Appendix

Appendix The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus* Criterion

Definition

Malar rash

Fixed erythema, flat or raised, over the malar eminences, nasolabial folds

Discoid rash

Erythematous raised patches plugging; atrophic scarring

Photosensitivity

Skin rash as a result of unusual physician observation

Oral ulcers

Oral or nasopharyngeal

Arthritis

Nonerosive arthritis involving two or more peripheral tenderness, swelling, or effusion

Serositis

Pleuritis-convincing history of pleuritic pain or rub heard by a physician or evidence of pleural effusion or Pericarditis-documented by ECG or rub or evidence of pericardial effusion

Renal disorder

Persistent proteinuria 0.05 g/day or 3-t if quantification not performed or Cellular casts-may be red cell, hemoglobin, granular, tubular or mixed

Neurologic

Seizures-in the absence of offending drugs of known metabolic (eg. uremia, ketoacidosis, or electrolyte imbalance)

disorder

tending

with adherent keratotic scaling may occur in older lesions

ulceration,

reaction

to sunlight,

to spare the

and follicular

by patient

usually painless, observed

history

or

by physician

joints, characterized

by

derangements

or Psychosis-in the absence of offending drugs or known metabolic derangements (eg, uremia, ketoacidosis, or electrolyte imbalance) Hematologic

disorder

Hemolytic

anemia-with

reticulocytosis

or Leukopenia-less than 4000/mm3 total on two or more occasion or Lymphopenia-less than 1500/mm3on two or more occasions orThrombocytopenia-less than 100,000/mm3 in the absence of offending drugs Immunologic

disorder

Positive LE-cell preparation or Anti-DNA: antibody to native DNA in abnormal titer or Anti-Sm: presence of antibody to Sm nuclear antigen or False-positive serologic test for syphilis known to be positive for at least 6 months and confirmed by Treponema pallidurn immobilization or fluorescent treponemal antibody absorption test

Antinuclear

‘The person serially criteria

antibody

An abnormal titer of antinuclear antibody by immunofluorescence or an equivalent assay at any time and in the absence of drugs known to be associated with “drug-induced lupus” syndrome

proposed classification is based on 11 criteria. For the purpose of identifying patients in clinical studies, a shall be said to have systemic lupus erythematosus if any four or more of the 11 criteria are present, or simultaneously, during any interval of observation. (Tan EM, Cohen AS, Fries JF, eta/. The 1982revised for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25:1271-7277.)

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