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1997 Update of Revised Systemic Lupus Erythematosus

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1997 Update of the 1982 American College of Rheumatology Revised Criteria for Classification of Systemic Lupus Erythematosus



1. Malar Rash

Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds

2. Discoid rash

Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions

3. Photosensitivity

Skin rash as a result of unusual reaction to sunlight, by patient history or physician observation

4. Oral ulcers

Oral or nasopharyngeal ulceration, usually painless, observed by physician

5. Nonerosive Arthritis

Involving 2 or more peripheral joints, characterized by tenderness, swelling, or effusion

6. Pleuritis or Pericarditis

  1. Pleuritis--convincing history of pleuritic pain or rubbing heard by a physician or evidence of pleural effusion
  1. OR
  1. Pericarditis--documented by electrocardigram or rub or evidence of pericardial effusion

7. Renal Disorder

  1. Persistent proteinuria > 0.5 grams per day or > than 3+ if quantitation not performed
  1. OR
  1. Cellular casts--may be red cell, hemoglobin, granular, tubular, or mixed

8. Neurologic Disorder

  1. Seizures--in the absence of offending drugs or known metabolic derangements; e.g., uremia, ketoacidosis, or electrolyte imbalance
  1. OR
  1. Psychosis--in the absence of offending drugs or known metabolic derangements, e.g., uremia, ketoacidosis, or electrolyte imbalance

9. Hematologic Disorder

  1. Hemolytic anemia--with reticulocytosis
  1. OR
  1. Leukopenia--< 4,000/mm3 on ≥ 2 occasions
  1. OR
  1. Lyphopenia--< 1,500/ mm3 on ≥ 2 occasions
  1. OR
  1. Thrombocytopenia--<100,000/ mm3 in the absence of offending drugs

10. Immunologic Disorder

  1. Anti-DNA: antibody to native DNA in abnormal titer
  1. OR
  1. Anti-Sm: presence of antibody to Sm nuclear antigen
  1. OR
  1. Positive finding of antiphospholipid antibodies on:
  1. 1. an abnormal serum level of IgG or IgM anticardiolipin antibodies,
  2. 2. a positive test result for lupus anticoagulant using a standard method, or
  3. 3. a false-positive test result for at least 6 months confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption test

11. Positive Antinuclear Antibody

An abnormal titer of antinuclear antibody by immunofluorescence or an equivalent assay at any point in time and in the absence of drugs

  • 1982 Revised Criteria for SLE, UpdatePDF:
    Hochberg MC. for the Diagnostic and Therapeutic Criteria Committee of the American College of Rheumatology. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus [letter]. Arthritis Rheum 1997;40:1725.
  • 1982 Revised Criteria for SLE:
    Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982;25:1271-7.