Use of the American Rheumatism Association's Preliminary Criteria for the Classification of Systemic Lupus Erythematosus

Abstract

To examine the usefulness of the American Rheumatism Association's classification criteria for systemic lupus erythematosus, we reviewed the records of 65 patients and tabulated the incidence of the 14 proposed manifestations. A lower incidence of facial erythema, discoid lupus, Raynaud's phenomenon, alopecia, photosensitivity, and oronasopharyngeal ulceration was found. We observed that, if these features were not present on physical examination, specific questioning for their prior existence was not carried out. This resulted in a reduction in sensitivity of the classification criteria from 89.8% to 72.3%. Effective application of these classification criteria to a general hospital patient population being evaluated by nonrheumatologists requires detailed inquiry regarding each of the manifestations.