Patients with ile met three acr criteria and were not classified with sle by slicc standards. While achieving their goal of increasing sensitivity, the slicc criteria have lower specificity than the 1997 acr criteria 9,10. Alcohol use disorders identification testconcise auditc brief screen to detecting heavy alcohol use alcohol use disorders identification test audit screen for active alcohol abuse or dependence cage questionnaire 4 question screening for alcohol problems car, relax, alone, forget, friends, trouble crafft 2. Slicc criteria for sle slicc classification criteria for. Three sets of lupus criteria sle acr1997, sle slicc and 2019 sle eularacr criteria were tested in each group of patients. Sep 11, 2019 recommendations for immunologic domains and criteria. Derivation and validation of systemic lupus international. A multicentre study article pdf available in clinical and experimental rheumatology 323. Pdf 2015 acrslicc revised criteria for diagnosis of. Although both men and women of all age groups can be affected, women outnumber men almost 10 fold and.
Patients may be labelled as systemic lupus erythematosus sle in their medical records, when in fact they have cutaneous lupus. Translated to english based on english version 3 slicc criteria for sle 2012 4 acr criteria for sle 1997 definition the criteria are classification criteria used in research. American college of rheumatology provisional criteria for. The diagnostic accuracies of the 2012 slicc criteria and. Like many rheumatological diseases, systemic lupus erythematosus sle is difficult to diagnose owing to the constellation of findings required. Sle is a chronic disease of variable severity with a waxing and waning course, with signifi cant morbidity that can be fatalif not treated earlyin some patients fi gure 1. To be classified with sle, both acr and slicc require patients to meet 4 or more criteria, but. Designed to increase classification sensitivity and specificity, these criteria were indicated for inclusion in sle research studies and trials rather than for diagnostic purposes. The 2012 revised slicc criteria for classification of. Slicc damage index score in systemic lupus erythematosus.
Background systemic lupus erythematosus sle is a disease with an autoimmune origin, which occurs nine times more often. Th e figure 1 natural history of systemic lupus erythematosus. The use of slicc and acr criteria to correctly label patients. There are currently two classification criteria in use.
What are eularacr diagnostic criteria for systemic lupus erythematosus sle. Although the outlook for patients with sle has greatly improved, many unmet needs remain, chief of which is the development of safer and more efficacious therapies. In september 2019, the european league against rheumatism eular and the american college of rheumatology acr published new criteria for the classification of sle. San diegothe proposed classification criteria for systemic lupus erythematosus sle, supported but not yet approved by the acr and eular, were debuted on nov. Sleacronly were classified with sle by acr criteria, but not slicc criteria. The heterogeneity of systemic lupus erythematosus sle, long recognised by clinicians, is now challenging the entire lupus community, from geneticists to clinical investigators.
Slicc criteria for sle slicc classification criteria for sle. Application of two separate criteria for classification of one disease is not a normalnatural way. The patients were divided into 2 groups based on sdi score assigned by the attending physician, 0 without damage or. Comparison among acr1997, slicc and the new eularacr. Eularacr clinical domains and criteria for sle open table in a new window. The slicc criteria for sle classification requires. 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. What are eularacr diagnostic criteria for systemic lupus. This study examined large cohorts of subjects with sle and incomplete lupus erythematosus ile to compare the impact of acr and slicc criteria. Criteria are cumulative and need not be present concurrently. The systemic lupus international collaborating clinics slicc. Newly diagnosed sle patients with disease duration less than 6 months were excluded. 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. Sleslicconly were classified with sle by slicc criteria, but not acr criteria.
Sleboth were classified with sle by both slicc and acr criteria. The diagnostic accuracies of the 2012 slicc criteria and the. Lupus international collaborating clinics slicc classification criteria. Slicc 12, the new set of criteria established in 2012 to classify systemic lupus erythematosus, was recently. Slicc 12 criteria are more effectiveness than acr 97 score. Iraj salehiabari 2015, 2015 acr slicc revised criteria for diagnosis of systemic lupus erythematosus. Use of slicc criteria in a large, diverse lupus registry. Background systemic lupus erythematosus sle is a disease with an autoimmune origin, which occurs nine times more often in women than in. Objective sle is traditionally classified using the american college of rheumatology acr criteria. Performance of the new slicc classification criteria in childhood systemic lupus erythematosus. American college of rheumatology classification criteria for systemic lupus. American college of rheumatology classification criteria for. New understandings of sle pathogenesis have rendered the 1982 acr criteria outdated, according to a recently published paper arthritis care res.
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. In the text below the form there is information on the slicc, along with instructions on how to interpret the criteria that is present. New acr, eular criteria distinguish lupus from imitators. Jun 22, 2018 until now, classification of systemic lupus erythematosus sle was a yesorno decision, based on whether the patient had a minimum number of characteristic signs or symptoms. May 02, 2019 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 lupusmimicking conditions. Researchers from around the world contributed to the development of classification criteria for systemic lupus erythematosus sle designed to distinguish the autoimmunity from common mimickers.
