MDCalc

SLICC Criteria for Systemic Lupus Erythematosus (SLE) 2012

Provides criteria for diagnosis of SLE.

Criteria are cumulative; any historical information counts and findings do not need to be present concurrently.

Lupus nephritis

If both are present, diagnosis is positive for SLE

Clinical criteria

Must have ≥1 clinical and immunological criteria each and ≥4 total for positive SLE diagnosis

Lupus malar rash (not malar discoid), bullous lupus, toxic epidermal necrolysis variant of SLE, maculopapular lupus rash, photosensitive lupus rash (not dermatomyositis), subacute cutaneous lupus (nonindurated psoriasiform and/or annular polycyclic lesions that resolve without scarring, although occasionally with postinflammatory dyspigmentation or telangiectasias)
Localized (above the neck) and/or generalized (above and below the neck) classical discoid rash, hypertrophic (verrucous) lupus, lupus panniculitis (profundus), mucosal lupus, lupus erythematosus tumidus, chilblains lupus, discoid lupus/lichen planus overlap
Palate, buccal, tongue, or nasal ulcers; in absence of other causes
In absence of other causes
Involving ≥2 joints, characterized by swelling or effusion OR tenderness in ≥2 joints and 30 mins or more of morning stiffness
Typical pleurisy for >1 day, pleural effusions, or pleural rub, typical pericardial pain for >1 day, pericardial effusion, pericardial rub, or pericarditis by EKG (in absence of other causes)
Urine protein/creatinine (or 24 hr urine protein) representing 500 mg of protein/24 hr, RBC casts
Seizures, psychosis, mononeuritis multiplex (in absence of other causes), myelitis, peripheral or cranial neuropathy (in absence of other causes), acute confusional state (in absence of other causes)
In absence of other causes
<4,000/mm³ at least once (leukopenia) or <1,000/mm³ at least once (lymphopenia); in absence of other causes
<100,000/mm³ at least once; in absence of other causes

Immunological criteria

Must have ≥1 clinical and immunological criteria each and ≥4 total for positive SLE diagnosis

Lupus anticoagulant, false positive RPR, medium or high titer anticardiolipin (IgA, IgG, or IgM), anti-β₂ glycoprotein (IgA, IgG, or IgM)
Low C3, low C4, low CH50
In the absence of hemolytic anemia

Diagnostic Result

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Advice
  • Corroborate criteria results with clinical judgment, specialist consultation, and additional diagnostic tests as necessary.
  • Initiate appropriate treatment strategies based on a confirmed diagnosis, tailored to the patient's specific manifestations.
  • Engage rheumatologists or other relevant specialists for comprehensive management of multisystem involvement.
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