Lupus Diagnosis Criteria

To make a positive diagnosis of SLE, an individual must show clinical evidence of a multi-system disease – that means show abnormalities in several different organ systems.

The American College of Rheumatology lists 11 symptoms that help physician’s distinguish lupus from other diseases.  

 The Eleven Criteria Now Used for the Diagnosis of Lupus:

1.     Malar Rash – rash over the cheeks

2.     Discoid Rash – red raised patches

3.     Photosensitivity - reaction to sunlight, resulting in the development of or increase in skin rashes

4.     Oral Ulcers – ulcers in the nose or mouth, usually painless

5.     Arthritis – Nonerosive arthritis involving two or more peripheral joints: this is arthritis in which the bones around the joints do not become destroyed

6.     Serositis - Pleuritis or pericarditis, which is inflammation of the lining of the lung or heart

7.     Renal Disorder – Excessive protein in the urine (greater than 0.5 gm/day or 3+ on test sticks) and/or cellular casts (abnormal elements in the urine, derived from red and/or white cells and/or kidney tubule cells)

8.     Neurologic Disorder - Seizures (convulsions) and/or psychosis in the absence of drugs or metabolic disturbances, which are known to cause such effects

9.     Hematologic Disorder - Hemolytic anemia or leukopenia (white blood count below 4,000 cells per cubic millimeter) or lymphopenia (less than 1,500 lymphocytes per cubic millimeter) or thrombocytopenia (less than 100,000 platelets per cubic millimeter). The leukopenia and lymphopenia must be detected on two or more occasions. The thrombocytopenia must be detected in the absence of drugs known to induce it.

10.  Antinuclear Antibody - Positive test for antinuclear antibodies (ANA) in the absence of drugs known to induce it.  

11.  Immunologic Disorder - Positive anti-double stranded anti-DNA test, positive anti-Sm test, positive antiphospholipid antibody such as anticardiolipin, or false positive syphilis test (VDRL).