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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

  1. Diagnosis of systemic lupus erythematosus requires at least 4 out of 11 criteria [60]. Reprint permission was obtained from John Wiley and Sons, Inc.