EULAR/ACR classification criteria for systemic lupus erythematosus

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Entry criteria

Anti-nuclear antibodies at a titer of ≥ 1:80 on HEp-2 cells or an equivalent positive test (ever)

No positive test

Constitutional symptoms

Fever

Hematologic features

Leukopenia

Thrombocytopenia

Autoimmune hemolysis

Neuropsychiatric presentations

Delirium

Psychosis

Seizure

Mucocutaneous involvement

Non-scarring alopecia

Oral ulcers

Subacute cutaneous or discoid lupus

Acute cutaneous lupus

Serosal involvement

Pleural or pericardial effusion

Acute pericarditis

Musculoskeletal involvement

Joint involvement

Renal involvement

Proteinuria > 0.5 g/24 hours

Renal biopsy Class II-V lupus nephritis

Renal biopsy Class III-IV lupus nephritis

Antiphospholipid antibodies (anti-cardiolipin antibodies, anti-β2GP1 antibodies, or lupus anticoagulant)

Present

Absent

Complement proteins

Low C3 or C4

Low C3 and C4

Systemic lupus erythematosus-specific antibodies (anti-double stranded DNA antibody or anti-Smith antibodies)

Present

Absent

Calculation

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The calculator in question is the EULAR/ACR classification criteria for systemic lupus erythematosus (SLE). EULAR stands for the European League Against Rheumatism, and ACR is the American College of Rheumatology. This calculator is used in the clinical setting to help diagnose systemic lupus erythematosus, a chronic autoimmune disease that can affect various parts of the body, including the skin, joints, kidneys, and brain. The EULAR/ACR classification criteria for SLE is applicable to patients who have at least one clinical manifestation suggestive of SLE. The criteria are based on a weighted scoring system that includes various clinical and immunologic domains. The higher the score, the higher the likelihood of SLE. The clinical utility of this calculator is to aid in the diagnosis of SLE, particularly in cases where the presentation may be ambiguous. It can also be used to stratify patients in clinical research studies. Exclusion criteria for the use of this calculator include patients with a clear alternative diagnosis, or those who have not had any clinical manifestations suggestive of SLE. It's also important to note that this calculator is not intended to replace clinical judgment, but rather to support it.

Reference

Martin Aringer, Karen Costenbader, David Daikh et al. 2019 European League Against Rheumatism / American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019 Sep;71(9):1400-1412.

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