TABLE 1
SLE classification criteria proposed by the SLICC group
Anti-nDNA: native anti-DNA antibodies; ANA: antinuclear antibodies; ELISA: enzyme-linked
immunosorbent assay; SLE: systemic lupus erythematosus.
The criteria are cumulative and they need not all be present at the same time. For individuals to be
classified as having SLE: a) they should meet at least four criteria, including at least one clinical
criterion and one immunological criterion, or b) have proven LN via biopsy in presence of ANA or
native anti-DNA antibodies.
A. Clinical criteria
Acute cutaneous lupus
or subacute cutaneous
lupus
Malar rash (does not count if malar discoid), bullous lupus, toxic epidermal
necrolysis (variant of SLE), maculopapular lupus rash, photosensitive lupus rash
in the absence of dermatomyositis
or
Subacute cutaneous lupus: Non-indurated psoriaform and/or annular polycyclic
lesions, that resolve without scarring, although occasionally with postinflammatory
dyspigmentation or telangiectasias
Chronic cutaneous lupus
Classic discoid rash above the neck (localised) or above and below the neck
(generalised), hypertrophic (verrucous) lupus), lupus panniculitis (profundus),
mucosal lupus, lupus erythematosus tumidus, chilblains lupus, discoid lupus/
lichen planus overlap
Oral ulcers
In oral cavity or tongue or nose, in the absence of other causes such as vasculitis,
Behcet’s disease, infection (herpes virus), inflammatory bowel disease, reactive
arthritis and acidic foods
Non-scarring alopecia
Diffuse thinning or hair fragility with visible broken hairs, in the absence of other
causes such as alopecia areata, drugs, iron deficiency, and androgenic alopecia
Joint disorder
Synovitis in two or more joints, characterised by swelling or effusion
or
tenderness in two or more joints and at least 30 minutes of morning stiffness
Serositis
a) Pleurisy: Typical pleuritic pain for at least one day or pleural rub or pleural
effusions
or
b) Pericarditis: Typical pericardial pain (pain with recumbence improved by sitting
forward) for at least one day, or pericardial effusion or pericardial rub or pericarditis
shown by ECG, in the absence of other causes such as infection, uraemia and
Dressler’s pericarditis
Renal disorder
a) Urine protein–to-creatinine ratio (or 24-hour proteinuria) of over 500mg/day
or
b) Presence of red blood cell casts in urine sediment
Neurological disorder
Seizures, psychosis, mononeuritis multiplex(in the absence of other known causes
such as primary vasculitis), myelitis, peripheral or cranial neuropathy (in the
absence of other known causes such as primary vasculitis, infection, and diabetes
mellitus), acute confusional state (in the absence of other causes, including
toxic/metabolic, uraemia, drugs)
Haemolytic anaemia
Leukopaenia
a) Leukopaenia less than 4/mm 3 at least once: In the absence of other known
causes such as Felty’s syndrome, drugs, and portal hypertension
or
b) Lymphopaenia of less than 1000/mm 3 at least once, in the absence of other
causes such as corticosteroids, other drugs and infection
Thrombocytopaenia
Less than 100,000/mm 3 , at least once, in the absence of other causes such as drugs,
portal hypertension and thrombotic thrombocytopaenia purpura
B. Immunological criteria
ANA
Titres above laboratory reference range
Anti-nDNA Titres above laboratory reference range (or two-fold the reference range if
determined by ELISA)
Anti-Sm antibodies
Antiphospholipid
antibodies
a) Lupus anticoagulant
b) False-positive test result for rapid plasma reagin
c) Medium or high-tire anticardiolipin antibody level (IgA, IgG or IgM)
d) Presence of anti-b2-glycoprotein I antibodies (IgA, IgG or IgM)
Complement Low levels of C3, C4 or CH50
Positive direct
Coombs test In absence of haemolytic anaemia
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