Stoll bloomsbury rheumatology unitdivision of rheumatology, department of medicine, university college of london. Cases of sle were defined according to the american college of rheumatology acr criteria met. Systemic lupus erythematosus sle or lupus is a chronic, progressive, autoimmune disorder that affects multiple organ systems, with a broad range of clinical and laboratory manifestations. Systemic lupus erythematosus is a multiorgan system autoimmune disease with clinical and serological heterogeneity. Iraj salehiabari 2015, 2015 acr slicc revised criteria for diagnosis of systemic lupus erythematosus. Your primary care doctor or rheumatologist will use your medical history, a physical exam, and many routine as well as special tests to rule out other diseases. The cutaneous criteria, including both acute and subacute cutaneous lupus, are closer to the frequently used classification for cle the gilliam and sontheimers. The present study is the first to evaluate the performance of slicc12 in an adult european study population. Comparison between three systems of classification.
In this initial validation testing, the slicc revised criteria had greater sensitivity but lower specificity than the 1997 acr classification criteria sensitivity of 97 versus 83 percent and specificity of 84 versus 96 percent, respectively. This health tool is based on the 2012 classification created. Objective sle is traditionally classified using the american college of rheumatology acr criteria. Altmetric use of slicc criteria in a large, diverse. Calculate is a nextgeneration clinical calculator and decision support tool freely available to the medical community. Evaluation of the slicc classification criteria in patients with. Other criteria were chosen from 7 clinical constitutional, hematologic, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal and 3 immunologic antiphospholipid antibodies, complement proteins, slespecific antibodies categories, and weighted from 2 to 10. As an example, one of the major limitations of the 1997 acr criteria is that patients with biopsyconfirmed lupus.
Slicc criteria for sle slicc classification criteria for. To date there are no specific classification criteria for childhoodonset systemic lupus erythematosus csle. This study aims to compare the performance among the american college of rheumatology acr 1997, the systemic lupus international collaborating clinics criteria slicc and the new european league against rheumatism eular. Weighted criteria system for the classification of sle, which was based on.
Altmetric use of slicc criteria in a large, diverse lupus. The slicc criteria were validated by analysis of 690. Positive ana or positive antidsdna revised 2015 criteria endorsed by the acr combines 1997 criteria and slicc criteria 4 out of 16 points, definite sle 3 out of 16 points. Newly diagnosed sle patients with disease duration less than 6 months were excluded.
Thus, slicc12 criteria were applied to confirmed sle cases in our regional sle register as well as to individuals. This systemic lupus diagnostic criteria slicc calculator helps the classification and diagnosis of sle based on clinical and immunological criteria. The patients were divided into 2 groups based on sdi score assigned by the attending physician, 0 without damage or. Use of slicc criteria in a large, diverse lupus registry. The new 2019 eularacr classification criteria for sle requires a positive ana as obligatory entry criterion. Pdf 2015 acrslicc revised criteria for diagnosis of systemic. The formulation of initial criteria for sle was first proposed by the american college of rheumatology and appeared in 1971. The aim of this study was to compare the performance of bw and slicc criteria with the 1997 acr criteria in a jsle cohort. However, they have become widely used as diagnostic criteria in clinical situations. The slicc criteria were validated by analysis of 690 patients with sle or other rheumatic diseases. In this classification, biopsyconfirmed lupus nephritis with positive antinuclear or antidoublestranded dna antibodies became a standalone criterion. Validation of the systemic lupus international collaborating. Pdf version slicc classification criteria for sle amith balachandran, department of anaesthesia, cmc vellore, and ashish jacob mathew, assistant professor, department of rheumatology, cmc, vellore.
Slicc damage index score in systemic lupus erythematosus. Concerns about the clinical criteria in the current acr classification including. However, despite the improved sensitivity compared. Objective the systemic lupus international collaborating clinics slicc group revised and validated the american college of rheumatology acr systemic lupus erythematosus sle classification criteria in order to improve clinical relevance, meet stringent methodology requirements, and incorporate new knowledge regarding the immunology of sle. In 2012, the systemic lupus international collaborating clinics slicc presented a new classification for systemic lupus erythematosus sle.
The systemic lupus erythematosus international collaborating clinics slicc group has recently proposed a revised classification criteria, 10 which hopes to replace the 1997 american college of rheumatology criteria, 11 to improve on the sensitivity and specificity table 1. The application of slicc criteria resulted in higher sensitivity 82. Association of iga anti2 glycoprotein i with clinical and. Pdf 2015 acrslicc revised criteria for diagnosis of.
The most widely used classification criteria for sle are those derived and validated in adult patients by the acr. Many lupus symptoms imitate symptoms of other diseases and often come and go. The american college of rheumatology acr classification criteria for lupus and systemic lupus international collaborating clinics slicc criteria are designed to classify disease. The 2012 revised slicc criteria for classification of. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. In 2012, the systemic lupus international collaborating clinics slicc network presented a new set of criteria slicc12 to classify systemic lupus erythematosus sle.
