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Wong KO, Bond K, Homik J, et al. Antinuclear Antibody, Rheumatoid Factor, and Cyclic-Citrullinated Peptide Tests for Evaluating Musculoskeletal Complaints in Children [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Mar. (Comparative Effectiveness Reviews, No. 50.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Appendix AAmerican College of Rheumatology Criteria for Classification of Systemic Lupus Erythematosus

1997 Update of the 1982 American College of Rheumatology revised criteria for classification of systemic lupus erythematosus

1. Malar RashFixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds
2. Discoid rashErythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions
3. PhotosensitivitySkin rash as a result of unusual reaction to sunlight, by patient history or physician observation
4. Oral ulcersOral or nasopharyngeal ulceration, usually painless, observed by physician
5. Nonerosive arthritisInvolving 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
    OR
  2. 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
    OR
  2. 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
    OR
  2. 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
    OR
  2. Leukopenia--< 4,000/mm3 on ≥ 2 occasions
    OR
  3. Lyphopenia--< 1,500/ mm3 on ≥ 2 occasions
    OR
  4. Thrombocytopenia--<100,000/ mm3 in the absence of offending drugs
10. Immunologic disorder
  1. Anti-DNA: antibody to native DNA in abnormal titer
    OR
  2. Anti-Sm: presence of antibody to Sm nuclear antigen
    OR
  3. Positive finding of antiphospholipid antibodies on:
    1. an abnormal serum level of IgG or IgM anticardiolipin antibodies,
    2. a positive test result for lupus anticoagulant using a standard method, or
    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 antibodyAn abnormal titer of antinuclear antibody by immunofluorescence or an equivalent assay at any point in time and in the absence of drugs

The classification is based on 11 criteria. For the purpose of identifying patients in clinical studies, a person is defined as having SLE if any 4 or more of the 11 criteria are present, serially or simultaneously, during any interval of observation.

From: Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus [letter]. Arthritis Rheum 1997;40:1725. Reprinted with permission from John Wiley and Sons.

Cover of Antinuclear Antibody, Rheumatoid Factor, and Cyclic-Citrullinated Peptide Tests for Evaluating Musculoskeletal Complaints in Children
Antinuclear Antibody, Rheumatoid Factor, and Cyclic-Citrullinated Peptide Tests for Evaluating Musculoskeletal Complaints in Children [Internet].
Comparative Effectiveness Reviews, No. 50.
Wong KO, Bond K, Homik J, et al.

AHRQ (US Agency for Healthcare Research and Quality)

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