The Lupus Activity Criteria Count (LACC) uses 7 variables to determine if systemic lupus erythematosus is active. The study was done at the University of Toronto and McMaster University in Canada.
Variables used for count:
(1) arthritis
(2) abnormal laboratory tests
(3) rash, ulcer of mucus membranes or alopecia
(4) pleurisy or pericarditis
(5) CNS symptoms (seizures, psychosis, organic brain syndrome, lupus headache)
(6) vasculitis
(7) hematuria
|
Variable |
Description |
|
arthritis |
nonerosive arthritis involving 2 or more peripheral joints, characterized by tenderness, swelling or effusion |
|
abnormal laboratory test |
positive LE cell prep; leukopenia < 4,000 per µL; low CH50; low C3; anti-DNA antibodies |
|
rash, ulcer of mucus membrane, alopecia |
New onset or aggravation of existing rash, mucus membrane ulceration or alopecia |
|
pleurisy or pericarditis |
Pleurisy: convincing history of pleuritic pain , or rub heard by physician, or evidence of pleural effusion; Pericarditis: rub heard by physician, or ECG changes, or evidence of a pericardial effusion |
|
seizures, psychosis, organic brain syndrome, lupus headache |
Seizures, psychosis or organic brain syndrome in the absence of drugs or known metabolic derangements. Lupus headache: severe headaches which are unusual, intractable and unresponsive to standard analgesic therapy |
|
vasculitis |
skin or digital ulceration, or biopsy showing vasculitis |
|
hematuria |
urinalysis with >= 5 RBC per high power field |
from Table 2, page 785
LACC =
= SUM(variables present in a patient)
Interpretation:
• minimum number of criteria: 0
• maximum number of criteria: 7
• The presence of >= 2 criteria predict active disease in 100% of cases.
• The higher the count, the higher the disease activity.
Purpose: To evaluate a person with lupus for disease activity.
Specialty: Immunology/Rheumatology
Objective: clinical diagnosis, including family history for genetics, imaging studies, laboratory tests, disease progression
ICD-10: M32.0, M32.1, M32.8, M32.9,