Mean arterial pressure map calculate map centor score modified for gas pharyngitis estimate likelihood of gas pharyngitis maintenance fluid calculations determine maintenance iv fluid rates ottawa chronic obstructive pulmonary disease risk scale ocrs guide admission vs discharge in copd exacerbation lights criteria determine whether a. Clinics slicc group is an international group of investigators dedicated to sle clinical research. Systemic lupus erythematosus is a systemic autoimmune disease with a worldwide distribution. Edi hidayat free download as powerpoint presentation. Several groups have compared the two sets, and there is complete agreement that the slicc criteria are more sensitive. 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. Jul 14, 2014 from this data pool containing the records of 716 patients 293 sle, 423 other rheumatic diseases, the slicc scientists derived a set of preliminary criteria for classifying sle. The formulation of initial criteria for sle was first proposed by the american college of rheumatology and appeared in 1971.
Gladman was a key facilitator in the development and validation of the slicc acr damage index. This is a retrospective cohort study of 94 sle patients attending rheumatology clinics in 2 local hospitals in kelantan, malaysia. The slicc group has proposed a modification of the revisedupdated sle acr classification criteria. Systemic lupus international collaborating clinics slicc criteria. Novel paradigms in systemic lupus erythematosus the lancet. 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. As the precursor of the slicc group, members of the nato conference on prognosis studies in sle which took place in 1985 in toronto, recognized the need for three instruments to better describe the prognosis of sle including the domains of disease activity, accumulated damage. 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. Systemic lupus erythematosus is a multiorgan system autoimmune disease with clinical and serological heterogeneity. The slicc group defined improved sensitivity as a major goal, and their sle criteria have indeed clearly surpassed the 1997 acr criteria in this regard. The systemic lupus international collaborating clinics slicc 2012 criteria were more sensitive than the american college of rheumatology acr 1997 criteria in real. The reliability of the systemic lupus international collaborating clinicsamerican college of rheumatology damage index in patients with systemic lupus erythematosus arthritis rheum, 40 5 1997, pp.
During the followup 23 new patients reached the sle slicc criteria and 14 patients met the acr criteria with a stable rate of progression to sle over time. Slicc criteria but the 2015 acr slicc revised criteria can. Scribd is the worlds largest social reading and publishing site. The systemic lupus international collaborating clinics slicc recently validated an alternative system.
Sle slicconly subjects gained criteria through low complement levels 81178, 45. The american college of rheumatology has 11 classification criteria for lupus. The slicc criteria are validated criteria for making the diagnosis of lupus. Classification criteria sle eular acr 2018, slicc 2012. Performance of the proposed acr eular classification. Slicc classification criteria for sle amith balachandran, department of anaesthesia, cmc vellore, and ashish jacob mathew, assistant professor, department of rheumatology, cmc, vellore. Abstract systemic lupus erythematosus sle is an autoimmune rheumatic disease that has variety symptoms and affects multi organ or system in the body.
Original article american college of rheumatology provisional criteria for global flares in childhoodonset systemic lupus erythematosus hermine i. This health tool is based on the 2012 classification created. Neuropsychiatric manifestations of sle were added in the 2012 slicc classification criteria. Toward new criteria for systemic lupus erythematosusa. New sle classification criteria reset disease definition. New classification system for sle may aid earlier diagnosis. The new slicc 2012 classification criteria are far more sensitive in reallife clinical practice than the acr97 lupus criteria, especially within the first 5 years of onset. To date there are no specific classification criteria for childhoodonset systemic lupus erythematosus csle. The slicc criteria are more consistent with advancing concepts of sle, and they will exert substantial impact on clinical practice. 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. Slicc damage index score in systemic lupus erythematosus pat. The longer the time from disease onset, the fewer the differences between the two. The new criteria, which are on track for formal endorsement before the end of 2018 by the two medical societies that sponsored the revision, instead use a point system. Use of slicc criteria in a large, diverse lupus registry enables sle.
Based on emerging evidence and multidisciplinary and international input, a steering committee nominated by the european league against rheumatism eular and the american college of rheumatology acr has developed new classification criteria for systemic lupus erythematosus sle. Existing sle classification criteria perform better in patients with longstanding disease than in newonset sle 11, and there is an increasing recognition and demand that subjects with early. The systemic lupus erythematosus international collaborating clinics slicc is an international group of rheumatologists and immunologists with special interests in lupus who have been working together on lupus research since 1991. Antiphospholipid antibody tests were added to the 2012 slicc classification criteria, and the presence of any 1 of the following are included in the eularacr recommendations to increase sensitivity. The criteria for sle using acr 97 requires that the patient present four of the eleven criteria, but the slicc revised and validated those criteria in 2012 proposing that the patient meet four of the seventeen criteria being at least one clinical criterion and one criterion included in the diagnosis. We included 56 confirmed sle cases meeting the 1982 acr criteria. The acr criteria continue to perform well compared with the current gold standard of physician diagnosis but do not include the updated and more inclusive definitions of variables of the slicc criteria. Slicc classification criteria for systemic lupus erythematosus. The study, conducted among more than 2,000 sle patients in spain and portugal, finds that the slicc12 is significantly more sensitive than the older acr criteria set 93. Derivation and validation of the systemic lupus international. Dec 15, 2017 rheumatology researchers referred to both the 1997 acr revised criteria and 2012 systemic lupus international collaborating clinics slicc criteria when developing the new criteria, said martin aringer, md, steering committee cochair and chief of rheumatology at university medical center carl gustav carus in dresden, germany. We have now compared both sets of criteria in a wellcharacterized sle cohort. Discoid rash raised erythematous patches with keratotic scaling, follicular plugging, and atrophic scarring 3. Clinics slicc 2012 criteria were more sensitive than the american college of rheumatology acr 1997 criteria in reallife systemic lupus erythematosus sle clinical practice.
