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 [email protected].

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.