ToolsCalculators
SLICC Criteria for Systemic Lupus Erythematosus (SLE) 2012
Classifies systemic lupus erythematosus using clinical and immunologic criteria.
SLICC Criteria for Systemic Lupus Erythematosus (SLE) 2012
Acute or subacute cutaneous lupus
Malar rash, bullous lupus, photosensitive lupus rash, toxic epidermal necrolysis variant of SLE, or subacute cutaneous lupus lesions (non-indurated psoriaform and/or annular polycyclic lesions).
Chronic cutaneous lupus
Classic discoid rash, hypertrophic (verrucous) lupus, lupus panniculitis/profundus, mucosal lupus, lupus erythematosus tumidus, or chilblains lupus.
Oral or nasal ulcers
In the absence of other causes such as vasculitis, Behcet disease, infection, or drug reaction.
Nonscarring alopecia
Diffuse thinning or hair fragility with visible broken hairs, in the absence of other causes.
Synovitis involving 2 or more joints
Swelling or effusion, or tenderness in 2+ joints with 30+ minutes of morning stiffness.
Serositis
Typical pleurisy or pleural effusion/rub, or typical pericardial pain, effusion, rub, or ECG evidence of pericarditis, for more than 1 day.
Renal involvement
Urine protein/creatinine ratio (or 24-hour urine protein) representing >=500 mg protein/24h, or red blood cell casts.
Neurologic involvement
Seizures, psychosis, mononeuritis multiplex, myelitis, peripheral or cranial neuropathy, or acute confusional state, without other cause.
Hemolytic anemia
Leukopenia or lymphopenia
Leukopenia <4,000/mm3 at least once, or lymphopenia <1,000/mm3 at least once, without other cause.
Thrombocytopenia
<100,000/mm3 at least once, without other cause.
ANA above laboratory reference range
Anti-dsDNA above laboratory reference range
If tested by ELISA, twice above the laboratory reference range.
Anti-Sm antibody present
Antiphospholipid antibody positive
Lupus anticoagulant, false-positive RPR, medium-high titre anticardiolipin (IgA, IgG, or IgM), or anti-beta2-glycoprotein I (IgA, IgG, or IgM).
Low complement
Low C3, low C4, or low CH50.
Direct Coombs test positive
In the absence of haemolytic anaemia.
Biopsy-proven lupus nephritis, with ANA or anti-dsDNA positive
If present, this alone satisfies classification regardless of the criteria count below.
ResultDoes not meet SLICC 2012 criteria for SLE
Classification is not satisfied with the criteria entered. Requires either biopsy-proven lupus nephritis (with ANA/anti-dsDNA), or 4+ total criteria including at least 1 clinical and 1 immunologic criterion.
- Clinical criteria met
- 0
- Immunologic criteria met
- 0
- Total criteria met
- 0
- Biopsy-proven nephritis pathway
- Not satisfied
When to use
- Classifying a patient as having SLE for research or diagnostic-support purposes when lupus is clinically suspected.
- Distinguishing SLE from other connective tissue diseases using combined clinical and immunologic features.
Formula
Classify as SLE if biopsy-confirmed lupus nephritis compatible with SLE is present with a positive ANA or anti-dsDNA, OR if >=4 of the 17 criteria (11 clinical + 6 immunologic) are met, including at least 1 clinical and at least 1 immunologic criterion.
Pearls and pitfalls
- These are classification criteria intended primarily for research cohort definition; clinical diagnosis still relies on overall judgement.
- The SLICC criteria were designed to improve clinical plausibility and sensitivity relative to the 1997 ACR criteria, at some cost to specificity.