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Systemic Lupus Erythematosis: Likelihood Ratios

Introduction: None written.

[Edit Diagnosis] [Merge dx] [Add prevalence]

Tags: Autoimmune Tag this Diagnosis.

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

Blood Test

Finding +LR-LR Comments, Study
ANA Edit 9.90

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

Anti-dsDNA Edit 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 Edit Sensitivity = 25%

Specificity not listed here, but reportedly high.

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

Combination of Tests

Finding +LR-LR Comments, Study
ACR Criteria Edit 910.1

**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

    Untagged

    Finding +LR-LR Comments, Study
    Serositis Edit 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