The systemic lupus international cooperating clinics slicc 2012 criteria increased sensitivity, but at the price of reduced specificity. Listing a study does not mean it has been evaluated by the u. 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. The diagnostic accuracies of the 2012 slicc criteria and the. The slicc 2012 criteria may allow patients to be classified as having sle earlier in the disease course.
All patients with lupus should receive education, counseling, and support. Its diversity of clinical features is matched by the complexity of the factors genetic, hormonal, and environmental that cause it, and the array of autoantibodies with which it is associated. Application of the 2012 systemic lupus international collaborating. Systemic lupus erythematosus diagnosis and management bernard thong. It was felt that important control groups, including chronic cutaneous lupus, needed to be included in a. In the validation cohort, the new criteria had a sensitivity of 96. Symptoms vary between people and may be mild to severe. If a patient meets at least four criteria, lupus can be diagnosed with 95% specificity and 85% sensitivity. What are eularacr diagnostic criteria for systemic lupus. Acr endorsed criteria american college of rheumatology.
Hydroxychloroquine is the cornerstone of treatment because it reduces disease flares and other constitutional symptoms. How do patients with newly diagnosed systemic lupus. Systemic lupus erythematosus sle is a severe and chronic inflammatory autoimmune disorder that has multisystem affection. Lupus, technically known as systemic lupus erythematosus sle, is an autoimmune disease in which the bodys immune system mistakenly attacks healthy tissue in many parts of the body. Our objective was to update the eular recommendations for the management of systemic lupus erythematosus sle, based on emerging new evidence. Systemic lupus erythematosus sle is a rheumatic disease characterized by autoantibodies directed against selfantigens, immune complex formation, and immune dysregulation, resulting in damage to essentially any organ. Mucocutaneous and neuropsychiatric manifestations were added, as were hypocomplementemia and new antiphospholipid. The acr 1997 criteria were criticized for their suboptimal sensitivity. Slicc classification criteria for systemic lupus erythematosus.
Acr and the 2012 systemic lupus international cooperating clinics slicc sets of classi. The thorough heterogeneity among patients with systemic lupus erythematosus sle causes problems regarding diagnostic accuracy in clinical. Systemic lupus erythematosus sle is an autoimmune disorder characterized by antibodies to nuclear and cytoplasmic antigens, multisystem inflammation, protean clinical manifestations, and a. Diagnostic criteria for systemic lupus erythematosus. Neuropsychiatric systemic lupus erythematosus npsle is a complex neurological disorder characterized by neuropsychological dysfunction. The most recent addendum to the classification criteria for sle dates from 2012, when the systemic lupus international collaborating clinics slicc group published a revision and validation of the acr criteria 5. The american college of rheumatology acr established 11 criteria as a classificatory instrument to operationalise the definition of sle in clinical trials. Effect of curcumin on systemic lupus erythematosus full. Classification criteria for systemic lupus erythematosus. Correspondence to professor andrea doria, department of medicine, division of rheumatology, university of padua, padova 35128, italy. Derivation and validation of systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Derivation and validation of systemic lupus international.
Indeed, it is the diversity of presentation, accumulation of manifestations over time, and undulating disease course that challenge the most astute of clinicians. Systemic lupus erythematosus sle is a complex autoim mune disease. 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. Background in a joint effort, the european league against rheumatism eular and the american college of rheumatology acr recently proposed new criteria for the classification of systemic lupus erythematosus sle with the overarching goal to identify potential participants for clinical studies. In 2012, the slicc criteria were published in an attempt to improve clinical relevance of sle criteria. Systemic lupus erythematosus, the most common form of lupus, is a chronic autoimmune disease that can cause severe fatigue and joint pain. Systemic lupus erythematosus, interferon score, complement, autoinflammation, autoimmunity, patients stratification introduction systemic lupus erythematosus systemic lupus erythematosus sle is a multisystem inflammatory and autoimmune disorder and it is characterized by a wide spectrum of clinical manifestations. Systemic lupus erythematosus sle is a multiorgan autoimmune disease of unknown etiology with many clinical manifestations. This study aimed to evaluate manifestations at disease onset and to compare early sle manifestations. Systemic lupus erythematosus sle presents with nonspecific signs and symptoms that are also found in other conditions. There have been two rcts of rituximab in sle, the lunar. New therapeutic strategies in systemic lupus erythematosus. More than 90% of cases of sle occur in women, frequently starting at childbearing age. The current treatment approach for systemic lupus erythematosus sle, as outlined in the recommendations by international medical associations including eular and the acr, is.
Discoid rash raised erythematous patches with keratotic scaling, follicular plugging, and atrophic scarring 3. Toward new criteria for systemic lupus erythematosusa. The signs and symptoms of sle vary among affected individuals, and can involve many organs and systems, including the skin, joints, kidneys, lungs, central nervous. In this seminar we reflect on changes in its classification criteria. American college of rheumatology classification criteria for.
