Diagnosis

Early diagnosis of the disease can be achieved by clinical assessment of the patient: (1)

• clinical features should be differentiated as to whether they are due to:
  • lupus disease activity (i.e. a lupus flare)
  • other lupus-related pathology, e.g. thrombosis or vasospasm
  • irreversible organ damage
• consideration should be given to co-existing disease as well e.g. - infection which may be worsened by a lupus flare causing a “dual pathology”.

There is no diagnostic test specific for SLE and investigations should be guided by the extent of the organ involvement.

There are no internationally validated diagnostic criteria for SLE.

In a validation cohort, the 2019 European League Against Rheumatism/American College of Rheumatology (ACR) classification criteria had a sensitivity of 96.1% and specificity of 93.4% (2)

References:

1. Gordon C, Amissah-Arthur MB, Gayed M, et al. The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults. Rheumatology (Oxford). 2017 Oct 6.
2. Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Arthritis Rheumatol. 2019 Sep;71(9):1400-12.