Systemic Lupus Activity Measure (SLAM)

weight loss

none

0

mild-to-moderate (1-10%)

1

severe (> 10%)

3

fatigue

none

0

mild-to-moderate (no limit on activity)

1

severe (functional limitation)

3

fever

none

0

37.5 – 38.5°C

1

> 38.5°C

3

oral/nasal ulcer, periungal erythema, malar rash, photosensitivity, nail fold infarct

absent

0

present

1

alopecia

none

0

with trauma

1

spontaneous

2

erythematous, maculopapular rash or DLE, or lupus profundus or bullae

absent

0

< 20% BSA

1

20 – 50% BSA

2

> 50%

3

vasculitis (leukocytoclastic vasculitis, urticaria, palpable purpura, livedo reticularis, ulcer or panniculitis)

none

0

< 20% BSA

1

20 – 50% BSA

2

> 50%

3

cytoid bodies

absent

0

present but mild

1

visual acuity < 20/200

3

hemorrhages (retinal or choroidal) or episcleritis

absent

0

present but mild

1

visual acuity < 20/200

3

papillitis or pseudotumor cerebri

absent

0

present but mild

1

visual acuity < 20/200

3

lymphadenopathy

none

0

shotty

1

> 1 x 1.5 cm

2

hepatomegaly or splenomegaly

none

0

palpable on inspiration

1

palpable without inspiration

2

effusion and/or pleurisy

absent

0

shortness of breath or pain only with prompting, exam normal

1

shortness of breath or pain with exercise, decreased breath sounds, dull lower lobes

2

shortness of breath at rest, decreased breath sounds, dull middle and lower lobes

3

pneumonitis

none

0

on X-ray only

1

shortness of breath on exertion

2

shortness of breath at rest

3

Raynaud's

absent

0

present

1

hypertension

absent

0

diastolic 90 – 104 mm Hg

1

diastolic 105 – 115 mm Hg

2

diastolic > 115 mm Hg

3

carditis

absent

0

by ECG, rub or ECHO; no symptoms

1

chest pain or arrhythmia

2

myocarditis and hemodynamic compromise or arrhythmia

3

abdominal pain (serositis, ischemic bowel, pancreatitis)

none

0

mild (complaint)

1

moderate (limiting)

2

severe (signs, ascites)

3

stroke syndrome

absent

0

single TIA

1

multiple TIA or mononeuritis multiplex, chorea, cranial neuropathy

2

CVA/myelitis, retinal vascular occlusion

3

seizure

none

0

1-2 months

1

> 2 months

2

status epilepticus

3

cortical dysfunction

none

0

mild depression, personality disorder, or cognitive impairment

1

severe depression, limiting cognitive impairment

2

psychosis, dementia, coma

3

headache (including migraine)

none

0

mild symptoms or transient neurological signs

1

interferes with normal activities

2

incapacitating, aseptic meningitis

3

myalgia and/or myositis

absent

0

mild

1

limits some activities

2

incapacitating

3

joint pain from synovitis or tenosynovitis

absent

0

arthralgias

1

objective inflammation

2

limited function

3

hematocrit

> 35%

0

30-35%

1

25 – 29.9%

2

< 25%

3

WBC count

> 3,500 per µL

0

2,000 – 3,500 per µL

1

1,000 – 2,000 per µL

2

< 1,000 per µL

3

lymphocytes

1,500 – 4,000 per µL

0

1,000 – 1,499 per µL

1

500 – 999 per µL

2

< 500 per µL

3

platelets

> 150,000 per µL

0

100,000 – 150,000 per µL

1

50,000 – 99,999 per µL

2

< 50,000 per µL

3

ESR (Westergren method)

< 25 mm/h

0

25 – 50 mm/h

1

51 – 75 mm/h

2

> 75 mm/h

3

serum creatinine or creatinine clearance

0.5 – 1.3 mg/dL; 80-100% normal creatinine clearance

0

1.4 – 2.0 mg/dL; 60-79% normal creatinine clearance

1

2.1 – 4.0 mg/dL; 30-60% normal creatinine clearance

2

> 4 mg/dL; < 30% normal creatinine clearance

3

urine sediment

normal

0

6-10 RBC or WBC per hpf; or 1-3 granular casts per hpf; or 1-2+ proteinuria; or < 0.5 g/L per 24 hours urine protein

1

11-25 RBC or WBC per hpf; or > 3 granular casts per hpf; or 3-4+ proteinuria; or 0.5 to 3.5 g/L per 24 hours urine protein

2

>25 RBC or WBC per hpf; or  > 4+ proteinuria; or > 3.5 g/L per 24 hours urine protein

3