Systemic lupus diagnostic criteria slicc calculator. The present study is the first to evaluate the performance of slicc 12 in an adult european study population. Autoantibodies were assessed by indirect immunofluorescence ana, antidoublestranded dna, precipitin sm and elisa anticardiolipin. According to the slicc authors, the new clinical criteria improve the 1997 acr criteria in several ways. However, our patient met the acr criteria for sle which has a sensitivity of 85% and specificity of 95%11 as he had arthralgias, pleural and pericardial effusions, lymphopenia and raised antidsdna, and met 5 out of 11 criteria according to newer systemic lupus international collaboration clinics criteria slicc criteria due to decreased. The 2012 systemic lupus international collaborating clin ics slicc classification criteria addressed many of these issues.
The incidence and prevalence of systemic lupus erythematosus. Abstract systemic lupus erythematosus sle is an autoimmune rheumatic disease that has variety symptoms and affects multi organ or system in the body. Acr criteria has made in 1997 for the diagnosis of sle disease and in 2012 appeared a new criteria to diagnose sle. Sleslicconly subjects gained criteria through low complement levels 81178, 45.
Their work included both a derivation and a validation of the new set of criteria as well as of acr97. Comparison between three systems of classification criteria. The 1997 american college of rheumatology acr criteria 7 and its complementary criteria. Slicc criteria through biopsyproven lupus nephritis with positive ana or antidsdna. Derivation and validation of the systemic lupus international. What are eularacr diagnostic criteria for systemic lupus. Study evaluates slicc12 classification criteria for lupus. Therapeutic opportunities in systemic lupus erythematosus. This study examined large cohorts of subjects with sle and incomplete lupus erythematosus ile to compare the impact of acr and slicc criteria. The mean renal damage score ds at 1 yr after diagnosis was a significant predictor of endstage renal failure and the mean pulmonary ds at 1 yr significantly predicted death within 10 yr of diagnosis. Patients may be labelled as systemic lupus erythematosus sle in their medical records, when in fact they have cutaneous lupus. Many physicians also use the american college of rheumatologys eleven criteria of lupus to aid in the. New eularacr classification criteria for sle rheumnow. As an example, one of the major limitations of the 1997 acr criteria is that patients with biopsyconfirmed lupus nephritis could still fail to fulfill criteria.
The new slicc classification criteria performed well in a large set of patient scenarios rated by experts. Oct 22, 2015 pdf version slicc classification criteria for sle amith balachandran, department of anaesthesia, cmc vellore, and ashish jacob mathew, assistant professor, department of rheumatology, cmc, vellore. We retrospectively studied disease course within 10 yr of diagnosis in an inception cohort of 80 patients with systemic lupus erythematosus sle. Jul 14, 2014 a comparison of the proposed slicc criteria and the current 1997 acr criteria in the validation cohort showed a better performance of the slicc rule with higher sensitivity and fewer misclassifications of patients. The use of slicc and acr criteria to correctly label. Slicc classification criteria for sle current medical. In the text below the form there is information on the slicc, along with instructions on how to interpret the criteria that is present. Background systemic lupus erythematosus sle is a disease with an autoimmune origin, which occurs nine times more often in women than in men, and is especially. Slicc 12, the new set of criteria established in 2012 to. Slicc damage index score in systemic lupus erythematosus pat. Slicc criteria for sle slicc classification criteria for sle. The systemic lupus international collaborating clinics slicc network, devoted to clinical research in sle, presented a new set of classification criteria in 2012 slicc 12 based on the evaluation of almost 1,400 patient scenarios. Alternatives include the boston weighted bw and slicc criteria. We aimed, in a cohort of patients with recentonset sle, to determine whether raised serum opn levels precede damage andor are associated with disease activity or certain.
Healthdayneither the american college of rheumatology acr nor the systemic lupus international collaborating clinics slicc criteria distinguishes patients with. Wallace,8 ola nived,9 gunnar sturfelt,9 rosalind ramseygoldman,10 sangcheol bae,11. Racgp systemic lupus erythmatosus when to consider and. Background systemic lupus erythematosus sle is a disease with an autoimmune origin, which occurs nine times more often in women than in men, and is especially prevalent among women of. Systemic lupus erythematosus is a systemic autoimmune disease with a worldwide distribution. These criteria are useful and give consistency in the classification.
Patients may be labelled as systemic lupus erythematosus sle in their medical records, when in fact they have. Hydroxychloroquine is the cornerstone of treatment because it reduces disease flares and other constitutional symptoms. Slicc12, the new set of criteria established in 2012 to classify systemic lupus erythematosus, was recently examined for the first time on an adult european. Discoid rash raised erythematous patches with keratotic scaling, follicular plugging, and atrophic scarring 3. Apr 27, 2016 healthdayneither the american college of rheumatology acr nor the systemic lupus international collaborating clinics slicc criteria distinguishes patients with subacute cutaneous lupus. May, 2020 aringer m, costenbader k, daikh d, et al.
