Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)

Addition of the selected points: Variable Points Recent onset seizure Exclude metabolic, infectious, or drug causes No 0 Yes 8 Psychosis Altered ability to function in normal activity due to severe disturbance in the perception of reality (include hallucinations, incoherence, marked loose associations, impoverished thought content, marked illogical thinking, and bizarre, disorganized, or catatonic behavior); exclude uremia and drug causes No 0 Yes 8 Organic brain syndrome Altered mental function with impaired orientation, memory, or other intellectual function (with rapid onset and fluctuating clinical features), inability to sustain attention to environment, and ≥2 of the following: perceptual disturbance, incoherent speech, insomnia or daytime drowsiness, and increased or decreased psychomotor activity; exclude metabolic, infectious, or drug causes No 0 Yes 8 Visual disturbance Retinal changes of SLE (include cytoid bodies, retinal hemorrhages, serous exudates or hemorrhages in choroid, and optic neuritis); exclude hypertensive, infectious, or drug causes No 0 Yes 8 New onset sensory or motor neuropathy involving cranial nerves No 0 Yes 8 Lupus headache Severe, persistent headache (may be migrainous but must be nonresponsive to narcotic analgesia) No 0 Yes 8 New onset stroke Exclude arteriosclerosis No 0 Yes 8 Vasculitis Ulceration, gangrene, tender finger nodules, periungual infarction, splinter hemorrhages or biopsy, and angiogram proof of vasculitis No 0 Yes 8 Arthritis ≥2 joints with pain and signs of inflammation (i.e., tenderness, swelling, or effusion) No 0 Yes 4 Myositis Proximal muscle aching/weakness associated with elevated CPK /aldolase, EMG changes, or a biopsy showing myositis No 0 Yes 4 Heme-granular or RBC urinary casts No 0 Yes 4 Hematuria >5 RBC/high-power field; exclude stone, infection, or other cause No 0 Yes 4 Proteinuria >0.5 g/24 hours No 0 Yes 4 Pyuria >5 WBC/high-power field; exclude infection No 0 Yes 4 Inflammatory-type rash No 0 Yes 2 Alopecia No 0 Yes 2 Oral or nasal mucosal ulcers No 0 Yes 2 Pleuritic chest pain with pleural rub/effusion or pleural thickening No 0 Yes 2 Pericarditis Pericardial pain with ≥1 of the following: rub, effusion, or EKG/echocardiogram confirmation No 0 Yes 2 Low complement CH50, C3, or C4 decreased below lower limit of normal for lab No 0 Yes 2 High DNA binding Increased above normal range for lab No 0 Yes 2 Temp >100.4°F (38°C) Exclude infectious causes No 0 Yes 1 Platelets <100 x 10 9 /L Exclude drug causes No 0 Yes 1 WBC <3 x 10 9 /L Exclude drug causes No 0 Yes 1