The American College of Rheumatology classification of SLE requires presence of 4 of the following 11 criteria (a person is said to have SLE if any 4 or more of the 11 criteria are present, serially or simultaneously, during an interval of observation).
Photosensitivity (skin rash as a result of an unusual reaction to sunlight) Malar rash (affects ˜60% of patients; butterfly distribution on face, spares nasolabial folds; macular erythematous blush or erythematous papules) Oral or nasopharyngeal ulcers (affects ˜85% of patients; painless) Discoid lupus (uncommon in children; deeper lesions showing atrophy, adherent scales, hyper- and hypopigmentation, erythema, scarring; most common on face and scalp) Arthritis (affects ˜15% of patients; nonerosive arthritis involving small joints of hands or large joints, characterized by tenderness, swelling, or effusion) Serositis (pleurisy, pericarditis, ascites) Renal lupus (affects ˜50%–90% of children; diagnosed by persistent proteinuria >0.5 g/d or 3+ if quantitation not performed, red blood cells and cellular casts in urine) CNS lupus (eg, psychosis, seizures, encephalopathy, myelitis, coma, stroke, peripheral neuropathy, migraines) Hematologic lupus (anemia [hemolytic with positive direct Coombs test or anemia of chronic disease], leukopenia, lymphopenia, thrombocytopenia) Positive antinuclear antibody Immunologic tests (anti-dsDNA, anti-Sm, antiphospholipid antibodies)
Other Clinical Features of SLE Alopecia, Raynaud phenomenon, vasculitis with palpable purpura and petechiae, urticaria, angioedema, vesicobullous SLE, deep vein thrombosis, cerebrovascular accidents, digital ulceration, fever, myalgia, arthralgia, poor weight gain, depression, hepatosplenomegaly, lymphadenopathy |