1982 SLE Classification

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Classification Criteria for Rheumatic Diseases

The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Criterion	Definition
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. Arthritis	Nonerosive arthritis involving 2 or more peripheral joints, characterized by tenderness, swelling, or effusion
6. Serositis	a) Pleuritis--convincing history of pleuritic pain or rubbing heard by a physician or evidence of pleural effusion OR b) Pericarditis--documented by ECG or rub or evidence of pericardial effusion
7. Renal disorder	a) Persistent proteinuria greater than 0.5 grams per day or grater than 3+ if quantitation not performed OR b) Cellular casts--may be red cell, hemoglobin, granular, tubular, or mixed
8. Neurologic disorder	a) Seizures--in the absence of offending drugs or known metabolic derangements; e.g., uremia, ketoacidosis, or electrolyte imbalance OR b) Psychosis--in the absence of offending drugs or known metabolic derangements, e.g., uremia, ketoacidosis, or electrolyte imbalance
9. Hematologic disorder	a) Hemolytic anemia--with reticulocytosis OR b) Leukopenia--less than 4,000/mm<>3<> total on 2 or more occasions OR c) Lyphopenia--less than 1,500/mm<>3<> on 2 or more occasions OR d) Thrombocytopenia--less than 100,000/mm<>3<> in the absence of offending drugs
10. Immunologic disorder	a) Positive LE cell preparation OR b) Anti-DNA: antibody to native DNA in abnormal titer OR c) Anti-Sm: presence of antibody to Sm nuclear antigen OR d) False positive serologic test for syphilis known to be positive for at least 6 months and confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption test
11. 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 known to be associated with "drug-induced lupus" syndrome

Criterion

Definition

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. Arthritis

Nonerosive arthritis involving 2 or more peripheral joints, characterized by tenderness, swelling, or effusion

6. Serositis

a) Pleuritis--convincing history of pleuritic pain or rubbing heard by a physician or evidence of pleural effusion: OR
b) Pericarditis--documented by ECG or rub or evidence of pericardial effusion

7. Renal disorder

a) Persistent proteinuria greater than 0.5 grams per day or grater than 3+ if quantitation not performed: OR
b) Cellular casts--may be red cell, hemoglobin, granular, tubular, or mixed

8. Neurologic disorder

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

9. Hematologic disorder

a) Hemolytic anemia--with reticulocytosis: OR
b) Leukopenia--less than 4,000/mm<>3<> total on 2 or more occasions: OR
c) Lyphopenia--less than 1,500/mm<>3<> on 2 or more occasions: OR
d) Thrombocytopenia--less than 100,000/mm<>3<> in the absence of offending drugs

10. Immunologic disorder

a) Positive LE cell preparation: OR
b) Anti-DNA: antibody to native DNA in abnormal titer: OR
c) Anti-Sm: presence of antibody to Sm nuclear antigen: OR
d) False positive serologic test for syphilis known to be positive for at least 6 months and confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption test

11. 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 known to be associated with "drug-induced lupus" syndrome

* The proposed classification is based on 11 criteria. For the purpose of identifying patients in clinical studies, a person shall be said to have systemic lupus erythematosus if any 4 or more of the 11 criteria are present, serially or simultaneously, during any interval of observation.

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. and Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus [letter]. Arthritis Rheum 1997;40:1725.

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1982 SLE Classification

The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus