Table 2 Revised criteria of the American College of Rheumatology
From: Renal involvement in autoimmune connective tissue diseases
1. Malar rash | Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds |
2. Discoid rash | Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions |
3. Photosensitivity | Skin rash as a result of unusual reaction to sunlight, by patient history or physician observation |
4. Oral ulcers | Oral or nasopharyngeal ulceration, usually painless, observed by physician |
5. Non-erosive arthritis | Involving two or more peripheral joints, characterized by tenderness, swelling or effusion |
6. Pleuritis/Pericarditis | 1. Pleuritis, convincing history of pleuritic pain or rubbing heard by a physician or evidence of pleural effusion, or |
2. Pericarditis, documented by electrocardiogram or rub or evidence of pericardial effusion | |
7. Renal disorder | 1. Persistent proteinuria >0.5 grams per day or more than 3+ on urine dipstick testing, or |
2. Cellular casts (may be red cell, hemoglobin, granular, tubular, or mixed) | |
8. Neurologic disorder | 1. Seizures, in the absence of offending drugs or known metabolic derangements; for example, uremia, ketoacidosis, or electrolye imbalance, or |
2. Psychosis, in the absence of offending drugs or known metabolic derangements; for example, uremia, ketoacidosis, or electrolyte imbalance | |
9. Hematologic disorder | 1. Hemolytic anemia with reticulocytosis, or |
2. Leukopenia <4.000/mm3 on ≥2 occasions, or | |
3. Lymphopenia <1.500/mm3 on ≥2 occasions, or | |
4. Thrombocytopenia <100.000/mm3 in the absence of offending drugs | |
10. Immunologic disorder | 1. Anti-DNA: antibody to native DNA in abnormal titer, or |
2. Anti-Sm: presence to antibody of SM nuclear antigen, or | |
3. Positive finding of antiphospholipid antibodies on: | |
● An abnormal serum level of IgG or IgM anticardiolipin antibodies | |
● A positive test result for lupus anticoagulant using a standard method, or | |
● A false-positive test result for at least six months confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption test | |
11. Positive anti-nuclear antibody | An abnormal titer of anti- nuclear antibody by immunofluorescence or an equivalent assay at any point in time and in the absence of drugs |