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Table 1 Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus

From: Update on differences between childhood-onset and adult-onset systemic lupus erythematosus

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

 
  1. ECG, eletrocardiogram; SLE, systemic lupus erythematosus; SLICC, Systemic Lupus International Collaborating Clinics. Adapted from [2].