SLE Disease Assessment — SCE Rheumatology MCQ

Correct answer: E — SDI quantifies accumulated organ damage; SLEDAI-2K quantifies recent disease activity

Explanation lettering: C = shown as A · D = shown as B · A = shown as C · B = shown as D

The SDI measures accumulated, generally irreversible damage occurring after SLE onset, regardless of whether it resulted from active lupus, treatment toxicity or another illness. Once an item is scored, it remains part of the cumulative damage score. SLEDAI-2K instead measures recent SLE disease activity using weighted clinical and laboratory manifestations within its defined assessment window, so its score can rise or fall. Thus E is correct. Options B and D reverse the role of the SDI. Neither instrument is principally a health-related quality-of-life measure, excluding C and D. Although SLEDAI-2K includes serological variables such as complement and anti-dsDNA status, serological activity alone is not the construct measured by the SDI, excluding A.

Reference: Arora S, Isenberg DA, Castrejon I. Measures of Adult Systemic Lupus Erythematosus: Disease Activity and Damage. Arthritis Care & Research. 2020;72 Suppl 10:27–46. https://oml.eular.org/oml_search_results_details.cfm?action=All%20information&id=345