SLICC Classification Criteria for Systemic Lupus Erythematosus

Clinical Criteria

• Acute cutaneous lupus: • Malar rash, bullous lupus, toxic epidermal necrolysis variant of SLE, maculopapular lupus rash, photosensitive lupus rash, or subacute cutaneous lupus
• Chronic cutaneous lupus: • Classic discoid rash, lupus panniculitis, mucosal lupus, lupus erythematous tumidus, chilblains lupus, discoid lupus/lichen planus overlap
• Oral or nasal ulcers
• Nonscarring alopecia
• Synovitis (≥2 joints)
• Serositis: • Pleurisy or pericardial pain ≥1 day, pleural effusion or rub, pericardial effusion or rub, ECG evidence of pericarditis
• Renal: • Presence of red blood cell casts or urine protein/creatinine ratio representing >500 mg protein/24 hr
• Neurologic: • Seizures, psychosis, mononeuritis multiplex, myelitis, peripheral or cranial neuropathy, or acute confusional state
• Hemolytic anemia
• Leukopenia (<4,000/mm3) or lymphopenia (<1,000/mm3)
• Thrombocytopenia (<100,000/mm3)

Immunologic Criteria

• Positive antinuclear antibody
• Positive double-stranded DNA antibody
• Positive anti-Smith antibody
• Antiphospholipid antibody positivity: • Positive lupus anticoagulant, false-positive test for rapid plasma regain, medium- to high-titer anticardiolipin antibody level (IgA, IgG, IgM), or positive anti–β2- glycoprotein-1 antibody (IgA, IgG, IgM)
• Low complement: • Low C3, C4, or CH50 level
• Positive direct Coombs test

Classification

• Classify as SLE if ≥4 criteria are met, with at least 1 clinical criterion and at least 1 immunologic criterion.