The 2012 revised slicc criteria for classification of. Validation of the systemic lupus international collaborating. An autoimmune work revealed positive ana and low c3 levels. This systemic lupus diagnostic criteria slicc calculator helps the classification and diagnosis of sle based on clinical and immunological criteria. Slicc originally represented a union of members of the british isles lupus assessment group bilag, the systemic lupus erythematosus disease activity index sledai group from toronto, dr. New 2019 sle eularacr classification criteria are valuable. Slicc classification criteria for sle current medical. Validation of the systemic lupus international collaborating clinics. Patients may be labelled as systemic lupus erythematosus sle in their medical records, when in fact they have cutaneous lupus. A comparison of the american college of rheumatology acr. Reprinted with permission from bertsias gk, salmon je, boumpas dt. Slicc 12, the new set of criteria established in 2012 to. This performance was independently confirmed in the validation cohort.
Eularacr improved on the sensitivity of existing criteria by refining the definitions of mucocutaneous manifestations to include nonscarring alopecia, oral ulcers, subacute cutaneous or discoid lupus, and acute cutaneous lupus. The slicc criteria are more consistent with advancing concepts of sle, and they will exert substantial impact on clinical practice. Systemic lupus erythematosus sle is a complex auto immune disease with. The slicc criteria emphasized that sle is primarily an autoantibody disease. The slicc criteria were validated by analysis of 690 patients with sle or other rheumatic diseases. Childhoodonset systemic lupus erythematosus clinically relevant improvement in children and adolescents. The diagnostic accuracies of the 2012 slicc criteria and the. Slicc sle diagnostic criteria systemic lupus erythematosus clinical and immunologic criteria clinical criteria acute cutaneous lupus or subacute cutaneous lupus chronic cutaneous lupus oral ulcers or nasal ulcers nonscarring alopecia synovitis involving 2 or more joints serositis renal neurologic hemolytic anemia. If a patient meets at least four criteria, lupus can be diagnosed with 95% specificity and 85% sensitivity.
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. Systemic lupus erythematosus is a systemic autoimmune disease with a worldwide distribution. Comparison among acr1997, slicc and the new eularacr. Derivation and validation of systemic lupus international. This study examined large cohorts of subjects with sle and incomplete lupus erythematosus ile to compare the impact of acr and slicc criteria. Although both men and women of all age groups can be affected, women outnumber men almost 10 fold and. Slicc classification criteria for systemic lupus erythematosus. In this classification, biopsyconfirmed lupus nephritis with positive antinuclear or antidoublestranded dna antibodies became a standalone criterion. Pdf on apr 20, 2015, iraj salehi abari and others published 2015 acrslicc revised criteria for diagnosis of systemic lupus.
Disease duration was equal between the three groups, and was around 14 years in each arm. Pdf 2015 acrslicc revised criteria for diagnosis of systemic. 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. The diagnostic accuracies of the 2012 slicc criteria and.
Slicc criteria for sle slicc classification criteria for sle. Background systemic lupus erythematosus sle is a disease with an autoimmune origin, which occurs nine times more often in women than in men, and. Using the data up to v0, we determined the dates at which the acr and slicc criteria were first met. Mucocutaneous and neuropsychiatric manifestations were added, as were hypocomplementemia and. Because of the unknown diagnostic performance among patients from nephrology clinics, we aimed to. However, they have become widely used as diagnostic criteria in clinical situations. Study evaluates slicc12 classification criteria for lupus. Hartman ear, van royenkerkhof a, jacobs jwg, et al. Sep 11, 2019 similarly, mucocutaneous manifestations were also added in the 2012 slicc classification criteria. 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. Hematologic for the purpose of identifying patients in clinical. Classification criteria sle eular acr 2018, slicc 2012.
Slicc classification criteria for sle amith balachandran, department of anaesthesia, cmc vellore, and ashish jacob mathew, assistant professor, department of rheumatology, cmc, vellore. Acrendorsed criteria for rheumatic diseases below are a number of acrapproved criteria sets. The 2012 slicc criteria are very complexextended criteria and it can be used when the acr criteria cannot classify sle. Op0020 validation of new systemic lupus erythematosus. Mucocutaneous and neuropsychiatric manifestations were added, as were hypocomplementemia and new antiphospholipid antibody tests. May 02, 2019 the recent attempts to create modern criteria for the classification of sle have aimed at being more sensitive, clinically relevant and meaningful than the older american college of rheumatology acr classification criteria. Pdf 2015 acrslicc revised criteria for diagnosis of. Applying systemic lupus international collaborating.
