Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)

seizure

Recent onset. Exclude metabolic, infectious or drug causes.

8

psychosis

Altered ability to function in normal activity due to severe disturbance in the perception of reality. Include hallucinations, incoherence, marked loose associations, impoverished thought content, marked illogical thinking, bizarre disorganized, or catatonic behavior. Exclude uremia and drug causes.

8

organic brain syndrome

Altered mental function with impaired orientation, memory or other intellectual functions, with rapid onset and fluctuating clinical features. Include clouding of consciousness with reduced capacity to focus, and inability to sustain attention to environment, plus at least 2 of the following: perceptual disturbance, incoherent speech, insomnia or daytime drowsiness, or increased or decreased psychomotor activity. Exclude metabolic, infectious or drug causes.

8

visual disturbance

Retinal changes of SLE. Include cytoid bodies, retinal hemorrhages, serous exudate or hemorrhages in the choroid, or optic neuritis. Exclude metabolic, infectious or drug causes.

8

cranial nerve disorder

New onset of sensory or motor neuropathy involving cranial nerves

8

lupus headache

Severe, persistent headache; may be migrainous, but must be nonresponsive to narcotic analgesics

8

cerebrovascular accident (CVA)

New onset of cerebrovascular accident(s). Exclude arteriosclerosis.

8

vasculitis

Ulceration, gangrene, tender finger nodules, periungual infarction, splinter hemorrhages, or biopsy or angiogram proof of vasculitis

8

arthritis

More than 2 joints with pain and signs of inflammation (i.e., tenderness, swelling or effusion)

4

myositis

Proximal muscle aching or weakness, associated with elevated creatine phosphokinase or aldolase, or electromyogram changes or a biopsy showing myositis

4

urinary casts

Heme-granular or red blood cell casts

4

hematuria

> 5 red blood cells per high power field. Exclude stone, infection or other causes.

4

proteinuria

> 0.5 gram per 24 hours. New onset or recent increase of more than 0.5 grams per 24 hours.

4

pyuria

> 5 white blood cells per high power field. Exclude infection.

4

new rash

New onset or recurrence of inflammatory type  rash

2

alopecia

New onset or recurrence of abnormal, patchy or diffuse loss of hair

2

mucosal ulcers

New onset or recurrence of oral or nasal ulcerations

2

pleurisy

Pleuritic chest pain with pleural rub or effusion, or pleural thickening

2

pericarditis

Pericardial pain with at least 1 one of the following: rub, effusion, or (electrocardiogram or echocardiogram confirmation)

2

low complement

Decrease in CH50, C3 or C4 below the lower limit of normal for testing laboratory

2

increased DNA binding

> 25% binding by Farr assay or above normal range for testing laboratory.

2

fever

> 38°C. Exclude infectious cause.

1

thrombocytopenia

< 100,000 platelets per µL

1

leukopenia

< 3,000 white blood cells per µL. Exclude drug causes.

1