Table 1.
Clinical criteria | Immunological criteria |
---|---|
1. Acute cutaneous lupus: including lupus malar rash, bullous lupus, toxic epidermal necrolysis variant of | 1. Antinuclear antibody above laboratory reference range |
SLE, maculopapular lupus rash, photosensitive lupus | |
rash in the absence of dermatomyositis, or subacute cutaneous lupus | 2. Anti-dsDNA antibody above laboratory reference range, except ELISA: twice above laboratory reference range |
3. Anti-Smith antibody | |
2. Chronic cutaneous lupus: including classical discoid rash, localized or generalized, hypertrophic | |
lupus, lupus panniculitis, mucosal lupus, lupus erythematosus tumidus, chillblain lupus, discoid lupus/lichen planus overlap | 4. Anti-phospholipid antibody: any of the following lupus anticoagulant, false-positive RPR, medium or high titer anticardiolipin (IgA, IgG or IgM), anti-β2-glycoprotein I (IgA, IgG or IgM) |
3. Oral ulcers: palate, buccal, tongue, or nasal ulcers, | |
in the absence of other causes | 5. Low complement, low C3, low C4, low CH50 |
4. Nonscarring alopecia (diffuse thinning or hair fragility with visible broken hairs) in the absence of other causes | 6. Direct Coombs test in the absence of hemolytic anemia |
5. Synovitis involving two or more joints, characterized by swelling or effusion or tenderness in two or more joints and 30 minutes or more of morning stiffness | SLICC criteria for SLE classification require: |
1. Fulfillment of at least four criteria, with at least one clinical criterion and one immunologic criterion | |
6. Serositis: typical pleurisy for more than 1 day, or pleural effusions, or pleural rub, typical pericardial | or |
pain for more than 1 day, or pericardial effusion or pericardial rub, or pericarditis by ECG, in the absence of other causes | 2. Lupus nephritis as the sole clinical criterion in the presence of antinuclear antibody or anti-dsDNA antibodies |
7. Renal: urine protein/creatinine (or 24-hour urine | |
protein) representing 500 mg protein/24 hours, red blood cell casts | |
8. Neurologic: seizures, psychosis, mononeuritis multiplex, myelitis, peripheral or cranial neuropathy, acute confusional state, in the absence of other causes | |
9. Hemolytic anemia | |
10. Leukopenia (<4,000/mm3 at least once) in the absence of other known causes or lymphopenia (<1,000/mm3 at least once) in the absence of other known causes | |
11. Thrombocytopenia (<100,000/mm3) at least once in the absence of other known causes |
ECG, eletrocardiogram; SLE, systemic lupus erythematosus; SLICC, Systemic Lupus International Collaborating Clinics. Adapted from [2].