전신홍반 루프스 진단 기준: 과거 (1997 ACR Criteria )와 2012년 새로운 기준

1997 ACR Criteria  (과거 기준)

우리가 DOPAMIN RASH로 외운 것. 11개 중 4개 이상 만족시 진단 가능.

1. Discoid rash

2. Oral ulcer

3. Photosensitivity (recurrence of unusual skin rash in sun-exposed areas)

4. Arthritis (non-erosive)

5. Malar rash

6. Immunologic disorder

- Anti–double-stranded DNA antibody (anti-dsDNA)

- Anti-Smith antibody (anti-Sm)

- Antiphospholipid antibodies (anticardiolipin IgM or IgG, lupus anticoagulant, anti-beta-2 glycoprotein IgM or IgG, or false-positive fluorescent treponemal antibody absorption test or Treponema pallidum immobilization for 6 months)

7. Neurologic disorder (seizures, psychosis [in absence of offending drugs or metabolic derangement)

8. Renal disorder

9. ANA positive

10. Serositis (pleuritis, pericarditis)

11 Hematologic disorder

- Hemolytic anemia with reticulocytosis

- Leukopenia (<4000/mm ³ total on two or more occasions)

- Lymphopenia (<1500/mm ³ on two or more occasions)

- Thrombocytopenia (<100,000/mm ³ in the absence of offending drugs)

 

2012 SLICC Criteria SLE

Biopsy-proven nephritis with either ANA or anti-dsDNA antibodies  이거나

아래 기준 중 총 4개 이상 만족시키면서 임상 지표 1, 면역 지표 1개 이상이어야 한다.

I. Clinical Criteria

1.  Acute cutaneous lupus (malar rash, bullous lupus, toxic epidermal necrolysis, photosensitive lupus rash, maculopapular lupus, subacute cutaneous lupus

2. Chronic cutaneous lupus (discoid, hypertrophic verrucous, panniculitis, mucosal lupus, lupus tumidus, chilblains lupus, lichen planus)

3. Oral ulcers or nasal ulcers

4. Nonscarring alopecia

5. Synovitis (more than two joints or inflammatory arthralgias of more than two joints)

6. Serositis (pleurisy for more than 1 day, pericardial pain for more than 1 day)

7. Renal (>500 mg proteinuria/24 hours) or RBC casts)

8. Neurologic (seizures, psychosis, mononeuritis multiplex, myelitis, peripheral or cranial neuropathy, acute confusional state)

9. Hemolytic anemia

10. Lymphopenia (<1000/mm ³ at least once)

11. Thrombocytopenia (<100,000/mm ³ at least once)

 

II. immunologic criteria

1. ANA

2. Anti-dsDNA

3. Anti--Smith

4. Antiphospholipid antibodies (lupus anticoagulant, RPR, anti-cardiolipin IgA, IgG, IgM, anti-β2 glycoprotein IgA, IgG, IgM)

5. Low complement

6. Direct Coombs test in the absence of hemolytic anemia

 

 

 

 

 

The 2012 Systemic Lupus International Collaborating Clinics (SLICC) Classification Criteria (sensitivity 94%, specificity 92%) is also a validated tool for the diagnosis of SLE.