EULAR/ACR 2019 SLE Classification Criteria

Aringer M, Costenbader K, Daikh D, et al. — Ann Rheum Dis / Arthritis Rheumatol, 2019

Purpose
Classification (not diagnostic) criteria for SLE, designed for research cohorts and trials; useful in clinic as a structured check of systemic involvement in patients with cutaneous lupus.
Population
Adults and children with suspected SLE. Entry criterion: ANA ≥ 1:80 on HEp-2 cells (or equivalent positive test), at any time. A criterion is not counted if a cause more likely than SLE explains it. Occurrence at least once is sufficient.
Formula
Within each of the 7 clinical and 3 immunological domains only the highest-weighted criterion counts. At least one clinical criterion is required. Total ≥ 10 points → classified as SLE.
Performance
Validation cohort: sensitivity 96.1 %, specificity 93.4 % (Aringer 2019). Criteria need not be simultaneous. Lupus nephritis class III/IV on biopsy alone (with positive ANA) reaches 10 points.
🚪 Entry criterion
ℹ️ If the entry criterion is not met, do not classify as SLE. If it is met, apply the additive criteria below. Do not count a criterion if there is a more likely explanation than SLE.
🩺 Clinical domains

Select every criterion that has ever been present and is attributable to SLE. Only the highest-weighted criterion in each domain is counted (shown in green).

Clinical points 0
🧪 Immunology domains
Immunology points 0
📚 References
  1. Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis. 2019;78(9):1151–9 / Arthritis Rheumatol. 2019;71(9):1400–12.
  2. Aringer M, Petri M. An update on the new classification criteria for systemic lupus erythematosus. Curr Opin Rheumatol. 2020;32(6):590–6.
  3. Aringer M, Brinks R, Dörner T, et al. European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) SLE classification criteria item performance. Ann Rheum Dis. 2021;80(6):775–81.
  4. Fanouriakis A, Kostopoulou M, Andersen J, et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis. 2024;83(1):15–29.
  5. Worm M, Zidane M, Eisert L, et al. S2k guideline: Diagnosis and management of cutaneous lupus erythematosus – Part 1. J Dtsch Dermatol Ges. 2021;19(8):1236–47.
Clinical decision support only. This tool is intended to assist clinical assessment and does not replace professional judgment. Always interpret results in the context of the individual patient.