Criteria for Classification of Systemic Lupus Erythematosus

Abstract

In 1971, the American Rheumatism Association (ARA) Committee on Therapeutic Criteria proposed Preliminary Criteria for the Classification of Systemic Lupus Erythematosus [SLE]. 1 Any four of the 14 items listed below, when present, indicate SLE. 1 Facial erythema (butterfly rash) Discoid lupus erythematosus Raynaud phenomenon Alopecia Photosensitivity Oral or nasopharyngeal ulceration Arthritis without deformity Lupus erythematosus cells Chronic false-positive serologic test for syphilis Profuse proteinuria Cellular casts Pleuritis or pericarditis Psychosis or convulsions Hemolytic anemia or leukopenia or thrombocytopenia These criteria were formulated by computer analysis of 57 symptoms, signs, and laboratory findings in 245 patients (with unequivocal SLE) under the care of 52 different rheumatologists in the United States and Canada. Insufficient data at the time of evaluating these records prevented further analyses of such commonly used tests as antinuclear antibody, Coombs test, anti-DNA antibody, tissue biopsies, and direct immunofluorescence of skin biopsy specimen. The first six criteria relate