Criterion

Definition

SLE can be diagnosed if any 4 or more of the following 11 criteria are present, serially or simultaneously, during any interval of observation.

1. Malar rash

Fixed, flat or raised erythema over the malar eminences, tending to spare the nasolabial folds

2. Discoid rash

Erythematous raised patches with adherent keratotic scaling and follicular plugging (older lesions may demonstrate atrophic scarring)

3. Photosensitivity

Skin rash as a result of unusual reaction to sunlight, by patient history or physician observation

4. Oral ulcers

Oral or nasopharyngeal ulceration, usually painless, observed by a physician

5. Arthritis

Nonerosive arthritis involving =2 peripheral joints, characterized by tenderness, swelling, or effusion

6. Serositis

(A) Pleuritis: Convincing history of pleuritic pain or rub heard by a physician or evidence of pleural effusion

or

(B) Pericarditis: Documented by ECG or rub or evidence of pericardial effusion

7. Renal disorder

(A) Persistent proteinuria >0.5 g/day or >3+ if quantitation not performed

or

(B) Cellular casts: May be red blood cell, hemoglobin, granular, tubular, or mixed

8. Neurologic disorder

(A) Seizures: In the absence of offending drugs or known metabolic derangements (eg, uremia, ketoacidosis, electrolyte imbalance)

or

(B) Psychosis: In the absence of offending drugs or known metabolic derangements (eg, uremia, ketoacidosis, electrolyte imbalance)

9. Hematologic disorder

(A) Hemolytic anemia: With reticulocytosis

or

(B) Leukopenia: < 4000/mm³Â total on =2 occasions

or

(C) Lymphopenia: < 1500/mm³Â on =2 occasions

or

(D) Thrombocytopenia: < 100,000/mm³Â in the absence of offending drugs

10. Immunologic disorder

(A) Anti-DNA: Antibody to native DNA in abnormal titer

or

(B) Anti-Sm: Presence of antibody to Smith (Sm) nuclear antigen

or

(C) Positive finding of antiphospholipid antibodies based on (1) an abnormal serum level of IgG or IgM anticardiolipin antibodies, (2) a positive test result for lupus anticoagulant using a standard method, or (3) a false-positive serologic test for syphilis known to be positive for =6 months and confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption tests

11. Antinuclear antibody (ANA)

An abnormal titer of antinuclear antibody by immunofluorescence or an equivalent assay at any point in time and in the absence of drugs known to be associated with drug-induced lupus syndrome

Sources: (1.) American College of Rheumatology. 1997 Update of the 1982 American College of Rheumatology revised criteria for classification of systemic lupus erythematosus. Available at: http://tinyurl.com/1997SLEcriteria Accessed: March 15, 2012^[87] ; (2.) Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. Sep 1997;40(9):1725.^[5]