Slicc 12, the new set of criteria established in 2012 to classify systemic lupus erythematosus, was recently examined for the. Performance of the proposed acreular classification. Disease duration was equal between the three groups, and was around 14 years in each arm. I offer a mnemonic that contains the 11 categories used by the american college of rheumatology,1from which four or more must be present to diagnose sle. Systemic lupus diagnostic criteria slicc calculator. This group produced tools that form the basis of outcome studies in sle today, such as the slicc acr damage index 12. Evidence based medicine slicc criteria for sle cmi.
Diagnostic criteria for systemic lupus erythematosus. 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 abstract. New classification system for sle may aid earlier diagnosis rheumatology network. Background systemic lupus erythematosus sle is a disease with an autoimmune origin, which occurs nine times more often in women than in men, and. The slicc 2012 may allow patients to be classified as having sle earlier in the disease course. A list of items considered to reflect damage in sle was generated through a nominal group from the systemic lupus international collaborating clin ics slicc and the american college of rheumatology diagnostic and therapeutic criteria committee. An international steering committee developed and validated the criteria, with patient input and the consensus of more than 150 global sle experts.
A comparison of the american college of rheumatology acr. New eularacr classification criteria for sle rheumnow. Katarzyna gilekseibert, md abstract systemic lupus erythematosus sle is a chronic, compli cated and challenging disease to diagnose and treat. Study evaluates slicc12 classification criteria for lupus. The 2012 slicc criteria are very complex extended criteria and it can be used when the acr criteria cannot classify sle.
Acr criteria has made in 1997 for the diagnosis of sle disease and in 2012 appeared a new criteria to diagnose sle. To determine the prevalence of american college of rheumatology acr and systemic lupus international collaborating clinics slicc classification criteria among systemic lupus erythematosus sle patients. Other criteria were chosen from 7 clinical constitutional, hematologic, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal and 3 immunologic antiphospholipid antibodies, complement proteins, slespecific antibodies. The selection resulted from a statistical analysis of the data refined by a consensus decision of the paricipatin clinical resaechers. However, our patient met the acr criteria for sle which has a sensitivity of 85% and specificity of 95%11 as he had arthralgias, pleural and pericardial effusions, lymphopenia and raised antidsdna, and met 5 out of 11 criteria according to newer systemic lupus international collaboration clinics criteria slicc criteria due to decreased. Slicc classification criteria for sle current medical. Systemic lupus erythematosus larissa lisnevskaia, grainne murphy, david isenberg systemic lupus erythematosus is a remarkable and challenging disorder. The new 2019 eularacr classification criteria for sle requires a positive ana as obligatory entry criterion. New classification system for systemic lupus erythematosus. The slicc criteria emphasized that sle is primarily an autoantibody disease, requiring at least one immunologic criterion to be present, and. According to inclusion criteria at t0 no patient met the sle acr criteria, whilst, retrospectively applying the sle slicc criteria, 44 patients already satisfied this set of criteria for sle.
In order to create a more homogeneous patient group, the american college of rheumatology acr developed classification criteria for research purposes in 1972. The slicc criteria require either that a patient satisfy at least 4 of 17 criteria, including at least 1 of the 11 clinical criteria and one of the six immunologic criteria, or that the patient has biopsyproven nephritis compatible with sle in the presence of antinuclear antibodies ana or antidoublestranded dna antidsdna antibodies. A mnemonic for sle diagnostic criteria annals of the. A comparison between the classification criteria for sle slicc 2012 acr 1997 acr 1982 ara 1971 clinical criteria 1. This systemic lupus diagnostic criteria slicc calculator helps the classification and diagnosis of sle based on clinical and immunological criteria. The slicc classification criteria provide alternative classification criteria for use in sle clinical care and research. If a patient meets at least four criteria, lupus can be diagnosed with 95% specificity and 85% sensitivity. 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. Pdf performance of the new slicc classification criteria. In the current study, the slicc group undertook a revision of the sle classification criteria to. The american college of rheumatology acr classification criteria for lupus and systemic lupus international collaborating clinics slicc criteria are designed to classify disease. Performance of the new slicc classification criteria in juvenile systemic lupus erythematosus, in two observation periods. Slicc, systemic lupus international collaborating clinicsamerican college of rheumatology damage index. However, they have become widely used as diagnostic criteria in clinical situations.
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