Maryam Razavi

maryam.razavi@cambio.se

@CambioCDS

To assist clinicians to diagnose Systemic Lupus Erythematosus (SLE) based on SLICC Criteria 2012.

Instructions: Criteria are cumulative; i.e., any history counts and findings need not be present concurrently. Formula: SLE diagnosis is positive if patient has: Biopsy-proven nephritis compatible with SLE and ANA or anti-dsDNA antibodies Or: ≥4 of the criteria below at any time including at least one clinical criterion and one immunological criterion. Clinical criteria (≥1 must be present): - Acute cutaneous lupus: Lupus malar rash (not malar discoid), Bullous lupus, Toxic epidermal necrolysis variant of SLE, Maculopapular lupus rash, Photosensitive lupus rash (not dermatomyositis), Subacute cutaneous lupus (nonindurated psoriasiform and/or annular polycyclic lesions that resolve without scarring, although occasionally with postinflammatory dyspigmentation or telangiectasias) - Chronic cutaneous lupus: Localized (above the neck) and/or generalized (above and below the neck) classical discoid rash, Hypertrophic (verrucous) lupus, Lupus panniculitis (profundus), Mucosal lupus, Lupus erythematosus tumidus, Chilblains lupus , Discoid lupus/lichen planus overlap - Oral ulcers (in absence of other causes): Palate, buccal, tongue, or nasal ulcers; in absence of other causes - Nonscarring alopecia (in absence of other causes) - Synovitis involving ≥2 joints, characterized by swelling or effusion OR tenderness in ≥2 joints and 30 mins or more of morning stiffness - Serositis: Typical pleurisy for >1 day, pleural effusions, or pleural rub, typical pericardial pain for >1 day, pericardial effusion, pericardial rub, or pericarditis by EKG (in absence of other causes) - Renal: Urine protein/creatinine (or 24 hr urine protein) representing 500 mg of protein/24 hr, RBC casts - Neurologic: Seizures, psychosis, mononeuritis multiplex (in absence of other causes), myelitis, peripheral or cranial neuropathy (in absence of other causes), acute confusional state (in absence of other causes) - Hemolytic anemia in absence of other causes - Leukopenia or lymphopenia: <4,000/mm³ at least once (leukopenia) or <1,000/mm³ at least once (lymphopenia); in absence of other causes - Thrombocytopenia: <100,000/mm³ at least once; in absence of other causes Immunological criteria: - ANA above laboratory reference range - Anti-dsDNA above laboratory reference range, except ELISA (2x above laboratory reference range) - Anti-Sm - Antiphospholipid antibody: Lupus anticoagulant, false positive RPR, medium or high titer anticardiolipin (IgA, IgG, or IgM), anti-β₂ glycoprotein (IgA, IgG, or IgM) - Low complement: Low C3, low C4, low CH50 - Positive direct Coombs test: In the absence of hemolytic anemia

1. Petri M, Orbai A-M, Alarcón GS, et al. Derivation and Validation of Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus. Arthritis and rheumatism. 2012;64(8):2677-2686. 2. Inês L, Silva C, Galindo M, et al. Classification of Systemic Lupus Erythematosus: Systemic Lupus International Collaborating Clinics Versus American College of Rheumatology Criteria. A Comparative Study of 2,055 Patients From a Real-Life, International Systemic Lupus Erythematosus Cohort. Arthritis Care Res (Hoboken). 2015;67(8):1180-5.

OBSERVATION.slicc_criteria_for_systemic_lupus_erythematosus_sle_2012.v0