Classification criteria SLE (EULAR / ACR 2018, SLICC 2012, ACR 1997) 4.5/5 (4)

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The criteria are "classification criteria" used in research. In clinical practice, diagnoses can be made even if the classification criteria are not met.

EULAR / ACR classification criteria for SLE. Preliminary version. Translated to Norwegian based on English version

The criteria use "weighting" so that some disease traits count more than others when summing up. The criteria are published as 2019 EULAR classification criteria (Aringer M, 2019).

This joint project between ACR (USA) and EULAR (Europe) has been working for several years. The criteria will probably, with some adjustments, be used for many years to come. The purpose of these criteria is: 1) Better define SLE as autoimmune diseases. 2) Exclude SLE-like diseases. 3) Emphasize the most typical manifestations of the disease. 4) Enable classification earlier in the course of the disease. 5) Could use the criteria also among child with SLE.

The criteria use "weighting" so that some items count more than others when one sums up.

A preliminary Norwegian version:

  • Everyone must have ANA (antinuclear antibody in blood test) with titer of at least 80.
  • Total score of at least 10 Required for SLE, please calculate below:

Nephritis (renal inflammation)               SCORE

  • Class III / IV (severe nephritis) 10
  • Class II / V 8
  • Protein more than 0,5g / d 4


  • Anti-Sm or Anti-DsDNA 6

Serositis (pericarditis / pleuritis)

Skin and mucous membranes

  • ACLE (Acute Skin Lupus) 6
  • SCLE / DLE (Subacute Cutaneous / Discoid) 4
  • Oral ulcers (Mouth ulcers) 2
  • Alopecia (hair loss, without scars) 2


  • Seizures (epilepsy-like) 5
  • Psychosis (lack of reality) 3
  • Delirium (disturbed consciousness) 2


  • Arthritis (arthritis) 6



TOTAL least score = 10?

SLICC Criteria for SLE (2012)

Systemic Lupus International Collaborating Clinics
criteria for classification (SLICC) or systemic lupus erythematosus (Petri M, 2012)
Clinical criteria
• Acute cutaneous lupus
• Chronic cutaneous lupus
• Oral ulcers
• Non-scarring alopecia
• Synovitis in two or more joints (includes tenderness and
30 min of early morning stiff ness)
• Serositis
• Renal: urine protein-to-creatinine ratio or 24 h collection
Representing 500 mg protein / 24 h
• Neurological
• Haemolytic anemia
• Leucopenia
• Thrombocytopenia
Immunological criteria
• Antinuclear antibodies
• Anti-double stranded DNA
• Anti-Smith
• Antiphospholipid antibody
• Low complement
• Direct Coomb's test in the absence of haemolytic anemia
Classification needs four criteria sequentially, including one clinical and one
Immunological, or biopsy-proven lupus nephritis with a positive antinuclear antibody
Or anti-double stranded DNA antibody. Items are only generally scored if present
Without other known causes.

ACR criteria for SLE 1997

For research, the following SLE classification is used: ACR criteria from 1997 (Hochberg MC, 1997).

4 or more:

  1. Butterfly Rash
  2. Diskoid rash
  3. Photosensitivity (sun rash)
  4. Typical mouth ulcer, considered by a doctor
  5. Arthritis (joint inflammation of two or more peripheral joints)
  6. Serositis (inflammation of the lung or heart / pleurisy / pericarditis)
  7. Kidney disease (Proteins / egg whites in urine; 0,5g / 24 hours or 3 +++ on urine)
  8. Nervous system disorders (epilepsy-like seizures or psychosis)
  9. Hematological disease (anemia (eg by hemolysis) or low white blood cell count (leukocytes less than 4,0) by multiple measurements or lymphopenia two or more times or low platelets (platelets less than 100)
  10. Immunological Disease (Antibody: Dna or Sm or Cardiolipin or Lupus Anticoagulant)
  11. Antinuclear Antibodies (ANA)

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