Calculators & Tools

SLEDAI-2K — SLE Disease Activity Index

Disease activity in the preceding 10 days. Weighted descriptors.

1 What is the SLEDAI-2K — SLE Disease Activity Index?

The SLEDAI-2K — SLE Disease Activity Index is a rheumatology scoring tool used in paediatric practice. Disease activity in the preceding 10 days. Weighted descriptors. It scores 24 criteria and interprets the total across 5 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 24 criteria: Seizure (recent onset, excluding metabolic/infectious/drug causes); Psychosis; Organic brain syndrome; Visual disturbance (retinal changes of SLE); Cranial nerve disorder; Lupus headache (severe, persistent, narcotic-resistant); Cerebrovascular accident; Vasculitis (ulceration, gangrene, nail-fold infarcts, biopsy-proven); Arthritis (≥2 joints with pain and inflammatory signs); Myositis (proximal weakness with raised CK/aldolase or typical EMG/biopsy); Urinary casts (heme-granular or red cell casts); Haematuria (> 5 RBC/hpf); and 12 further criteria. Totals are then banded: any score - No activity: sLEDAI 0 - no disease activity in the last 10 days; 1 point or more - Mild activity: sLEDAI 1-5 - mild activity. Usually managed with hydroxychloroquine ± low-dose steroid; 6 points or more - Moderate activity: sLEDAI 6-10 - moderate activity. Escalate immunosuppression; a change of ≥4 points indicates a clinically meaningful flare; 11 points or more - High activity: sLEDAI 11-19 - high activity. Intensive immunosuppression required; 20 points or more - Very high activity: sLEDAI ≥20 - very high activity, often with major organ involvement. Urgent intensive therapy and specialist input.
  • Total possible 105. SLEDAI-2K differs from the original by allowing persistent (not only new) rash, alopecia, mucosal ulcers and proteinuria to score.
  • Source: Gladman DD, Ibañez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol 2002;29:288-91.

4 Frequently asked questions

How many criteria does the SLEDAI-2K — SLE Disease Activity Index use?

24. They are Seizure (recent onset, excluding metabolic/infectious/drug causes); Psychosis; Organic brain syndrome; Visual disturbance (retinal changes of SLE); Cranial nerve disorder; Lupus headache (severe, persistent, narcotic-resistant); and others.

What do the bands of the SLEDAI-2K — SLE Disease Activity Index mean?

The total is interpreted as: any score - No activity: sLEDAI 0 - no disease activity in the last 10 days; 1 point or more - Mild activity: sLEDAI 1-5 - mild activity. Usually managed with hydroxychloroquine ± low-dose steroid; 6 points or more - Moderate activity: sLEDAI 6-10 - moderate activity. Escalate immunosuppression; a change of ≥4 points indicates a clinically meaningful flare; 11 points or more - High activity: sLEDAI 11-19 - high activity. Intensive immunosuppression required; 20 points or more - Very high activity: sLEDAI ≥20 - very high activity, often with major organ involvement. Urgent intensive therapy and specialist input.

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?

Total possible 105. SLEDAI-2K differs from the original by allowing persistent (not only new) rash, alopecia, mucosal ulcers and proteinuria to score.

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.