Calculators & Tools

EULAR/ACR SLE Classification (2019)

Entry criterion: ANA ≥ 1:80. Then weighted criteria - only the HIGHEST-weighted item in each domain counts; ≥10 points classifies SLE.

1 What is the EULAR/ACR SLE Classification (2019)?

The EULAR/ACR SLE Classification (2019) is a rheumatology scoring tool used in paediatric practice. Entry criterion: ANA ≥ 1:80. Then weighted criteria - only the HIGHEST-weighted item in each domain counts; ≥10 points classifies SLE. It scores 11 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in rheumatology
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 11 criteria: ENTRY - ANA ≥ 1:80 on HEp-2 cells (required); Constitutional - fever; Haematological - leucopenia (2) / thrombocytopenia (4) / autoimmune haemolysis (4); Neuropsychiatric - delirium (2) / psychosis (3) / seizure (5); Mucocutaneous - non-scarring alopecia (2) / oral ulcers (2) / subacute or discoid lupus (4) / acute cutaneous lupus (6); Serosal - pleural or pericardial effusion (5) / acute pericarditis (6); Musculoskeletal - joint involvement (≥2 joints with synovitis or tenderness plus stiffness); Renal - proteinuria > 0.5 g/24 h (4) / class II or V nephritis (8) / class III or IV nephritis (10); Antiphospholipid antibodies - anticardiolipin, anti-β2GP1 or lupus anticoagulant; Complement - low C3 OR low C4 (3) / low C3 AND low C4 (4); SLE-specific antibodies - anti-dsDNA or anti-Smith. Totals are then banded: any score - Does not classify: fewer than 10 points, or ANA negative. Without a positive ANA (≥1:80) the criteria cannot be applied at all; 10 points or more - Classifies as SLE: ≥10 points with a positive ANA and at least one clinical criterion - classifies as SLE (sensitivity 96%, specificity 93%). Classification supports, but does not replace, clinical diagnosis.
  • Each toggle here carries the HIGHEST weight in its domain - deselect and use clinical judgement if only a lower-weighted item in that domain is present.
  • At least one CLINICAL criterion is required; criteria need not occur simultaneously. Do not count a criterion if a more likely explanation exists.
  • Source: Aringer M et al. 2019 EULAR/ACR classification criteria for systemic lupus erythematosus. Ann Rheum Dis 2019;78:1151-9.

4 Frequently asked questions

How many criteria does the EULAR/ACR SLE Classification (2019) use?

11. They are ENTRY - ANA ≥ 1:80 on HEp-2 cells (required); Constitutional - fever; Haematological - leucopenia (2) / thrombocytopenia (4) / autoimmune haemolysis (4); Neuropsychiatric - delirium (2) / psychosis (3) / seizure (5); Mucocutaneous - non-scarring alopecia (2) / oral ulcers (2) / subacute or discoid lupus (4) / acute cutaneous lupus (6); Serosal - pleural or pericardial effusion (5) / acute pericarditis (6); and others.

What do the bands of the EULAR/ACR SLE Classification (2019) mean?

The total is interpreted as: any score - Does not classify: fewer than 10 points, or ANA negative. Without a positive ANA (≥1:80) the criteria cannot be applied at all; 10 points or more - Classifies as SLE: ≥10 points with a positive ANA and at least one clinical criterion - classifies as SLE (sensitivity 96%, specificity 93%). Classification supports, but does not replace, clinical diagnosis.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Each toggle here carries the HIGHEST weight in its domain - deselect and use clinical judgement if only a lower-weighted item in that domain is present.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.