SLE Classification Score — SCE Rheumatology MCQ

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EasySLE & Antiphospholipid SyndromeSLE Classification ScoreSCE Rheumatology

A 28-year-old woman being assessed for systemic lupus erythematosus has an ANA titre of 1:640. She has acute cutaneous lupus, joint involvement, low C3 and C4, and positive anti-dsDNA antibodies, with no more likely alternative explanation. Under the 2019 EULAR/ACR SLE classification criteria, what is the minimum weighted total required to classify her as having SLE, provided that at least one clinical criterion is present?

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Correct answer: D — 10

The correct answer is D: 10. The 2019 EULAR/ACR criteria require ANA positivity at a titre of at least 1:80 on HEp-2 cells or an equivalent assay as an obligatory entry criterion. After entry, a patient is classified as having SLE when attributable criteria from the weighted domains total at least 10 points and at least one clinical criterion is present. Only the highest-weighted item within each domain is counted. This patient scores 22 points: acute cutaneous lupus 6, joint involvement 6, low C3 and C4 4, and anti-dsDNA antibodies 6. Scores of 15 or 20 exceed the required threshold but are not the minimum. Scores of 5 or 8 are insufficient. These are classification criteria for research-standard case definition and should not be treated as a substitute for clinical diagnosis.

Reference: Aringer M et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis & Rheumatology. 2019;71:1400–1412. https://pubmed.ncbi.nlm.nih.gov/31385462/