Jesus et al reported the SLE Disease Activity Score (SLE-DAS) for evaluating a patient with SLE. The authors are from Universitario de Coimbra, Polytechnic Institute of Viseu, University of Padova and University of Beira Interior.
Patient selection: SLE
Parameters (defined in Table 1):
(1) arthritis
(2) swollen joint count (from 0 to 28)
(3) mucocutaneous vasculitis
(4) rash
(5) alopecia
(6) mucosal ulcers
(7) hypocomplementemia
(8) increased anti-double stranded DNA antibodies
(9) proteinuria
(10) proteinuria and urine protein in mg per 24 hours
(11) thrombocytopenia
(12) thrombocytopenia and platelet count in 10^9/L
(13) leukopenia
(14) leukopenia and leukocyte count in 10^9/L
(15) neuropsychiatric symptoms
(16) systemic vasculitis
(17) cardiac and/or pulmonary involvement
(18) myositis
(19) serositis
(20) hemolytic anemia
|
Parameter |
Finding |
Points |
|
arthritis |
no |
0 |
|
|
yes |
3.132 |
|
swollen joint count |
|
0.454 * (count) |
|
mucocutaneous vasculitis |
no |
0 |
|
|
yes |
4.408 |
|
rash |
none |
0 |
|
|
local |
3.138 |
|
|
generalized |
3.887 |
|
alopecia |
no |
0 |
|
|
yes |
0.973 |
|
mucosal ulcers |
no |
0 |
|
|
yes |
2.769 |
|
hypocomplementemia |
no |
0 |
|
|
yes |
0.754 |
|
increased dsDNA antibodies |
no |
0 |
|
|
yes |
0.956 |
|
proteinuria |
<= 500 mg per 24 hr |
0 |
|
|
> 500 mg per 24 hr |
-17.584 |
|
proteinuria and urine protein |
<= 500 mg per 24 hr |
0 |
|
|
> 500 mg per 24 hr |
3.811*LN(urine protein) |
|
thrombocytopenia |
>= 100 * 10^9/L |
0 |
|
|
< 100 * 10^9/L |
26.105 |
|
thrombocytopenia and platelet count |
>= 100 * 10^9/L |
0 |
|
|
< 100 * 10^9/L |
-5.577 * LN(platelet count) |
|
leukopenia |
>= 3 * 10^9/L |
0 |
|
|
< 3 * 10^9/L |
6.118 |
|
leukopenia and WBC count |
>= 3 * 10^9/L |
0 |
|
|
< 3 * 10^9/L |
-5.058*LN(WBC count) |
|
neuropsychiatric findings |
no |
0 |
|
|
yes |
18 |
|
systemic vasculitis |
no |
0 |
|
|
yes |
18 |
|
cardiopulmonary findings |
no |
0 |
|
|
yes |
18 |
|
myositis |
no |
0 |
|
|
yes |
9 |
|
serositis |
no |
0 |
|
|
yes |
6 |
|
hemolytic anemia |
no |
0 |
|
|
yes |
9 |
where:
• It is assumed that the patient cannot have both a localized and generalized rash.
• The LN of the various counts is assumed to exclude the 10^9 component.
score =
= SUM(points for all 20 parameters) + 0.366
Interpretation:
• A clinically meaningful change was defined as a delta(SLE-DAS) >= 1.72.
Specialty: Immunology/Rheumatology
