criteria for classification of SLE (systemic lupus erythematosus)

Last reviewed 08/2021

1997 updated American College of Rheumatology (ACR) criteria for classification of SLE

A person is considered to have SLE if at least 4 of the 11 criteria are present, serially or simultaneously, during any interval of observation.

  • malar rash - fixed erythema over the malar eminences, tending to spare the nasolabial folds
  • discoid rash - erythematous, raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions
  • photosensitivity - skin rash as a result of unusual reaction to sunlight, by patient history or physician observation
  • oral ulcers - oral or nasopharyngeal ulceration, usually painless, observed by physician
  • arthritis - non-erosive, involving two or more peripheral joints, characterized by tenderness, swelling, or effusion
  • serositis
    • pleuritis - convincing history of pleuritic pain or rubbing heard by a physician or evidence of pleural effusion
    • pericarditis - documentation on electrocardiography, rubbing, or evidence of pericardial effusion
  • renal disorder
    • persistent proteinuria: greater than 0.5 g per day or greater than 3+ if quantitation not performed
    • cellular casts: may be red blood cell, hemoglobin, granular, tubular, or mixed
  • neurological disorder
    • seizures: in the absence of offending drugs or known metabolic derangements (e.g., uremia, ketoacidosis, electrolyte imbalance)
    • psychosis: in the absence of offending drugs or known metabolic derangements (e.g., uremia, ketoacidosis, electrolyte imbalance)
  • haematological disorder
    • hemolytic anemia: with reticulocytosis
    • leukopenia: lymphocyte count less than 4,000 per µL (4 × 109 per L) on two or more occasions
    • lymphopenia: lymphocyte count less than 1,500 per µL (1.5 × 109 per L) on two or more occasions
    • thrombocytopenia: platelet count less than 100 × 103 per µL (100 × 109 per L) in the absence of offending drugs
  • immunological disorder 
    • a) anti-DNA antibodies
    • b) anti-Sm antibodies
    • c) anti-phospholipid antibodies
  • anti-nuclear antibody - exclude drug causes (1,2)

Reference:

Related pages:

systemic lupus erythematosus (SLE)