE), Mixed connective ... (SLE), Sjogren's ... Syndrome (SS), ... (SLE), Systemic ... rheumatology #diagnosis #differential
Pulmonary Renal Syndrome

Definition: Diffuse alveolar hemorrhage + Glomerulonephritis
Presentation (Pulmonary and renal manifestations can occur weeks apart):
Pulmonary Renal ... Syndrome Definition ... Syndromes: • ... Infection, Alport Syndrome ... #Syndrome #differential
Causes of Hypocomplementemia - CHAMPS Mnemonic
C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis
H - Heavy Chain deposition
Causes of Hypocomplementemia ... antiphospholipid syndrome ... Lupus Erythematosus ... (total 50, renal ... Mnemonic #diagnosis #differential
Mucous Membrane Disorder - Differential Diagnosis Algorithm
Erosions/Ulcers/Blisters
 - Primary Dermatologic Diseases
     •
Stevens-Johnson Syndrome ... lupus erythematosus ... • Behcet's syndrome ... #Differential # ... Diagnosis #Algorithm #causes
Causes of Metabolic Alkalosis - Differential Diagnosis
Chloride depletion syndromes
 • Gastrointestinal losses
    -
Chloride depletion syndromes ... villous adenomas • Renal ... - Bartter syndrome ... - Gitelman syndrome ... • Liddle syndrome
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Lupus (SLE) General ... Demyelinating syndromes ... Abdominal pain (20%) Renal ... Thrombocytopenia #Lupus ... #SLE #systemic
Hypertension and Altered Mental Status (AMS) - Differential Diagnosis Framework

Hypertension:
 • Hypertensive emergency
 • Hypertensive encephalopathy
• Cushing’s syndrome ... Acute/Chronic renal ... failure • Renal ... • Scleroderma renal ... • Serotonin syndrome