Brunner et al proposed several criteria for determining if a patient with childhood-onset systemic lupus erythematosus (SLE) is having a disease flare. The authors are from multiple institutions in North America, South America and Europe.
Patient selection: childhood-onset SLE
Parameters:
(1) baseline SLEDAI score, from 0 to 105
(2) current SLEDAI score
(3) baseline urine protein to creatinine ratio from a random urine
(4) current urine protein to creatinine ratio
(5) baseline physician global estimate of disease activity on a VAS scale from 0 to 10
(6) current physician global estimate of disease activity on a VAS scale from 0 to 10
(7) ESR at baseline in mm in first hour
(8) current ESR
change in SLEDAI =
= (current SLEDAI) - (baseline SLEDAI)
change in urine ratio =
= (current urine ratio) - (baseline urine ratio)
change in physician estimate =
= (current physician estimate) - (baseline physician estimate)
change in ESR =
= (current ESR) - (baseline ESR)
score =
= (0.5 * (change in SLEDAI)) + (0.45 * (change in urine ratio)) + (0.5 * (change in physician estimate)) + (0.02 * (change in ESR)
Interpretation:
• The higher the score the greater the flare.
|
Score
|
Flare
|
|
> 6.4
|
major
|
|
4.0 to 6.4
|
moderate
|
|
0.6 to 3.99
|
minor
|
|
< 0.6
|
no
|
