Evaluation of a lupus patient using the BILAG (British Isles Lupus Assessment Group) index can help to identify a patient experiencing a flare in disease activity.
Systems evaluated with the revised BILAG index:
(1) constitutional
(2) mucocutaneous
(3) neuropsychiatric
(4) musculoskeletal
(5) cardiorespiratory
(6) gastrointestinal
(7) renal
(8) hematological
(9) ophthalmic
|
Disease Activity |
Designation |
|
marked activity |
A |
|
moderate activity |
B |
|
mild and stable activity |
C |
|
inactivity |
D |
|
no activity ever |
E |
|
Change in BILAG Index |
Significance |
Therapy |
|
appearance of 1 or more A scores |
flare indicating severe disease |
usually new or increased therapy with cortico-steroids and/or cytotoxic agents. |
|
appearance of 1 or more B scores |
flare with less severe disease |
may or may not receive new or increased doses of disease-modifying therapy |
|
other |
not considered a flare |
continue to monitor the patient; therapy may be reduced if all scores decline |
A patient with one or more new B scores may not receive additional therapy if:
(1) the patient is already under treatment
(2) the process is expected to be self-limited (for example, triggered by a viral infection)
(3) physician waiting for more results before deciding whether or not to treat
Purpose: To determine if a patient with systemic lupus erythematosus (SLE) is experiencing a flare in disease activity based on changes in the BILAG index.
Specialty: Immunology/Rheumatology
Objective: severity, prognosis, stage, differential diagnosis and mimics, red flags, disease progression, prevention
ICD-10: M32,
