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Rheumatology

SLE

Classification

2019 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for systemic lupus erythematosus (SLE)


Absolute requirement

Antinuclear antibodies (ANA) at a titre of >1:80 on HEp-2 cells or an equivalent positive test at least once

Clinical criteria

Constitutional domain

Fever

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Haematologic domain

Leucopenia

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Thrombocytopenia

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Autoimmune haemolysis

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Neuropsychiatric domain

Delirium

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Psychosis

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Seizure

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Mucocutaneous domain

Non-scarring alopecia

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Oral ulcers

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Subacute cutaneous or discoid lupus

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Acute cutaneous lupus

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Serosal domain

Pleural or pericardial effusion

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Acute pericarditis

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Musculoskeletal domain

Joint involvement

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Renal domain

Proteinuria > 0.5g.24 hours

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Class II or V lupus nephritis on renal biopsy

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Class III or IV lupus nephritis on renal biopsy

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Immunology criteria: Antiphospholipid antibodies domain

Positive antiphospholipid antibodies

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Immunology criteria: Complement proteins domain

Low C3

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Low C4

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Immunology criteria: SLE-specific antibodies domain

Anti-dsDNA or anti-Smith (Sm) antibodies

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Statistics

Sensitivity: 96.1%

Specificity: 93.4%

Considerations

The tool is for educational use only, is not meant to be a substitute for professional advice and should not be used for medical diagnosis and/or medical treatment.

Reference

Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, Smolen JS, Wofsy D, Boumpas DT, Kamen DL, Jayne D, Cervera R, Costedoat-Chalumeau N, Diamond B, Gladman DD, Hahn B, Hiepe F, Jacobsen S, Khanna D, Lerstrøm K, Massarotti E, McCune J, Ruiz-Irastorza G, Sanchez-Guerrero J, Schneider M, Urowitz M, Bertsias G, Hoyer BF, Leuchten N, Tani C, Tedeschi SK, Touma Z, Schmajuk G, Anic B, Assan F, Chan TM, Clarke AE, Crow MK, Czirják L, Doria A, Graninger W, Halda-Kiss B, Hasni S, Izmirly PM, Jung M, Kumánovics G, Mariette X, Padjen I, Pego-Reigosa JM, Romero-Diaz J, Rúa-Figueroa Fernández Í, Seror R, Stummvoll GH, Tanaka Y, Tektonidou MG, Vasconcelos C, Vital EM, Wallace DJ, Yavuz S, Meroni PL, Fritzler MJ, Naden R, Dörner T, Johnson SR. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019 Sep;71(9):1400-1412. doi: 10.1002/art.40930. Epub 2019 Aug 6. PMID: 31385462; PMCID: PMC6827566.

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