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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
Differential diagnosis of schistocytes / fragmentation hemolysis:
 • Thrombotic microangiopathies (TMA)
    - TTP
Differential diagnosis ... : • Thrombotic ... syndrome (ST-HUS ... anemia" • HELLP ... #hematology #hemolysis
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Diagnostic Framework ... anemia): ... syndrome - Thrombotic ... usually IgG) (e.g. lupus ... #hematology #anemia
Causes of Anemia with Normal Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Decreased WBCs
 - Decreased/NormaI
- Differential Diagnosis ... RA, SLE, PRV, Chronic ... Bleed • Hemolysis ... Microangiopathic Hemolytic ... Algorithm #Causes #Hematology
SLICC SLE Diagnostic Criteria - Systemic Lupus Erythematosus
Clinical and Immunologic Criteria

CLINICAL CRITERIA
 - ACUTE CUTANEOUS LUPUS
SLICC SLE Diagnostic ... ANEMIA - LEUKOPENIA ... anemia #Diagnosis ... #Rheumatology # ... SLE #Lupus #Erythematosus
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
69% - Malar rash ... Lymphadenopathies 7% - Hemolytic ... anemia 4% - Myositis ... involvement 3% SLE-Related ... Lupusreference #SLE
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
(SLE) General: ... Photosensitivity, Butterfly rash ... ) Blood (75%): Anemia ... signs #symptoms #diagnosis ... #rheumatology
Red Blood Cell (RBC) Morphology Atlas
 • Microcytic - Iron-deficiency anemia, Thalassemia, Sideroblastic anemia, Lead poisoning
spherocytosis, Hemolytic ... Schistocytes - Hemolytic ... uremic syndrome, Thrombotic ... Morphology #Atlas #key #diagnosis ... #differential #hematology
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Joint Pain Rash ... infection Malar rash ... lesions • Discoid lupus ... Sarcoidosis #dermatology ... #differential #diagnosis
Pancytopenia - Differential Diagnosis

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

Cancer:
• Leukemia
• Lymphoma

Inflammatory
- Differential Diagnosis ... deficiency • Fanconi’s anemia ... Diseases: • Systemic lupus ... Antibody-mediated hemolysis ... #Hematology