Three sets of lupus criteria sle acr1997, sle slicc and 2019 sle eularacr criteria were tested in each group of patients. Compare the criteria proposed by acr 97 and slicc 12 for the diagnosis of sle and to gather information on. Background systemic lupus erythematosus sle is a disease with an autoimmune origin, which occurs nine times more often. The use of slicc and acr criteria to correctly label patients. In an early sle cohort the acr1997, slicc2012 and eular. Systemic lupus erythematosus is a multiorgan system autoimmune disease with clinical and serological heterogeneity. Slicc criteria for sle slicc classification criteria for. Compare the criteria proposed by acr 97 and slicc 12 for the diagnosis of sle and to gather information on clinical characteristics, diagnosis, and treatment. Discoid rash raised erythematous patches with keratotic scaling, follicular plugging, and atrophic scarring 3. Performance of the new slicc classification criteria in childhood systemic lupus erythematosus.
Acr endorsed criteria american college of rheumatology. Sensitivity was close to the slicc 2012 criteria, specificity maintained at the level of the acr 1997 criteria. Derivation and validation of the systemic lupus international. A comparison of the american college of rheumatology acr and systemic lupus international collaborating clinics classification slicc criteria to detect patients with systemic lupus erythematosus sle in electronic health record ehr data. Pediatric systemic lupus erythematosus american academy. Use of slicc criteria in a large, diverse lupus registry enables sle. The aims of this study were to determine damage index in systemic lupus erythematosus sle patients based on systemic lupus international collaborating clinicsamerican college of rheumatology slicc acr damage index sdi and to determine the laboratory and clinicodemographic factors affecting sdi this is a retrospective cohort study of 94 sle patients attending rheumatology clinics in. Association of iga anti2 glycoprotein i with clinical and.
The systemic lupus international collaborating clinics slicc recently validated an alternative system. The american college of rheumatology has 11 classification criteria for lupus. The use of slicc and acr criteria to correctly label. Mucocutaneous and neuropsychiatric manifestations were added, as were hypocomplementemia and new antiphospholipid. The new systemic lupus international collaborating clinics 2012 classification criteria slicc 12 are far more sensitive at identifying lupus patients in reallife clinical practice than the american college of rheumatology 1997 criteria acr97 especially within the first 5 years of disease onset, according to a large population study the study, conducted among more than 2,000 sle.
Toward new criteria for systemic lupus erythematosusa. Jun 22, 2018 amsterdam the new systemic lupus erythematosus classification criteria of the american college of rheumatology and the european league against rheumatism are based on a point system that will produce a paradigm shift in how the disease gets studied going forward, said sindhu johnson, md, while presenting the latest version of the newly revised classification scheme at the european. Systemic lupus diagnostic criteria slicc calculator. State the classification criteria of lupus and their limitations when used for diagnostic purposes.
See information about the purpose of criteria sets, their development and validation, and the role of the acr in adopting them. Using lab results and further questioning, we were able to make a diagnosis of sle based on the 2015 systemic lupus international collaborating clinics slicc and american college of rheumatology acr revised criteria for the diagnosis of sle 5. In 2012, the systemic lupus international collaborating clinics slicc presented a new classification for systemic lupus erythematosus sle. Collaborating clinics slicc criteria 8, both are designed for classification of sle and they are not diagnostic. Applying systemic lupus international collaborating clinics slicc and provisional acreular systemic lupus erythematosus classification criteria in a cohort of patients with undifferentiated connective tissue disease abstract. The slicc classification consists of seventeen criteria and for the 99 sle classification requires. Objective sle is traditionally classified using the american college of rheumatology acr criteria. American college of rheumatology classification criteria for. Evaluation of the slicc classification criteria in patients with. In an early sle cohort the acr1997, slicc2012 and eularacr. Accaha cv risk calculator 20 estimate 10year risk for atherosclerotic cardiovascular disease revised cardiac risk index lee criteria rapid preop assessment using the revised cardiac risk index asymptomatic ica internal carotid artery stenosis surgical risk stratification gupta perioperative cardiac risk determine perioperative risk for a wide array of surgeries. 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. Diagnostic criteria for systemic lupus erythematosus. New eularacr classification criteria for sle rheumnow.
Results the criteria were finetuned and simplified, using ana of. Toward new criteria for systemic lupus erythematosusa standpoint. Pdf derivation and validation of the systemic lupus international. 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. The slicc criteria for sle classification requires. Slicc, systemic lupus international collaborating clinics. Systemic lupus international collaborating clinics. To date there are no specific classification criteria for childhoodonset systemic lupus erythematosus csle. Some slicc criteria could not be applied some acute and chronic forms of cutaneous lupus, nonscarring alopecia, mononeuritis multiplex and complement values. Concerns about the clinical criteria used in the current acr classification system include possible duplication of highly correlated terms relating to cutaneous lupus such as malar rash and photosensitivity and the. The 2012 systemic lupus international collaborating clin ics slicc classification criteria addressed many of these issues. A multicentre study article pdf available in clinical and experimental rheumatology 323 march. 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.
