Systemic Lupus Erythematosus Diagnostic Criteria (ACR)

Malar rash: Fixed erythema, flat or raised, over the malar eminences

Discoid rash: Raised erythematous patches with adherent keratotic scaling and follicular plugging; old lesions may heal with scarring

Photosensitivity: A noticeable reaction to sunlight, resulting in a rash, noted from the medical history or observed by a physician

Oral ulcers: Oral or nasopharyngeal ulcers observed by a physician, generally painless

Arthritis: Non-erosive arthritis involving two or more peripheral joints, characterized by tenderness, swelling, or effusion

Serositis: Pleuritis or pericarditis

Renal disorder: Proteinuria > 0.5g/24h or +++, or casts (red blood cell, hemoglobin, granular, or mixed casts)

Neurologic disorder: Seizures or psychosis, excluding drug-induced or known metabolic derangements

Hematologic disorder: Hemolytic anemia, or leukopenia, or lymphopenia, or thrombocytopenia

Immunologic disorder: Anti-ds-DNA positive, or anti-Sm antibody positive, or antiphospholipid antibody positive (the latter includes anti-cardiolipin antibody, or lupus anticoagulant positive, or at least one positive test for a syphilis serology false positive lasting for at least six months)

Antinuclear antibody: An abnormal titer of antinuclear antibodies at any time and in the absence of drug-induced “lupus”

Score:

Interpretation of Results

If 4 or more of the above 11 items are met, a diagnosis of SLE can be made (specificity of 95%, sensitivity of 75%).

ACR: American College of Rheumatology.

(SLE) is an autoimmune-mediated, systemic connective tissue disease characterized by immune-mediated inflammation, with the presence of various autoantibodies represented by antinuclear antibodies and multi-system involvement as the two main clinical features of SLE.

References

1. Available at ACR website

2. Wang Jiyao, ed. Internal Medicine (Eight-Year Program) (2nd edition). People's Health Publishing House. 2010. p1119.

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