Systemic Lupus Erythematosis: Sensitivity and Specificity

Introduction: None written.

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The sensitivity and specificity of findings for Systemic Lupus Erythematosis are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

ACR Criteria

91%

99%

**For specificity versus non-SLE rheumatologic disoders**

Most recent are 1997 ACR criteria, which per PMID 15922144 have not been validated. Validation has been done for the 1982 criteria (differences noted at bottom).

Criteria: >=4/11 of the following

Malar rash

Discoid rash

Photosensitivity

Oral ulcers

Arthritis

Serositis

Renal dysfunction

Neurological dysfunction

Hematologic dysfunction

Immunologic dysfunction (** changes here: LE cells removed and anticardiolipin/lupus anticoagulant added)

Positive ANA

For full details of each criterion, see the references, especially PMID 15922144.

Study: Arthritis Rheum. 1985 Jun;28(6):715. PMID: 3890870

Arthritis Rheum. 1985 Jun;28(6):620-3. PMID: 4004972

ANA

99%

90%

specificity depends on age and gender of controls (higher false -ve in women, elderly)

Study: Am Fam Physician. 2002 Mar 15;65(6):1073-80. PMID: 11925083

Poorly Diagnostic Findings

Finding	Sensitivity	Specificity	Comments, Study
Anti-dsDNA	Sensitivity = 60%		high titers. Specificity not listed here, but is supposedly high. Also correlates with disease activity, especially nephritis. Study: Am Fam Physician. 2002 Mar 15;65(6):1073-80. PMID: 11925083
Anti-Smith	Sensitivity = 25%		Specificity not listed here, but reportedly high. Study: Am Fam Physician. 2002 Mar 15;65(6):1073-80. PMID: 11925083
Serositis	Sensitivity = 18%		ACR criterion: (A) Pleuritis: convincing history of pleuritic pain or rub heard by a physician or evidence of pleural effusion or (B) Pericarditis: documented by ECG or rub or evidence of pericardial effusion Study: Rheum Dis Clin North Am. 2005 May;31(2):245-54, vi. PMID: 15922144