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Abstract
Background The current use of the SLICC classification criteria for juvenile systemic lupus erythematosus (jSLE) is extrapolated from an adult-validated study.1 Efforts have been conducted to validate its applicability in the pediatric population.2,3
Objectives To validate the SLICC classification criteria among juvenile SLE patients
Methods A diagnostic criteria validity study was conducted. Medical records of <19 years old patients, who were seen in a tertiary hospital from June 2012 to June 2014, were reviewed to make 300 case summaries. Included were 150 jSLE and 150 non-jSLE cases. Non-jSLE cases, with jSLE as a consideration, comprised the control group. Patients who had no definite diagnosis, or who were lost to follow-up, were excluded. Each case summary was evaluated by at least 3 of 7 pediatric rheumatologists by utilizing the SLICC criteria. A consensus diagnosis for each case was reached based on majority agreement (>50%) of the individual subspecialist assessments. The clinical diagnosis of the team of attending physicians, with at least 1 pediatric rheumatologist, was used as the gold standard. The sensitivity, specificity and number of misclassified cases were determined.
Results The sensitivity of the SLICC criteria is at 94.0% (95%CI 88.9-97.2), and specificity at 96.7% (95%CI 92.4-98.9) in the cohort of Filipino jSLE patients. One-forty-one cases were correctly classified as jSLE, while 145 controls were correctly classified as non-jSLE. There were 9 false negatives, while 5 controls were false positives.
Conclusions The SLICC classification criteria is a valid guide for clinical practitioners to diagnose patients afflicted with jSLE.
References
Petri, M et al. Arthritis & Rheumatism 2012; 64: 2677-2686.
Fonesca, AR et al. Rheumatology. 2014. doi:10.1093/rheumatology/keu278.
Sag, E at al. Clinical and Experimental Rheumatology. 2014 June; 32 (3): 440-444.
Acknowledgements Dr. Pauline Camposano, Dr. Carien-Gulay-Carvajal, Dr. Christine Bernal, Dr. Karen Cruz, Dr. Shanida Camomot, and Dr. Maria Kristine Belen-Ciabal
Disclosure of Interest None declared