Systemic Lupus Erythematosus (SLE) Disease Activity Index (SLEDAI)

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Systemic Lupus Erythematosus (SLE) Disease Activity Index (SLEDAI)

Seizures: Recent onset, excluding metabolic, infectious, or drug-related causes

Severe psychosis: Cognitive impairment interfering with daily life, excluding uremia or drug effects

Organic brain syndrome

Visual disturbance: SLE retinopathy, excluding hypertension, infection, or drug-related causes

Cranial nerve disorder: New onset sensory or motor neuropathy involving cranial nerves

Lupus headache: Severe, persistent headache unresponsive to narcotic analgesics

Cerebrovascular accident: New onset cerebrovascular accident, excluding atherosclerosis

Vasculitis: Ulcers, gangrene, tender finger nodules, periungual infarcts, hemorrhage, or biopsy/angiogram confirmed

Arthritis: Pain and inflammatory signs (tenderness, swelling, effusion) in 2 or more joints

Myositis: Proximal muscle pain or weakness with elevated CPK, EMG changes, or biopsy confirmation

Urinary casts: Presence of granular or red blood cell casts

Hematuria: Red blood cells >5/HPF, excluding stones, infection, and other causes

Proteinuria: >0.5g/24h, new onset or recent increase

Pyuria: White blood cells >5/HPF, excluding infection

Alopecia: New onset or recurrent abnormal patchy or diffuse hair loss

New rash: New onset or recurrent inflammatory rash

Mucosal ulcers: New onset or recurrent oral or nasal mucosal ulcers

Pleuritis: Pleuritic chest pain with pleural rub, effusion, or pleural thickening

Pericarditis: Pericardial pain or pericardial rub or effusion (confirmed by ECG or echocardiography)

Low complement: CH50, C3, C4 below normal

Elevated anti-dsDNA antibody: >25% (Farr assay) or above detection range

Fever: >38°C, excluding infectious causes

Thrombocytopenia: <100×10^9/L

Leukopenia: <3.0×10^9/L, excluding drug-induced

Score:

Result Interpretation

0-4 points: No significant activity;

5-9 points: Mild activity;

10-14 points: Moderate activity;

≥15 points: Severe activity.

The SLEDAI score is commonly used to assess the disease activity of systemic lupus erythematosus. Different scores determine the use of different doses of steroids and the choice of different immunosuppressants.

References

Bombardier C, et al. Derivation of the SLEDAI: a disease activity index for lupus patients. Arthritis Rheum.1992;35:630-40.

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