Background Systemic lupus erythematosus (SLE) affects various organs and systems. This variable disease is usually classified by a set of criteria suggested by American College of Rheumatology (ACR) and accepted worldwide. Recently Systemic Lupus International Collaborating Clinics (SLICC) group published a revision of the SLE classification criteria which addressed “concerns that have arisen since development of the 1982 criteria” [1]. Like ACR criteria SLICC criteria requires the presence of at least 4 items but demands the presence of both “at least one clinical criterion and one immunologic criterion” [1] and unlike ACR criteria considers diagnosis of SLE in presence of biopsy-proven LN with SLE-specific autoantibodies. Since publication of the SLICC criteria no prevalence data in Russian patients was presented.

Objectives To describe the prevalence of each of the SLICC criteria in Russian SLE patient diagnosed clinically and to compare the data with the ACR criteria.

Methods A retrospective review of medical charts of SLE patients treated in a regional rheumatology center was performed. Only patients diagnosed as having definite SLE by a consensus of at least three experienced rheumatologists were included. Data on clinical and laboratory parameters were extracted, including “current” (at the time of the latest visit) and past manifestations from the disease onset until the most recent observation. Descriptive statistics were used for analysis.

Results Medical information regarding 160 SLE patients (19 male (11.9%) and 141 females (89.1%)) was analyzed. Mean (SD) age was 35.67 (11.49) years, disease duration 7.06 (6.68) years, age of SLE onset 28.72 (13.17) years. SLICC criteria were present with the following prevalence: acute or subacute cutaneous lupus – n=112 (70%); chronic cutaneous lupus – n=72 (45%); oral or nasal ulcers – n=26 (16.3%); nonscarring alopecia – n=64 (40%); synovitis or tenderness in 2 or more joints – n=134 (83.8%); serositis – n=87 (54.4%); renal – n=87 (54.4%); neurologic – n=38 (23.8%); hemolytic anemia – n=46 (28.8%); leukopenia or lymphopenia – n=68 (42.5%); thrombocytopenia – n=20 (12.5%); antinuclear antibody (ANA) – n=147 (91.9%); anti-dsDNA antibodies – n=109 (68.1%); antiphospholipid antibody – n=42 (26.3%); and low complement – n=73 (45.6%). Prevalence of anti-Sm and positive direct Coombs’ test in the absence of hemolytic anemia could not be determined since those tests were not routinely performed. Prevalence of ACR criteria was as follows: malar rash – n=96 (60%); discoid rash – n=60 (37.5%); photosensitivity – n=30 (18.8%); oral or nasal ulcers – n=26 (16.3%); nonerosive arthritis – n=91 (56.9%); pleuritis or pericarditis – n=87 (54.4%); renal disorder – n=90 (56.3%); neurologic disorder – n=10 (6.3%); hematologic disorder – n=102 (63.8%); immunologic disorder – n=118 (73.8%); positive ANA – n=147 (91.9%). Of 160 patients 11 did not fulfill ACR criteria and only 2 did not fulfill SLICC criteria, 10 not fulfilling ACR criteria were classified according to SLICC criteria.

Conclusions The SLICC classification criteria for SLE appears to be more comprehensive than ACR criteria and more clinically relevant.

References

1. Arthritis Rheum 2012 Aug; 64(8):2677-2686.

Disclosure of Interest None Declared