Rheumatology A

ACR/EULAR SLE Classification Criteria 2019

2019 ACR/EULAR classification criteria for SLE. Requires positive ANA (entry criterion). Score ≥10 classifies as SLE.

ANA positive (≥1:80) — ENTRY CRITERION (required)

Constitutional: Fever >38.3°C

Skin: Non-scarring alopecia

Skin: Oral ulcers

Skin: Subacute cutaneous or discoid lupus (or malar rash without scarring +4)

Serositis: Pleural or pericardial effusion

Renal: Proteinuria >500 mg/24h

Renal: Lupus nephritis class II or V biopsy (+8), class III/IV (+10)

Neuropsychiatric: Seizures, psychosis, mononeuritis multiplex, or myelitis

Haematological: Haemolytic anaemia, leukopenia <4×10⁹/L, or thrombocytopenia <100×10⁹/L

Immunology: Anti-dsDNA antibodies (in range) OR anti-Sm antibodies

Immunology: Antiphospholipid antibodies (aCL, anti-β2GPI, lupus anticoagulant)

Immunology: Low C3 and/or C4

Score interpretation

SLE Not Classified 0–9

Score <10: Does not meet 2019 ACR/EULAR classification for SLE

→ Consider other connective tissue diseases; follow up ANA-positive patients; rheumatology opinion if clinical suspicion

SLE Classified 10–100

Score ≥10: Meets 2019 ACR/EULAR criteria for SLE (requires positive ANA)

→ Rheumatology referral; baseline renal function, urinalysis, complement, anti-dsDNA; consider hydroxychloroquine; organise organ-specific investigations

Interpretation bands for the SLE Criteria 2019. Apply clinical judgement and local guidance.

References

Aringer M, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Arthritis Rheumatol. 2019;71(9):1400-1412.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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