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. Use of slicc criteria in a large, diverse lupus registry. Figure 1 natural history of systemic lupus erythematosus. Matthew liang and colleagues from boston, as well as several other rheumatologists. The new 2019 eularacr classification criteria for sle requires a positive ana as obligatory entry criterion. The aims of this study were to determine damage index in systemic lupus erythematosus sle patients based on systemic lupus international collaborating clinicsamerican college of rheumatology slicc acr damage index sdi and to determine the laboratory and clinicodemographic factors affecting sdi. To conclude, the recently proposed sle classification criteria from eular and acr and the 2012 slicc criteria showed comparable results regarding diagnostic sensitivity, specificity and accuracy using a scandinavian study population of confirmed sle cases and individuals with lupus mimicking conditions. In the text below the form there is information on the slicc, along with instructions on how to interpret the criteria that is present. The recent used diagnostic criteria widely used for sle is 2015 acr slicc revised criteria for diagnosis of systemic lupus erythematosus which is based on point systems. In 2012, the systemic lupus international collaborating clinics slicc network presented a set of criteria based on. We compared the european league against rheumatism eularamerican college of rheumatology acr2019, systemic lupus international collaborating clinics slicc 2012 and acr1997 criteria in an early median 48 months systemic lupus erythematosus sle cohort.
Pdf performance of the new slicc classification criteria. Sleslicconly subjects gained criteria through low complement levels 81178, 45. Slicc damage index score in systemic lupus erythematosus. Therapeutic opportunities in systemic lupus erythematosus. Systemic lupus erythematosus is a multisystemic disease that is associated with an increase in morbidity. Slicc damage index score in systemic lupus erythematosus pat. Slicc criteria through biopsyproven lupus nephritis with positive ana or antidsdna. Both the acr revised criteria and the validated slicc criteria are designed for classification of patients for clinical studies and have not been tested for purposes of diagnosis. The recent attempts to create modern criteria for the classification of sle have aimed at being more sensitive, clinically relevant and meaningful than the older american college of rheumatology acr classification criteria. Classification criteria for systemic lupus erythematosus. Most clinically diagnosed sle patients not satisfying the acr 1997 criteria ful. Fractions indicate the number of patients with a particular criterion divided by the.
Iraj salehiabari 2015, 2015 acr slicc revised criteria for diagnosis of systemic lupus erythematosus. Slicc 12 criteria are more effectiveness than acr 97 score. Amsterdam the new systemic lupus erythematosus classification criteria of the american college of rheumatology and the european league against rheumatism are based on a point system that will produce a paradigm shift in how the disease gets studied going forward, said sindhu johnson, md, while presenting the latest version of the newly revised classification scheme at the. Slicc, systemic lupus international collaborating clinicsamerican college of rheumatology damage index. The 2012 systemic lupus international collaborating clinics slicc classification criteria addressed many of these issues 9. We compared groups of patients based on whether the slicc criteria were met before. 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. 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.
Classification criteria for systemic lupus erythematosus sle have been developed to ensure the inclusion of homogeneous groups of patients in. How do we diagnose lupus american college of rheumatology acr criteria skin criteria systemic criteria 1. According to the slicc rule for the classification of sle, the patient must satisfy at least 4 criteria, including at least one clinical criterion and one. Objectives classification criteria are biased towards classifying longstanding disease. Similarly, mucocutaneous manifestations were also added in the 2012 slicc classification criteria. New sle classification criteria reset disease definition. Slicc criteria for sle 2012 systemic lupus international collaborating clinics criteria for classification slicc or systemic lupus erythematosus petri m, 2012 clinical criteria acute cutaneous lupus chronic cutaneous lupus oral ulcers nonscarring alopecia. Comparison among acr1997, slicc and the new eularacr classification criteria in childhoodonset systemic lupus erythematosus. Slicc is dedicated to generating new knowledge in the field of lupus, and translating these basic and clinical research discoveries into better health care practices and policies to help provide a healthier future for people diagnosed with lupus. Iraj salehiabari 2015, 2015 acrslicc revised criteria for diagnosis of systemic lupus erythematosus. The american college of rheumatology acr classification criteria for lupus and systemic lupus international collaborating clinics slicc criteria are designed to classify disease. Application of two separate criteria for classification of one disease is not a normalnatural way.
Slicc acr damage index 1996 1997 update of 1982 revised criteria for classification of sle. In 2012, the systemic lupus international collaborating clinics slicc 12 published a new set of criteria aimed at optimizing the classification of sle. The slicc group validated the classification criteria in a new validation. The formulation of initial criteria for sle was first proposed by the american college of rheumatology and appeared in 1971. What are eularacr diagnostic criteria for systemic lupus. Clinical criteria acute cutaneous lupus or subacute cutaneous lupus. Jul 14, 2014 both the acr revised criteria and the validated slicc criteria are designed for classification of patients for clinical studies and have not been tested for purposes of diagnosis. Apr 16, 2020 in september 2019, the european league against rheumatism eular and the american college of rheumatology acr published new criteria for the classification of sle.
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