ACR Criteria and how to use them - SLE

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In-Depth Disease Overview: Systemic Lupus Erythematosus

March 2, 2003

D. Lockshin, MD

Attending Rheumatologist, Hospital for Special Surgery

Director, Barbara Volcker Center for Women and Rheumatic Disease

Professor of Medicine and Obstetrics-Gynecology,

Weill College of Medicine of Cornell University

ACR Criteria and how to use them

The American College of Rheumatology has devised Classification Criteria

for SLE (See Table 1). When a patient has any four of the following, she

is said to have SLE: malar rash; discoid rash; photosensitivity; oral

ulcers; non-erosive arthritis; pleuritis or pericarditis; renal

disorder; neurologic disorder; hematologic disorder; anti-DNA, anti-Sm,

or antiphospholipid antibody; and antinuclear antibody.

These criteria classify groups of patients for clinical studies and do

not diagnose individual patients. In individual patients, the diagnosis

of lupus is fully sustainable with fewer criteria. For instance, a

patient who has high titer antinuclear antibody and lupus

glomerulonephritis on biopsy, but who has no other symptoms, clearly has

lupus even though she has only two criteria. Conversely, a patient with

rheumatoid arthritis might have antinuclear antibody, hemolytic anemia

or thrombocytopenia, proteinuria, and pleurisy-more than four

criteria-and not have lupus. Hence the ACR Criteria should not be used

to exclude or confirm the diagnosis of lupus in an individual patient.

http://www.rheumatology.hss.edu/pat/diseaseReviews/sysLupus/sysLupus_pat.asp

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org