With rare exception, the unifying laboratory abnormality is. Thus, slicc12 criteria were applied to confirmed sle cases in our. The diagnostic accuracies of the 2012 slicc criteria and the proposed eularacr criteria for systemic lupus erythematosus classification are comparable. Higher interferon score and normal complement levels may. Different classification criteria for systemic lupus erythematosus sle have been proposed over many years. Risk factors for cataracts in a cohort of egyptian. Pediatric systemic lupus erythematosus american academy. The 2012 systemic lupus international collaborating clinics slicc classification criteria addressed many of these issues 9. Systemic lupus erythematosus genetics home reference nih. Cutaneous manifestations of systemic lupus erythematosus. The slicc group is an international group of investigators dedicated to clinical research on sle. Systemic lupus erythematosus sle is a systemic autoimmune disease that predominantly affects the females female to male ratio is 9. Comparison among acr1997, slicc and the new eularacr.
Systemic lupus erythematosus sle, is the most common type of lupus. Systemic lupus erythematosus sle is a chronic autoimmune disease characterized by multisystemic involvement and diverse manifestations. Performance of the proposed acr eular classification. To date there are no specific classification criteria for childhoodonset systemic lupus erythematosus csle. The 2012 revised slicc criteria for classification of. Systemic lupus erythematosus diagnosis and management. Systemic lupus erythematosus is a remarkable and challenging disorder. Clinical criteria acute cutaneous lupus or subacute cutaneous lupus. Performance of the proposed acreular classification. Herein, we present the first independent evaluation of these criteria in comparison. The common manifestations are in the form of arthritis, skin rash, renal and hematological involvement along with fever and constitutional symptoms. Systemic lupus erythematosus sle is an autoimmune disorder characterized by antibodies to nuclear and cytoplasmic antigens, multisystem inflammation, protean clinical manifestations, and a relapsing and remitting course. The formulation of initial criteria for sle was first proposed by the american college of rheumatology and appeared in 1971.
Systemic lupus erythematosus is a multiorgan system autoimmune disease with clinical and serological heterogeneity. Effect of curcumin on systemic lupus erythematosus the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Validation of the 2017 weighted criteria compared to the. Childhoodonset systemic lupus erythematosus clinically relevant improvement in children and adolescents. Criteria are cumulative and need not be present concurrently. The slicc criteria for sle classification requires.
The diagnostic accuracies of the 2012 slicc criteria and. Sle is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. Systemic lupus erythematosus sle is a prototypic autoimmune disease. Systemic lupus erythematosus sle is a chronic disease that causes inflammation in connective tissues, such as cartilage and the lining of blood vessels, which provide strength and flexibility to structures throughout the body. Systemic lupus erythematosus larissa lisnevskaia, grainne murphy, david isenberg systemic lupus erythematosus is a remarkable and challenging disorder.
Indeed clinical trials have had to add the requirement for the presence of a sle autoantibody when recruiting patients to optimize the likelihood of response to immunosuppressive therapy 14. Pdf the diagnostic accuracies of the 2012 slicc criteria. Pathogenesis 20 and clinical features 1 introduction systemic lupus erythematosus sle is the prototypic multisystem autoimmune disorder with a broad spectrum of clinical presentations encompassing almost all organs and tissues. State the classification criteria of lupus and their. Table 1 1982 revised criteria for classification of sle the criteria were revised again in 1997 with changes to the immunologic disorder criterion that involve deleting a positive lupus erythematosus preparation and adding a positive finding of antiphospholipid antibodies based on 1 abnormal immunoglobulin g or. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Derivation and validation of the systemic lupus international. Correct classification of patients with systemic lupus erythematosus sle is critical for clinical trials and clinical and translational science. The skin is one of the target organs most variably affected by the disease.
Npsle is associated with increased morbidity and mortality. Iraj salehiabari 2015, 2015 acrslicc revised criteria for diagnosis of systemic lupus erythematosus. In 2012, the systemic lupus international collaborating clinics slicc developed and validated new sle classification criteria. Diffuse thinning or hair fragility with visible broken hairs with positive pulling test or apparent alopecia convincing the patient to ask for physician consultation. Performance of the 2012 systemic lupus international collaborating clinics classification criteria versus the 1997 american college of rheumatology classification criteria in adult and juvenile systemic lupus erythematosus. An epigeneticsbased hypothesis of autoantigen development in systemic lupus erythematosus author. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. Slicc revision of the acr classification criteria clinical criteria 1. Treatment in sle aims at remission or low disease activity and.
The disease can affect, for example, the kidneys, skin, blood cells, and nervous system. Systemic lupus erythematosus, a manual, is a useful reference for specialists in the diagnosis and management of patients with sle, a tool for measurement of clinical activity for pharmaceutical development and basic research of the disease and a reference work for hospital libraries. Currently, we have a limited understanding of mechanisms leading to systemic lupus erythematosus, but we know that genetics, environmental factors, and epigenetics contribute to. The most widely used and accepted criteria has been the 1997 acr criteria.
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