Classification Criteria for the Diagnosis of Systemic Lupus Erythematosus (SLE)

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown cause that can affect virtually any organ of the body. Immunologic abnormalities, especially the production of a number of antinuclear antibodies (ANA), are a prominent feature of the disease.

Any combination of 4 or more of 11 criteria, well-documented at any time during a patient’s history, makes it likely that the patient has SLE (specificity and sensitivity are 95% and 75%, respectively).

  1. Malar rash: Fixed erythema, flat or raised, over the malar eminences
  2. Discoid rash: Erythematous circular raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur
  3. Photosensitivity: Exposure to ultraviolet light causes rash
  4. Oral ulcers: Includes oral and nasopharyngeal ulcers, observed by physician
  5. Arthritis: Nonerosive arthritis of two or more peripheral joints, with tenderness, swelling, or effusion
  6. Serositis: Pleuritis or pericarditis documented by ECG or rub or evidence of effusion
  7. Renal disorder: Proteinuria >0.5 g/d or 3+, or cellular casts
  8. Neurologic disorder: Seizures or psychosis without other causes
  9. Hematologic disorder: Hemolytic anemia or leukopenia (<4000/L) or lymphopenia (<1500/L) or thrombocytopenia (<100,000/L) in the absence of offending drugs
  10. Immunologic disorder: Anti-dsDNA, anti-Sm, and/or anti-phospholipid
  11. Antinuclear antibodies: An abnormal titer of ANA by immunofluorescence or an equivalent assay at any point in time in the absence of drugs known to induce ANAs

Note: ECG, electrocardiography; dsDNA, double-stranded DNA; ANA, antinuclear antibodies.

 

 

References:

  1. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982;25:1271-7. [Medline]
  2. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997 Sep;40(9):1725. [Medline]
  3. Petri M. Review of classification criteria for systemic lupus erythematosus. Rheum Dis Clin North Am. 2005 May;31(2):245-54. [Medline]

Created: May 09, 2005