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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
Drug Induced Lupus vs SLE
Drug Induced Lupus (DIL):
 • Epidemiology: -10% of all lupus cases, drug-dependent,
cases, drug-dependent ... • Immunologic Workup ... Discontinuation of causal ... • Immunologic Workup ... #sle #comparison
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
Systemic Lupus Erythematosus ... , oral ulcers, Lupus ... • Immunologic Workup ... Positive in 60-80% of cases ... #lupus #Systemic
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Manifestations of Systemic Lupus ... Erythematosus (SLE ... autoantibodies that will cause ... vasculopathy, thrombosis ... Erythematosus #SLE
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
SLE (Systemic Lupus ... APLA/LAC: • Renal ... artery or vein thrombosis ... SSA can rule in SLE ... papillomavirus #SLE
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
Hydroxychloroquine Serum Measurement in SLE
 • Terminal elimination half-life = 40 days ([HCQI reflects long-term intake)
Measurement in SLE ... • Special cases ... (e.g. renal failure ... #Measurement #SLE ... pharmacology #levels #lupus
Causes of Thrombocytopenia and Platelet Disorders - Differential Diagnosis and Workup
History:
 - Prior platelet count, family
Causes of Thrombocytopenia ... Diagnosis and Workup ... test, ANA (e.g., SLE ... patients if the cause ... #Workup #hematology
Thrombotic Microangiopathy - TMAs
1. Not all MAHAs are due to TMAs but (almost) all TMAs cause
Thrombotic Microangiopathy ... almost) all TMAs cause ... /o significant renal ... catastrophic APS, SRC, SLE ... @AnnKumfer #Thrombotic
Causes of Fever of Unknown Origin (FUO) - Differential Diagnosis
 • Infection: Extrapulmonary tuberculosis, Abscess, Endocarditis,
Causes of Fever ... hardware, Infected thrombosis ... Solid tumors: Renal ... . autoimmune): Lupus ... vasculitis to cause