Background systemic lupus erythematosus sle is a disease with an autoimmune origin, which occurs nine times more often in women than in men, and. This study aims to compare the performance among the american college of rheumatology acr 1997, the systemic lupus international collaborating clinics criteria slicc and the new european league against rheumatism eularacr criteria, in a csle cohort. Thus, slicc 12 criteria were applied to confirmed sle cases in our regional sle register as well as to individuals. Figure 1 natural history of systemic lupus erythematosus.
Systemic lupus erythematosus sle, is the most common type of lupus. Performance of the new slicc classification criteria in. Alcohol use disorders identification testconcise auditc brief screen to detecting heavy alcohol use alcohol use disorders identification test audit screen for active alcohol abuse or dependence cage questionnaire 4 question screening for alcohol problems car, relax, alone, forget, friends, trouble crafft 2. The slicc criteria for sle classification requires. Systemic lupus erythematosus sle is a multiorgan disease. A list of items considered to reflect damage in sle was generated through a nominal group from the systemic lupus international collaborating clin ics slicc and the american college of rheumatology diagnostic and therapeutic criteria committee.
The diagnosis of sle and ra was based on the 2015 systemic lupus international collaborating clinics slicc and american college of. Renal 500 mg of protein24 hr or upcr equivalent or red blood cell casts 8. In 2012, the systemic lupus international collaborating clinics slicc network presented a new set of criteria slicc 12 to classify systemic lupus erythematosus sle. Osteopontin and disease activity in patients with recent. Although sle classification criteria have been designed for. Sle is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. Although both men and women of all age groups can be affected, women outnumber men almost 10 fold and. About 20% of the cases begin before the age of 16 years, being classified as juvenileonset systemic.
The slicc criteria improved on the revised acr classification criteria in several critical ways. In the validation cohort, the new criteria had a sensitivity of 96. Flow chart showing the manhattan lupus surveillance program case. Diagnostic criteria for systemic lupus erythematosus. This is a retrospective cohort study of 94 sle patients attending rheumatology clinics in 2 local hospitals in kelantan, malaysia. The slicc formal assessment of the important clinical manifestations of sle and limitations of the 1982 acr criteria is summarized in the journal. Iraj salehiabari 2015, 2015 acrslicc revised criteria for diagnosis of systemic lupus erythematosus. The slicc criteria are validated criteria for making the diagnosis of lupus. According to the slicc rule for the classification of sle. Application of the 2012 systemic lupus international. Comparison among acr1997, slicc and the new eularacr. The systemic lupus international collaborating clinics slicc classification criteria for systemic lupus erythematosus a. Systemic lupus erythematosus sle is a complex autoimmune disease with diverse clinical manifestations and presenting symptoms that have considerable overlap with other diseases. The american college of rheumatology has 11 classification criteria for lupus.
In crosssectional studies, elevated osteopontin opn levels have been proposed to reflect, andor precede, progressive organ damage and disease severity in systemic lupus erythematosus sle. Pdf derivation and validation of the systemic lupus international. Background systemic lupus erythematosus sle is a disease with an autoimmune origin, which occurs nine times more often. Slicc, systemic lupus international collaborating clinicsamerican college of rheumatology damage index. A comparison of the proposed slicc criteria and the current 1997 acr criteria in the validation cohort showed a better performance of the slicc rule with higher sensitivity and fewer misclassifications of patients. Jan 10, 2015 in 2012, the systemic lupus international collaborating clinics slicc network presented a new set of criteria slicc 12 to classify systemic lupus erythematosus sle. American college of rheumatology classification criteria for. Derivation and validation of systemic lupus international. Use of slicc criteria in a large, diverse lupus registry enables sle. Aug 14, 2014 the most widely used classification criteria for sle are those derived and validated in adult patients by the acr. The use of slicc and acr criteria to correctly label patients. Sle classification using slicc criteria requires either meeting.
All patients with lupus should receive education, counseling, and support. The systemic lupus international collaborating clinics slicc recently validated an alternative system. Sliccacr criteria dont id severe internal disease in scle. Slicc classification criteria for systemic lupus erythematosus. Slicc classification criteria for sle amith balachandran, department of anaesthesia, cmc vellore, and ashish jacob mathew, assistant professor, department of rheumatology, cmc, vellore. Reprinted with permission from bertsias gk, salmon je, boumpas dt. The systemic lupus international collaborating clinics slicc network, devoted to clinical research in sle, presented a new set of classification criteria in 2012 slicc12 based on the evaluation of almost 1,400 patient scenarios. Systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus michelle petri, 1anamaria orbai, graciela s. The current definition of the syndrome sle and problems linked to it systemic lupus erythematosus is a syndrome without a clear definition of what it is, and it is unclear whether the use of the term syndrome should at all. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Performance of the proposed slicc criteria compared with the current acr criteria in the validation sample n 690 scenarios rule 1997 acr criteria sensitivity specificity 290349 83 326341 96 0.