Preliminary criteria for the classification of systemic lupus erythematosus (SLE) evaluation in early diagnosed SLE and rheumatoid arthritis

Trimble, R. B.; Townes, Alexander S.; Robinson, Harry; Kaplan, Stanley B.; Chandler, Robert W.; Hanissian, Aram S.; Masi, Alfonse T.

doi:10.1002/art.1780170212

Cited by 58 publications

(16 citation statements)

References 8 publications

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“…A positive ANA was used in place of a positive LE cell preparation by Fries and Siege1 (12) and by Trimble et a1 (13), who thus did not test the preliminary criteria as defined. Criticisms were directed at the vague wording of some criteria, e.g., Raynaud's phenomenon, hemolytic anemia, convulsions, and psychosis (9), the type ("classic" nature) of and predominant features of the population tested (12), and the low sensitivity of the LE preparation versus the sensitivity of ANA (13). In the formulation of the 1982 revised criteria, ANA, anti-DNA, and anti-Sm were included while alopecia and Raynaud's phenomenon were dropped for lack of acceptable specificity.…”

Section: Discussionmentioning

confidence: 99%

A comparison of the sensitivity of the 1971 and 1982 american rheumatism association criteria for the classification of systemic lupus erythematosus

Levin

Weinstein

Peterson

et al. 1984

Arthritis & Rheumatism

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The sensitivity of the American Rheumatism Association's preliminary and revised criteria for the classification of systemic lupus erythematosus (SLE) was tested in 156 of our SLE patients. Eighty-eight percent met the 1971 preliminary criteria. Eighty-three percent fulfilled the 1982 revised criteria when arthritis was strictly defined (nonerosive arthritis) and 91 9' 0 when arthritis was more liberally defined (nondeforming arthritis). Analysis revealed that of the 3 serologic tests added in the revised criteria (antinuclear antibody, antiSm, anti-DNA), the antinuclear antibody test accounted for the increased sensitivity of the revised criteria.The American Rheumatism Association (ARA) revised criteria for the classification of systemic lupus erythematosus (SLE) have recently been published (1). The ARA preliminary criteria for the classification of systemic lupus erythematosus had been in use since publication in 1971 (2); the revision was considered necessary in order to add newer laboratory tests such as anti-DNA and antinuclear antibody (ANA) and to regroup laboratory tests and clinical findings into specific sets so as to increase the specificity and sensitivity of the preliminary criteria. Although many studies have been reported on testing of the preliminary criteria, no such studies have been reported on the revised criteria. We have therefore tested the revised criteria on our own group of SLE patients, in order to evaluate sensitivity and compare it with that of the preliminary criteria.The results of our study reveal that the revised criteria are minimally more sensitive than the preliminary criteria and that the addition of the antinuclear antibody manifestation is the major contributor to this increased sensitivity. PATIENTS AND METHODSPatients. Outpatients or hospitalized patients followed by faculty members of the Division of Rheumatic Diseases during the period January 1, 1980 through December 31, 1982 at the University of Connecticut Health Center were considered for study. Patients were considered by their physician to have SLE, based on the presence of multisystern disease considered to be compatible with SLE. The diagnosis of SLE was made by the faculty member whether or not the patient fulfilled the preliminary criteria.Data entry and analysis. Data on the 156 patients were reviewed and information entered into a database booklet by the fellow and/or faculty member caring for the patient. Data entered by fellows were checked by the faculty member who had been responsible for the patient. The database booklet listed the 36 elements of the 2 sets of criteria exactly as defined in the literature (Tables 1 and 2).For each element, the reviewer entered one of the following: "yes," "no," "unclear," or "unknown." "Unclear" entries were reviewed by one of the authors (NFR) and were

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Section: Discussionmentioning

confidence: 99%

A comparison of the sensitivity of the 1971 and 1982 american rheumatism association criteria for the classification of systemic lupus erythematosus

Levin

Weinstein

Peterson

et al. 1984

Arthritis & Rheumatism

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“…Comparison of the incidence of the various ARA criteria descriptives in the current series with those from whom the criteria were devcloped (4) and a subsequent followup study (29) revealed similar frequencies with two exceptions.…”

Section: Resultsmentioning

confidence: 61%

Relationship of clinical findings in systemic lupus erythematosus to seroreactivity

Rothschild

Jones

Chesney

et al. 1983

Arthritis & Rheumatism

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We have characterized 52 consecutive patients fulfilling 4 or more of the American Rheumatism Association criteria for systemic lupus erythematosus in order to provide, for the first time, a homogeneous sample for statistical comparison of antinuclear antibody (ANA)-positive and ANA-negative groups. Ten patients (19%) were seronegative. There was no significant difference in age, disease activity, organ system involvement, erythrocyte sedimentation rate, immune complex levels, or C3 levels. The ANA-negative group showed a higher incidence of involvement for whites and men. Leukopenia, lower levels of antibody to DNA, and higher C4 levels were also characteristic of the ANA-negative group.

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“…The immune-complex disease of our patient is close to the symptomatol ogy described in necrotizing vasculitis occurring in systemic lupus erythe matosus [TuffaneUi and Kay, 1969], In fact, according to the American Rheu matism Association, systemic lupus erythematosus is characterized by 14 criteria [Cohen and Canoso, 1972] and antinuclear antibodies are associated with 3 other signs in 92% of these patients [Trimble et al, 1974], In our patient, vasculitis is present with four of these major clinical and serological signs, namely: butterfly facial erythema, arthritis, leukopenia and antinuclear antibodies at a titer higher than 1/64. More precisely, this affection corre sponds to the so-called drug-induced lupus syndrome which differs from systemic lupus erythematosus in that it rarely involves kidneys, displays normal complement level with absence of anti-DNA antibodies and improves after withdrawal of the nociceptive drug [Harpey et a/., 1972;Blombren et al, 1972;Utsinger et al, 1976].…”

Section: Discussionmentioning

confidence: 94%

Immune Complex Disease Associated with Peroben® Intake

Neste¹,

Pierard²,

Hermanns³

1979

Dermatology

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The clinical history and biological investigations of a patient presenting an immune complex disease induced by Peroben® are reported. Biological signs were those of a drug-induced lupus syndrome. A provocation test allowed disclosure of its pathomechanism, since during Peroben intake a high Clq binding activity occurred and later regressed, while deposits of IgM and C3 were evidenced in the vessel walls. Complete or partial thrombosis succeeded accompanying a leukocytoclastic vasculitis.

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Preliminary criteria for the classification of systemic lupus erythematosus (SLE) evaluation in early diagnosed SLE and rheumatoid arthritis

Cited by 58 publications

References 8 publications

A comparison of the sensitivity of the 1971 and 1982 american rheumatism association criteria for the classification of systemic lupus erythematosus

A comparison of the sensitivity of the 1971 and 1982 american rheumatism association criteria for the classification of systemic lupus erythematosus

Relationship of clinical findings in systemic lupus erythematosus to seroreactivity

Immune Complex Disease Associated with Peroben® Intake

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