Systemic Lupus Erythematosis: Likelihood Ratios

Introduction: None written.

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The likelihood ratios of findings for Systemic Lupus Erythematosis are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

ANA

9.9

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

ACR Criteria

0.1

**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

Poorly Diagnostic Findings

Finding	+LR	-LR	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