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Difference between SLE classification and diagnosis and importance of attribution. Response to: ‘Do the 2019 EULAR/ACR SLE classification criteria close the door on certain groups of SLE patients?’ by Chi et al
  1. Martin Aringer1,
  2. Karen H Costenbader2,
  3. Thomas Dörner3,
  4. Sindhu R Johnson4
  1. 1Division of Rheumatology, Department of Medicine III, University Medical Center and Faculty of Medicine, TU Dresden, Dresden, Germany
  2. 2Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  3. 3Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Rheumatology and Clinical Immunology, Berlin, Germany
  4. 4Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Mount Sinai Hospital; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Professor Martin Aringer, Internal Medicine III, Medical Faculty, Technical University of Dresden, Dresden 01069, Germany; martin.aringer{at}

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In their letter, Dr Chi and colleagues1 express two concerns regarding the new European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria. On the one hand, they correctly remark that patients with uncommon, isolated organ manifestations may be more difficult to classify with any set of classification criteria. On the other hand, they caution against mistaking malignancies for systemic lupus erythematosus (SLE).

The first sensitivity-related issue is certainly correct. However, it is important to reiterate that the new EULAR/ACR criteria are classification …

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