Criteria for Classification of Systemic Lupus Erythematosus

In 1971, the American Rheumatism Association (ARA) Committee on Therapeutic Criteria proposed "Preliminary Criteria for the Classification of Systemic Lupus Erythematosus [SLE]".¹Any four of the 14 items listed below, when present, indicate SLE.¹

1. Facial erythema (butterfly rash)

2. Discoid lupus erythematosus

3. Raynaud phenomenon

4. Alopecia

5. Photosensitivity

6. Oral or nasopharyngeal ulceration

7. Arthritis without deformity

8. Lupus erythematosus cells

9. Chronic false-positive serologic test for syphilis

10. Profuse proteinuria

11. Cellular casts

12. Pleuritis or pericarditis

13. Psychosis or convulsions

14. Hemolytic anemia or leukopenia or thrombocytopenia

These criteria were formulated by computer analysis of 57 symptoms, signs, and laboratory findings in 245 patients (with "unequivocal SLE") under the care of 52 different rheumatologists in the United States and Canada. Insufficient data at the time of evaluating these records prevented further analyses of such commonly used tests as antinuclear antibody, Coombs test, anti-DNA antibody, tissue biopsies, and direct immunofluorescence of skin biopsy specimen.

The first six criteria relate