In classification, common features are most important, said Dr. Aringer. Although each lupus patient is unique, all have autoantibodies to nuclear antigens (ANAs), as well as many other autoantibodies, and evidence of immune complex deposition from histology to complement to interferon signature. This leads to many different organ manifestations in SLE. “ANA has very high sensitivity, but its specificity is pretty low. For anti-Smith antibodies, it’s the other way around. So it doesn’t make sense to have them side by side in the criteria,” said Dr. Aringer. They hypothesized that ANA would be the entry criterion and then tested if that was feasible.
Many conditions have overlapping features with SLE, “but if two of these attributes are found together, especially in a patient who also has autoantibodies, it’s usually SLE,” he said.
The committee agreed not to count a feature when it is more likely due to another condition and to create weighted criteria. Example: Such manifesttations as lupus nephritis carry a higher score than less common skin features. If the score is 10 or higher, the patient is classified as having SLE.
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Howaida Elsayed Mansour says
February 22, 2018 at 8:51 pmOne thing I don’t like in this criteria ….that is it is mandatory to have positive ANA testing to apply the criteria….this would result in many false negative cases on applying this criteria….. because all of us know that some SLE cases have negative ANA and DNA but they have consumed complement C3 and C4 …so according to the SLICC classification criteria they are having SLE but according to the New criteria they aren’t….!!!!
Breno says
April 2, 2018 at 9:13 pmI agree. And about the patients ANA negative, but anti-SSA/Ro positive? And, these new criteria are too sensive. Everything is lupus?
Sandra says
September 10, 2018 at 1:29 pmIn1995 I was diagnosed with autoimmune hepatitis following years of pain meds and neck surgeries . I was told after blood work I had positive ANA, negative RA, and a gamete of positive inflammation and other test hoeing autoimmune disease. The Rheumatologist walk in to my hospital room and said I had a classic butterfly rash on my face, blistering in mouth and nose, horrible headaches, but still working. So I went on about 6 months of prednisone and taken off any meds that process through my liver. I got better. I was told my trigger was the trigger of my first flare. Nothing but fatigue and headaches, occasional achy joints. So I rarely went to rheumatologist . 2 years ago I had anaphylactic shock from peanuts, my disease raised its ugly head. Now my mom has had lupus since she was twenty five, discoid type. My youngest daughter diagnosed with SLE at age nine, after very strange lumps on her tendons. She also had kidney issues, . So three women in my family lupus. My currrnt flare has been raging for coming up on two years. Horrible, could not turn over in bed by my self from pain let alone walk. I can walk some now but not for long, cannot stand in lines, can’t bath myself, I have horrible chest pain from pleurisy and lupus pneumonitis. I have trouble swallowing. My joints are hurting all the time. I am now on oxygen. I have two brain masses, and several lumps or masses growing on my groin and abdominal area. My lymph nodes are huge and some are painless while others mainly my temporal nodes are painful. Last night I awoke with vomit on me choking on it and coughing for hours. I am on lots of meds but progress is slow. Last blood work Ana negative.. WTF… my Dr says it doesn’t matter it is Lupus. New Rheumatologist lets do more test, lupus always had positive ANA and RA.. ugh no guys I have Lupus and I am sick. I aspirated last night, I could have died in my sleep easily and now need to worry about..go by the symptom list it seems to be very accurate wether you have one initial episode or many. Hang in and find some Dr that listen to your symptoms, write them down. Good luck