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Rheuminations


Aug 16, 2018

This episode covers a rare but life-threatening complication of lupus nephritis called complement-mediated thrombotic microangiopathy. Rheumatologist Lisa Zickuhr, MD, helps us better understand this often-overwhelming topic with a clinical case example, treatment options and practice pearls.

  • Intro :10
  • Introduction of Lisa Zickuhr, MD, rheumatologist :44
  • Complement-mediated thrombotic microangiopathy in lupus is an overwhelming topic 1:50
  • Definition of TMA 2:15
    • What is MAHA? 3:10
    • Four classic symptoms associated with TMA syndromes 3:35
    • What causes TMA? 3:50
  • Complement-mediated TMA 5:35
  • How this is seen in clinical practice 9:10
  • Case example of complement-mediated TMA 10:10
    • Summary of case presentation 13:05
    • What’s next? 13:50
    • Takeaways from this clinical presentation 15:48
  • Primary and secondary complement-mediated TMA 18:23
  • An argument for a primary etiology of complement-mediated TMA in lupus 18:51
  • CliffsNotes version for rheumatologists, HCPs caring for lupus patients 21:12
  • Therapy for complement-mediated TMA is two-pronged 22:35
  • Patient profile 24:05
  • Summary 25:10
  • Thank you to Dr. Lisa Zickuhr 26:13

Lisa Zickuhr, MD, is a rheumatologist at Washington University in St. Louis.

We’d love to hear from you! Send your comments/questions to rheuminationspodcast@healio.com.

References:

Dragon-Durey MA, et al. J Am Soc Nephrol. 2005:555-563.

Dragon-Durey MA, et al. Semin Thromb Hemost. 2010:633-640.

George JN, et al. N Engl J Med. 2014 Aug 14;371:654-666.

Jönsen A, et al. Arthritis Res Ther. 2011;13:R206.

Laszlo MH, et al. Ann Intern Med. 1955;42:1308-1320.

Nesher G, et al. Semin Arthritis Rheum. 1994;24:165-72.

Zickuhr L, et al. Arthritis Care Res (Hoboken). 2018;doi: 10.1002/acr.23561.