ToolsCalculators
Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)
Weighted, 24-descriptor index of SLE disease activity over the preceding 10 days.
Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)
Seizure
Recent onset, excluding metabolic, infectious, or drug causes.
Psychosis
Altered ability to function due to severe disturbance in perception of reality, excluding uraemia/drug causes.
Organic brain syndrome
Altered mental function with impaired orientation, memory, or other intellectual function, of acute onset and fluctuating course, excluding metabolic/infectious/drug causes.
Visual disturbance attributable to SLE
Retinal changes (cytoid bodies, retinal haemorrhages, serous exudate/haemorrhage in the choroid) or optic neuritis, excluding hypertension/infection/drug causes.
New cranial nerve disorder attributable to SLE
Lupus headache
Severe, persistent headache attributable to SLE; may be migrainous but unresponsive to narcotic analgesia.
New cerebrovascular accident attributable to SLE
Excluding arteriosclerosis.
Vasculitis
Ulceration, gangrene, tender finger nodules, periungual infarction, splinter haemorrhages, or biopsy/angiogram evidence of vasculitis.
Arthritis
>=2 joints with pain and signs of inflammation (tenderness, swelling, or effusion).
Myositis
Proximal muscle pain/weakness with elevated CK/aldolase, EMG changes, or biopsy showing myositis.
Urinary casts
Heme-granular or red blood cell casts.
Haematuria
>5 RBC/hpf, excluding stones, infection, or other cause.
Proteinuria
New onset or recent increase of >0.5 g/24h.
Pyuria
>5 WBC/hpf, excluding infection.
Inflammatory rash
New onset or recurrence.
Alopecia
New onset or recurrent abnormal, patchy or diffuse hair loss.
Mucosal ulcers
New onset or recurrent oral or nasal ulcerations.
Pleurisy
Pleuritic chest pain with rub or effusion, or pleural thickening.
Pericarditis
Pericardial pain with rub, effusion, or ECG/echo confirmation.
Low complement
Decrease in CH50, C3, or C4 below the laboratory reference range.
Increased anti-dsDNA binding
Above the laboratory reference range.
Fever
>38C, excluding infectious cause.
Thrombocytopenia
<100,000/mm3, excluding drug causes.
Leukopenia
<3,000/mm3, excluding drug causes.
Result0 points
SLEDAI-2K of 0 corresponds to no activity over the preceding 10 days.
- SLEDAI-2K score
- 0
When to use
- Quantifying global SLE disease activity attributable to lupus over the preceding 10 days, for clinical follow-up or trial endpoints.
Formula
Sum of weighted points for descriptors present in the preceding 10 days: 8 points each for seizure, psychosis, organic brain syndrome, visual disturbance, cranial nerve disorder, lupus headache, CVA, and vasculitis; 4 points each for arthritis, myositis, urinary casts, haematuria, proteinuria, and pyuria; 2 points each for rash, alopecia, mucosal ulcers, pleurisy, pericarditis, low complement, and increased anti-dsDNA binding; 1 point each for fever, thrombocytopenia, and leukopenia. Range 0-105.
Pearls and pitfalls
- Unlike the original 1992 SLEDAI, SLEDAI-2K credits persistently active rash, alopecia, mucosal ulcers, and proteinuria even if not newly worsening.
- The severity bands quoted here (mild/moderate/high/very high) follow the descriptive convention proposed by Uribe et al. (2004), not the original 2002 SLEDAI-2K definition paper.